Durante l’Investigators Meeting Pros-IT CNR di San Servolo (Venezia, 21-22.05.2015) sono state realizzate alcune interviste, disponibili ai seguenti link:

* Prof. Gaetano Crepaldi “Alimentazione e tumore della prostata: esiste una correlazione?”

* Dott.ssa Stefania Maggi “Registri sul tumore della prostata: perché sono importanti?”

* Prof. Walter Artibani “Stratificazione del rischio nel tumore della prostata”

* Prof. Stefano Maria Magrini “Radioterapia nel tumore della prostata, evoluzione storica e prospettive future”

* Dott. Angelo Porreca “Tumore della prostata, presentati i primi dati dello studio Pros-IT”

Lancet Oncol. 2014 Oct;15(11):e484-92. doi: 10.1016/S1470-2045(14)70211-6.

Prevention and early detection of prostate cancer.

Cuzick J, Thorat MA, Andriole G, Brawley OW, Brown PH, Culig Z, Eeles RA, Ford LG, Hamdy FC, Holmberg L, Ilic D, Key TJ, La Vecchia C, Lilja H, Marberger M, Meyskens FL, Minasian LM, Parker C, Parnes HL, Perner S, Rittenhouse H, Schalken J, Schmid HP, Schmitz-Dräger BJ, Schröder FH, Stenzl A, Tombal B, Wilt TJ, Wolk A.

Abstract
Prostate cancer is a common malignancy in men and the worldwide burden of this disease is rising. Lifestyle modifications such as smoking cessation, exercise, and weight control offer opportunities to reduce the risk of developing prostate cancer. Early detection of prostate cancer by prostate-specific antigen (PSA) screening is controversial, but changes in the PSA threshold, frequency of screening, and the use of other biomarkers have the potential to minimise the overdiagnosis associated with PSA screening. Several new biomarkers for individuals with raised PSA concentrations or those diagnosed with prostate cancer are likely to identify individuals who can be spared aggressive treatment. Several pharmacological agents such as 5α-reductase inhibitors and aspirin could prevent development of prostate cancer. In this Review, we discuss the present evidence and research questions regarding prevention, early detection of prostate cancer, and management of men either at high risk of prostate cancer or diagnosed with low-grade prostate cancer.
Copyright © 2014 Elsevier Ltd. All rights reserved.

Comment in
PSA testing for prostate cancer screening. [Lancet Oncol. 2015]
PSA testing for prostate cancer screening–authors’ reply. [Lancet Oncol. 2015]

JAMA. 2015 Jan 27;313(4):390-7. doi: 10.1001/jama.2014.17942.

Siddiqui MM1, Rais-Bahrami S2, Turkbey B3, George AK4, Rothwax J4, Shakir N4, Okoro C4, Raskolnikov D4, Parnes HL5, Linehan WM4, Merino MJ6, Simon RM7, Choyke PL3, Wood BJ8, Pinto PA8.

Abstract

IMPORTANCE:
Targeted magnetic resonance (MR)/ultrasound fusion prostate biopsy has been shown to detect prostate cancer. The implications of targeted biopsy alone vs standard extended-sextant biopsy or the 2 modalities combined are not well understood.

OBJECTIVE:
To assess targeted vs standard biopsy and the 2 approaches combined for the diagnosis of intermediate- to high-risk prostate cancer.

DESIGN, SETTING, AND PARTICIPANTS:
Prospective cohort study of 1003 men undergoing both targeted and standard biopsy concurrently from 2007 through 2014 at the National Cancer Institute in the United States. Patients were referred for elevated level of prostate-specific antigen (PSA) or abnormal digital rectal examination results, often with prior negative biopsy results. Risk categorization was compared among targeted and standard biopsy and, when available, whole-gland pathology after prostatectomy as the “gold standard.”

INTERVENTIONS:
Patients underwent multiparametric prostate magnetic resonance imaging to identify regions of prostate cancer suspicion followed by targeted MR/ultrasound fusion biopsy and concurrent standard biopsy.

MAIN OUTCOMES AND MEASURES:
The primary objective was to compare targeted and standard biopsy approaches for detection of high-risk prostate cancer (Gleason score ≥ 4 + 3); secondary end points focused on detection of low-risk prostate cancer (Gleason score 3 + 3 or low-volume 3 + 4) and the biopsy ability to predict whole-gland pathology at prostatectomy.

RESULTS:
Targeted MR/ultrasound fusion biopsy diagnosed 461 prostate cancer cases, and standard biopsy diagnosed 469 cases. There was exact agreement between targeted and standard biopsy in 690 men (69%) undergoing biopsy. Targeted biopsy diagnosed 30% more high-risk cancers vs standard biopsy (173 vs 122 cases, P < .001) and 17% fewer low-risk cancers (213 vs 258 cases, P < .001). When standard biopsy cores were combined with the targeted approach, an additional 103 cases (22%) of mostly low-risk prostate cancer were diagnosed (83% low risk, 12% intermediate risk, and 5% high risk). The predictive ability of targeted biopsy for differentiating low-risk from intermediate- and high-risk disease in 170 men with whole-gland pathology after prostatectomy was greater than that of standard biopsy or the 2 approaches combined (area under the curve, 0.73, 0.59, and 0.67, respectively; P < .05 for all comparisons). CONCLUSIONS AND RELEVANCE: Among men undergoing biopsy for suspected prostate cancer, targeted MR/ultrasound fusion biopsy, compared with standard extended-sextant ultrasound-guided biopsy, was associated with increased detection of high-risk prostate cancer and decreased detection of low-risk prostate cancer. Future studies will be needed to assess the ultimate clinical implications of targeted biopsy. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00102544. Comment in Decision curve analysis. [JAMA. 2015] MR/ultrasound fusion-guided biopsy in prostate cancer: what is the evidentiary standard? [JAMA. 2015]

Intervista al Prof. Stefano Maria Magrini, Ordinario di Radioterapia oncologica Università di Brescia, Direttore U.O. di Radioterapia, Spedali Civili di Brescia

http://www.pharmastar.it/index.html?pgnav=12&id=1991

Intervista al Prof. Gaetano Crepaldi

http://www.pharmastar.it/index.html?pgnav=12&id=1992

Su PHARMASTAR.it il testo relativo all’intervista al Prof. Gaetano Crepaldi e al Prof. Stefano Magrini, realizzata nel corso del XXIV congresso dell’Associazione italiana di radioterapia oncologica (AIRO), conclusosi pochi giorni fa a Padova.

http://www.pharmastar.it/index.html?cat=23&id=16569