Blogger Dr. Bjarne (B.J.) Gabrielsen at Boca Grande Lighthouse, Charlotte Harbor, Punta Gorda, Southwest Florida Gulf Coast
I am a prostate cancer survivor since 1995. If you know of any men in your life who may have an interest in prostate cancer at any stage of disease, please inform them of this website, Godandprostate.net, .com, .org or .info. As blogs are posted, readers can receive them automatically by e mail by simply inserting their e mail address in the indicated space on the right side of the home page. Posts focus on all aspects of prostate cancer as well as encouraging commentaries which we all need at one time or another. Comments on any specific post are always welcome. Remember, as men, we are all in this together and God desires to play a central role in our lives. While I am not a medical doctor, I received my doctorate in organic chemistry at the State University of New York – Stony Brook. My career was evenly distributed between academia (Wagner College, NY and the University of Florida, Gainesville, FL) and government (NCI). I retired from the National Cancer Institute (NCI), National Institutes of Health (NIH) as Senior Advisor in antiviral and antitumor Drug Discovery and Development.
Every year, the PCF publishes an electronic guide providing information on all aspects of prostate cancer. The chapters covered are as follows.
- General information including diagnosis, symptoms, risk factors, and medical basics.
- Information for the newly diagnosed, including detection, diagnosis and treatment selection.
- Treatment options for localized or locally advanced prostate cancer. These include active surveillance, surgery, various radiation modalities, and other experimental therapies for localized prostate cancer.
- Living with and after prostate cancer including sections on quality of life, recurrence, urinary, bowel and sexual function, diet, exercise and lifestyle changes.
- What to do if one’s PSA starts to rise. Topics include local treatments for recurrent cancer, therapies for advanced recurrent or metastatic cancer, hormone-resistant cancer, non-hormonal therapy options and side effects from various treatments for advanced prostate cancer.
- Cutting edge developments in prostate cancer research including precision medicine, PARP inhibitors, immune checkpoint inhibitors, CAR T cells and vaccines.
- Information for families of prostate cancer patients including future risk, genetic testing and screening and prevention.
- Here is a link to the most recent edition of the annual PCF prostate cancer guide.
At a recent meeting of a prostate cancer support group, a list of internet informational resources were listed. Upon checking each one, I have found the following to be most informative and current. For a complete listing, see the section entitled Medical Resources on this website.
- The National Cancer Institute (NCI) of the National Institutes of Health (NIH) in Bethesda and Frederick, Maryland have a site entitled cancer.gov.
2. For a searchable compilation of active and recruiting clinical trials, see clinicaltrials.gov.
3. The Prostate Cancer Foundation is a valuable source of information about all aspects of prostate cancer. See pcf.org.
4. Likewise, the Prostate Cancer Research Institute is also a valuable source. See prci.org.
5. I had never seen the following before, but it deserves a listing. See yananow.net.
Progenics Pharmaceuticals’ PyL, a new imaging agent for positron emission tomography (PET) scans, can accurately detect the location of recurrent prostate cancer lesions, according to data from the Phase 3 CONDOR clinical trial.
“There is a need for improved diagnostics for prostate cancer to replace conventional imaging tests that have limited performance characteristics, especially in men with biochemical recurrence of their disease,” said Barry Siegel, MD, CONDOR’s principal investigator at the Mallinckrodt Institute of Radiology at Washington University School of Medicine clinical site.
PyL (18F-DCFPyl) is a tracing agent composed of DCFPyL, a small molecule that specifically targets the prostate specific membrane antigen (PSMA) protein — present at high levels in prostate cancer cells — coupled with a radioactive compound labelled with fluorine 18. After PyL is injected intravenously into the patient, it travels through the blood and accumulates at prostate cancer sites, making them “light up” during PET scans. PyL has the potential to allow clinicians to detect very small lesions that are currently missed with conventional imaging methods, so can they determine if the disease has returned or spread to distant organs and adjust treatment plans accordingly.
The open-label CONDOR study (NCT03739684) evaluated whether PyL could safely, successfully, and accurately detect new prostate cancer lesions in 208 men suspected of prostate cancer relapse. These suspicions, which were based on biochemical relapse — rising levels of prostate-specific antigen (PSA), a biomarker of the disease — were accompanied by negative or ambiguous findings on conventional imaging scans.
Participants were recruited, dosed, and imaged with PyL at 14 sites in the U.S. and Canada. CONDOR’s primary goal was to assess the predictive value of PyL in detecting the right location of new cancer lesions that confirmed the disease had returned. For that, three blinded, independent researchers compared the results of PyL PET scans with those of confirmatory biopsy or surgery, conventional imaging, and/or changes in PSA levels following radiation therapy of PyL-suspected lesions, performed within 60 days after PyL imaging. The study’s secondary goal was determining the percentage of patients whose treatment plan was changed based on PyL imaging results.
Results showed that the trial met its primary goal, with PyL imaging detecting at least one posteriorly confirmed new lesion in 84.8% to 87% of the cases. This exceeded by far the 20% threshold established by the FDA “for the trial to be deemed a success,” reflecting “the impactful clinical utility of PyL imaging.”
As far as safety, the imaging agent was well-tolerated, consistent with data from the previous Phase 2/3 OSPREY clinical trial (NCT02981368). The most frequently reported adverse side effect (in 1.9% of patients) was headache, and one man had a serious immune reaction (hypersensitivity) to PyL.
“The high positive predictive value demonstrated in this study reflects the clinical utility of PSMA-targeted PET imaging agents providing actionable information to physicians to guide treatment plans and improve disease management of one of the most prevalent cancers in the U.S.,” Siegel said.
“The positive results of our Phase 3 CONDOR trial reinforce our belief in the potential of PyL to enable better physician treatment decisions and, ultimately, improve patient outcomes,” David Mims, Progenics’ interim CEO, said in a press release. The company plans to submit a new drug application for PyL to the U.S. Food and Drug Administration in the second half of this year, according to Mims.
Material cited above was received on January 13th in the Prostate Cancer News Today Weekly Digest to which I recommend a subscription.