Advances in prostate and urothelial cancer

Prostate cancer is the most common cancer in Western men and, when the disease is advanced, no curative agents are available. Joaquim Bellmunt, from the Medical Oncology department of the Hospital del Mar, researcher at the IMIM and professor at the UPF, has recently written a report on recent advances in the management of high-risk localized and metastatic prostate cancer. Together with some colleagues, Bellmunt participated in the 3rd annual Interactive Genitourinary Cancer Conference, held in Budapest last spring, and has summarized what was discussed there for the British Journal of Urology International. The report includes debates over radical prostatectomy versus radiation therapy, about how androgen deprivation therapy or adjuvant chemotherapy can help, or about the development of new agents, which has been aided by a greater understanding of the molecular mechanisms of resistance to current therapies.

Published in the Journal of Clinical Oncology, Bellmunt has recently been involved with different colleagues in a randomized phase III study comparing the efficiency of several drug combinations in the treatment of patients with locally advanced or metastatic urothelial cancer. From 2001 to 2004, 626 patients were randomly assigned to two combinations of drugs: a 2-drug combination with gemcitabine and cisplatin (GC) and a 3-drug combination in which paclitaxel was also included (PCG). After nearly 5 years of follow-up, the authors conclude that addition of paclitaxel to GC provides a higher response rate and a 3.1-month survival benefit. However, this increase was not statistically significant, say the authors, meaning that novel approaches will be required to obtain major improvements in survival of incurable urothelial cancer.

Recently, Bellmunt also participated in the identification of a mutation that confers resistance to cetuximab, one of the drugs used to treat colorectal cancer. You can read that story in this earlier post.

References:
Bellmunt J, Attard G, Bahl A, Huland H, Klotz L, Kuban D, Oudard S, Watson W. Advances in the management of high-risk localised and metastatic prostate cancer. BJU Int. 2012 Mar;109 Suppl 2:8-13

Bellmunt J, von der Maase H, Mead GM, Skoneczna I, De Santis M, Daugaard G, Boehle A, Chevreau C, Paz-Ares L, Laufman LR, Winquist E, Raghavan D, Marreaud S, Collette S, Sylvester R, de Wit R. Randomized Phase III Study Comparing Paclitaxel/Cisplatin/ Gemcitabine and Gemcitabine/Cisplatin in Patients With Locally Advanced or Metastatic Urothelial Cancer Without Prior Systemic Therapy: EORTC Intergroup Study 30987. J Clin Oncol. 2012 Feb 27;

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