OncologySTAT: How will we select men for biopsy in the future, and where are
we in terms of identifying molecular markers for aggressive prostate tumors?
Dr. Parker: I have no doubt that in the future we will be using risk
calculators based on multiple risk factors in order to decide who gets a
biopsy and who doesn't. Now, the adoption of these risk calculators has been
slow, partly because there are so many different risk calculators and no
consensus on which is better than any other, and partly because they have
not been extensively validated in separate cohorts. There is a pressing need
to validate these risk calculators and to see which of the currently
available risk calculators does the best job in different settings. I think
it is important that individual centers that do large numbers of prostate
biopsies should be auditing their results, seeking to validate these risk
calculators with a view to using them in future practice. So, in the very
near future, investigators should not be relying on PSA thresholds but
rather on the risk calculator that works best in their setting. There are a
large number of new markers that are coming through, which appear to predict
the risk of finding prostate cancer and, more importantly, the risk of
finding high-grade prostate cancer on biopsy. There is no doubt that some of
them will provide extra utility over and above the standard risk calculators
that are available today.
But, I'm also confident that none of these new markers is going to tell the
whole story. We should not expect any new marker to replace PSA and be used
on its own, to indicate who should get a biopsy and who shouldn't. Rather,
these new markers will need to be incorporated into existing risk
calculators. Among the novel markers, one of the best known is the urinary
PCA3 score, which looks promising. There are also a plethora of germline
genetic markers, which also appear to put men at increased risk of prostate
cancer, although, as yet, I'm not aware of any germline marker that is
associated with high-grade prostate cancer.
The fact that there are so many markers being evaluated underlines the need
for us to move from PSA-based decision-making to risk-based decision-making.
Right now, we have traditional risk factors, which I mentioned earlier, but
in 5 years' time, we are going to have a large number of new risk factors,
whether they are urinary markers, or blood markers, or germline genetic
markers. The only way we are going to make sense of all these new markers is
to use them as part of a risk-based approach.
So, again, the decision whether or not to have a prostate biopsy should be
made, in the future, not on a man's PSA level, but rather on the risk of
finding high-grade prostate cancer.
OncologySTAT: Then, aside from validating these different scoring systems
and validating more of the marker research, what are key, yet-unanswered
questions that need to be tested in clinical trials?
Dr. Parker: It will be important to know how effective these risk
calculators will be in avoiding unnecessary biopsies and reducing
over-diagnosis. Roobol et al have made a very nice first attempt at
estimating what the impact would be. They selected 10,000 men who took part
in the European randomized trial of prostate cancer screening, and described
what happened in the trial, given that biopsy was indicated for men with a
PSA level greater than 3 ng/mL. Then, they compared that with what would
have happened if they had used a risk threshold using the European risk
calculator.5
What they found was that about one-third of all the prostate biopsies would
have been avoided and that the number of indolent prostate cancers detected
would have been significantly reduced. Their work is a first step at showing
what could be gained from moving from a PSA-based system to a risk-based
system.
The other point to make is that while the immediate and obvious advantages
of using a risk-based system would be to reduce unnecessary biopsies and
reduce over-diagnosis, there is also a possible further benefit, because it
may be that we would be able to find harmful prostate cancers earlier,
before a man's PSA rises above the standard threshold, and finding it
earlier might improve the effectiveness of treatment. That is speculation,
but it is a further reason why we should be moving towards a risk
Thursday, March 3, 2011
Xgeva(denosumab)is more effective than Zometa® (
Xgeva Reduces Bone Complications From Prostate Cancer
Among men with bone metastases from prostate cancer, Xgeva™ (denosumab) was more effective than Zometa® (zoledronic acid) at delaying or preventing bone complications such as fracture. Results from this Phase III clinical trial were published in The Lancet.
Metastatic cancer refers to cancer that has spread to distant sites in the body. Several types of cancer—including prostate cancer—have a tendency to spread to the bone. Bone metastases can lead to serious problems such as fracture and spinal cord compression, and may require treatment with surgery or radiation therapy.
Bisphosphonate drugs such as Zometa have been commonly used to reduce the risk of complications from bone metastases. Xgeva is a newer type of drug that targets a protein known as the RANK ligand. This protein regulates the activity of osteoclasts (cells that break down bone). Xgeva was approved by the U.S. Food and Drug Administration (FDA) in 2010 for the prevention of bone complications in patients with bone metastases from solid (not blood-related) cancers, including prostate cancer.
To directly compare Xgeva to Zometa among prostate cancer patients with bone metastases, researchers conducted a Phase III clinical trial. The study enrolled 1,901 patients with metastatic, hormone-refractory prostate cancer. Study participants were assigned to receive either Xgeva or Zometa. Xgeva is given as a subcutaneous (under-the-skin) injection; Zometa is given intravenously (IV).
