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Integrated signatures define mutational processes in prostate cancer
Researchers identified eight integrated mutational footprints that collectively explain the mutational landscape of 85% of primary prostate cancer genomes. Published in Nature, the study combines multiple layers of genomic data into unified signatures, providing a comprehensive framework for understanding how mutations accumulate in prostate tumors. The findings could improve patient stratificatio…
Focal Therapy for Prostate Cancer
A retrospective analysis of the National Cancer Database examined utilization patterns and temporal trends of focal therapy for prostate cancer across US cancer centers. The study characterizes potentially inappropriate use of focal therapy in patients with low-, high-, or very-high-risk disease and describes its application in intermediate-risk cases. The findings aim to inform clinical practice …
Active Surveillance and Focal Therapy
A JAMA editorial accompanying two studies questions whether active surveillance and focal therapy for prostate cancer are being adopted on the strength of evidence or driven by prestige, novelty, and reimbursement incentives. Drawing an analogy to “The Emperor’s New Clothes,” the commentary argues that key opinion leaders, professional societies, and industry marketing may lead clinicians to embra…
Alcohol-attributable cancer deaths in the USA doubled between 1990 and 2023
Cancer deaths attributable to alcohol in the USA rose from 11,361 in 1990 to 23,126 in 2023 — a doubling over 33 years. The figures come from a secondary analysis of Global Burden of Disease data, so they are attributable-fraction estimates rather than counted deaths: they describe the scale of the problem in a population, not the risk faced by any one person. Increases spanned liver, breast, colo…
Randomized trial: PSMA PET/CT-guided robot-assisted prostate biopsy detected cancer in 97.1% versus 81.0% for cognitive MRI-fusion biopsy
In a single-centre randomized trial (NCT05137561), biopsy-naive men with PSA at least 4 ng/mL, abnormal digital rectal examination and PI-RADS 4-5 lesions were assigned to [68Ga]Ga-PSMA-11 PET/CT-guided robot-assisted biopsy or to cognitive MRI-ultrasound fusion biopsy. Prostate cancer was detected in 101 of 104 men (97.1%) versus 85 of 105 (81.0%), with major complications occurring only in the f…
Phase 3 PSMAddition: adding [177Lu]Lu-PSMA-617 to hormone therapy extends radiographic progression-free survival in PSMA-positive metastatic prostate cancer (HR 0.72)
In the phase 3 PSMAddition trial (1144 patients, 572 per arm), adding the radioligand [177Lu]Lu-PSMA-617 to androgen deprivation therapy plus an androgen-receptor pathway inhibitor prolonged radiographic progression-free survival: HR 0.72 (95% CI 0.58-0.90; p=0.0021), a 28% relative reduction in the risk of radiographic progression or death, with median not reached in either arm. Progression or de…
Global cancer statistics 2024: translating epidemiological trends into priorities for healthcare systems
A review in Nature Reviews Clinical Oncology discusses the global cancer burden using GLOBOCAN 2024 estimates: in 2024, 20.6 million people across 186 countries were diagnosed with cancer and 9.8 million died of it. Lung cancer remains the most common — 2.6 million new cases (12.8%) and 1.9 million deaths (19.1%) — ahead of female breast cancer (11.8% of cases), colorectal cancer (9.9%) and prosta…
Study Questions How Prostate Cancer Focal Therapy Is Being Used
A retrospective analysis of over 1.1 million men with nonmetastatic prostate cancer found that half of focal therapy procedures were performed in clinical settings not supported by current guidelines. While overall use of focal therapy remains limited, the finding raises concerns about appropriate patient selection and adherence to evidence-based indications. The study highlights a gap between gui…
SBRT Misses the Mark in Prostate Cancer Trial
In the NRG Oncology GU005 randomized trial (JAMA, n=698), stereotactic body radiotherapy (36.25 Gy in 5 fractions) was compared with moderately hypofractionated IMRT (70 Gy/28 or 60 Gy/20) in localized prostate cancer. At 2 years, fewer patients on SBRT reported a clinically important decline in the EPIC-26 bowel domain (34.9% vs 43.8%; P=.03), while the urinary irritative/obstructive domain showe…
Dramatic Increase in Active Surveillance Use for Prostate Cancer
Active surveillance use for low- and favorable intermediate-risk prostate cancer more than tripled among U.S. veterans since 2005, rising from 27% of low-risk cases to substantially higher rates in a large cohort study. The findings reflect a major shift in clinical practice away from immediate radical treatment toward monitoring in appropriately selected patients. This trend aligns with evolving …