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Developments in urologic oncology «OncoForum»: The best of 2016
F Gómez-Veiga1, A Alcaraz-Asensio2, J Burgos-Revilla3
1Servicio de Urología, Hospital Universitario de Salamanca, Grupo de Investigación Traslacional de Urología GITUR-IBSAL, Salamanca, España.
Objective:
To put forth new findings of urologic oncology with impact on clinical practice presented during 2016 in the main annual meetings.
Acquisition Of Evidence:
This document reviews abstracts on prostate, kidney and bladder cancer presented at the congresses of 2016 (EAU, AUA, ASCO, ESMO and ASTRO) and publications with the highest impact in this period valued with the highest scores by the OncoForum committee.
Synthesis Of Evidence:
In High-Risk Renal-Cell carcinoma after nephrectomy, disease-free survival was significantly greater for sunitinib than placebo group, with adverse events more frequents. In locally advanced and metastatic urotherial carcinoma patients, aletozumab achieved overall response rate in all subgroups of patients, included poor prognostic. In localized prostate cancer, the difference of prostate-cancer-specific mortality among active monitoring, radical prostatectomy and external-beam radiotherapy was not significant (P=0,48). In TERRAIN study, with castration-resistant prostate cancer patients, adverse events was reported in 31% and 23% of patients treated with enzalutamide and bicalutamide, respectively. Moreover, enzalutamide significantly improved median progression-free survival (15.7 months) compared bicalutamide (5.8 months) (P<.0001). In SRTIVE study, Enzalutamide reduced the risk of progression or death by 76% compared with bicalutamide (P<.001).
Conclusions:
In high-risk renal-cell carcinoma after nephrectomy, sunitinb has been considered as treatment choice. In localized prostate cancer, prostate-cancer-specific mortality was low irrespective of the treatment assigned (active monitoring, radical prostatectomy and external-beam radiotherapy). In metastatic castration-resistant prostate cancer new results of treatment with enzalutamide and abiraterone has been published, wich have been shown beneficial effects in metastatic and no metastatic patients.
Insights
New findings in urologic oncology show sunitinib improves survival in high-risk kidney cancer. Localized prostate cancer survival is similar across treatments. Enzalutamide demonstrates significant benefits for castration-resistant prostate cancer.
Area of Science:
- Urologic Oncology
- Medical Oncology
- Clinical Practice
Background:
- Key advancements in urologic oncology impact clinical practice.
- 2016 annual meetings highlighted significant research findings.
Purpose of the Study:
- To present new findings in urologic oncology from major 2016 meetings.
- To assess the clinical impact of recent advancements in kidney, prostate, and bladder cancers.
Main Methods:
- Review of abstracts from 2016 congresses (EAU, AUA, ASCO, ESMO, ASTRO).
- Inclusion of high-impact publications from 2016, scored by the OncoForum committee.
- Focus on prostate, kidney, and bladder cancers.
Main Results:
- High-risk renal-cell carcinoma: Sunitinib showed improved disease-free survival versus placebo post-nephrectomy.
- Localized prostate cancer: No significant difference in cancer-specific mortality among active monitoring, radical prostatectomy, and radiotherapy.
- Metastatic castration-resistant prostate cancer: Enzalutamide significantly improved progression-free survival compared to bicalutamide (TERRAIN study) and reduced risk of progression/death (SRTIVE study).
- Locally advanced/metastatic urothelial carcinoma: Aletozumab achieved response rates across patient subgroups.
Conclusions:
- Sunitinib is a treatment option for high-risk renal-cell carcinoma post-nephrectomy.
- Prostate cancer-specific mortality is low in localized prostate cancer, regardless of treatment (monitoring, surgery, radiotherapy).
- Enzalutamide and abiraterone show beneficial effects in metastatic castration-resistant prostate cancer.
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