The objective of the study was to determine whether the occurrence of bone complications (“skeletal related events”) differed between the two study groups. The bone complications that were evaluated were fracture, radiation to the bone, surgery to the bone, and spinal cord compression.
The results of this study suggest that Xgeva is more effective than Zometa at delaying or preventing skeletal complications in prostate cancer patients with bone metastases.
Reference: Fizazi K, Carducci M, Smith M et al. Denosumab versus zoledronic acid for treatment of bone metastases in men with castration-resistant prostate cancer: a randomized, double-blind study. The Lancet. Early online publication February 25, 2011.
Among men with bone metastases from prostate cancer, Xgeva™ (denosumab) was more effective than Zometa® (zoledronic acid) at delaying or preventing bone complications such as fracture. Results from this Phase III clinical trial were published in The Lancet.
Metastatic cancer refers to cancer that has spread to distant sites in the body. Several types of cancer—including prostate cancer—have a tendency to spread to the bone. Bone metastases can lead to serious problems such as fracture and spinal cord compression, and may require treatment with surgery or radiation therapy.
Bisphosphonate drugs such as Zometa have been commonly used to reduce the risk of complications from bone metastases. Xgeva is a newer type of drug that targets a protein known as the RANK ligand. This protein regulates the activity of osteoclasts (cells that break down bone). Xgeva was approved by the U.S. Food and Drug Administration (FDA) in 2010 for the prevention of bone complications in patients with bone metastases from solid (not blood-related) cancers, including prostate cancer.
To directly compare Xgeva to Zometa among prostate cancer patients with bone metastases, researchers conducted a Phase III clinical trial. The study enrolled 1,901 patients with metastatic, hormone-refractory prostate cancer. Study participants were assigned to receive either Xgeva or Zometa. Xgeva is given as a subcutaneous (under-the-skin) injection; Zometa is given intravenously (IV).
The objective of the study was to determine whether the occurrence of bone complications (“skeletal related events”) differed between the two study groups. The bone complications that were evaluated were fracture, radiation to the bone, surgery to the bone, and spinal cord compression.
The results of this study suggest that Xgeva is more effective than Zometa at delaying or preventing skeletal complications in prostate cancer patients with bone metastases.
Reference: Fizazi K, Carducci M, Smith M et al. Denosumab versus zoledronic acid for treatment of bone metastases in men with castration-resistant prostate cancer: a randomized, double-blind study. The Lancet. Early online publication February 25, 2011.
Monday, February 28, 2011
PSA Velocity, Helpful by Itself?
Current guidelines for the early detection of prostate cancer recommend a biopsy for men whose P.S.A. rises rapidly, no matter what the initial level. But a new study says that the practice does not help patients find aggressive cancers and that it results in many unnecessary biopsies.
P.S.A., or prostate-specific antigen, rises with age, and what is considered normal varies. In general, a level under 4 nanograms per milliliter is considered safe. But even with a normal reading, an increase of 0.35 nanograms per year is widely believed to be high enough to require a biopsy.
Researchers examined the records of 5,519 men with a base-line P.S.A. under 3. They followed them for seven years with yearly tests and a biopsy if the level rose above 4.
They also analyzed P.S.A. velocity — the rate of change in readings from year to year. But after adjusting for age, base-line P.S.A. and other factors, they found little evidence that giving a biopsy to men whose velocity was greater than 0.35 helped find prostate cancer. And it was particularly useless in uncovering the most aggressive types of cancer, the ones most important to treat.
The researchers, writing in the March 16 issue of The Journal of the National Cancer Institute, concluded that using P.S.A. velocity for prostate cancer detection is ineffective, that it leads to unnecessary biopsies and that references to it should be removed from professional guidelines and policy statements.
Andrew J. Vickers, the lead author, drew an analogy: A basketball player’s height, he said, is important to his ability to play, and it correlates very closely with his shoe size. But once you know his height, his shoe size is irrelevant to judging his value as a player.
Similarly, it is easy to demonstrate a statistical relationship between sharp rises in P.S.A. and cancer, but the correlation reveals no more information than is already available with a P.S.A. reading, a digital examination and a family history. It is irrelevant in deciding whether a biopsy is needed.
Not all experts agree. Dr. Anthony V. D’Amico, a professor of radiation oncology at Harvard, said that the methodology of Dr. Vickers’s study was sound, but that the data gathered were almost certainly flawed.
The problem, Dr. D’Amico said, is that many factors that have nothing to do with prostate cancer can cause a rapid increase in prostate-specific antigen. Sexual activity, riding on a bicycle or on horseback, a recent colonoscopy, a bladder or prostate infection, even variations in the ways laboratories perform the test can radically affect the readings.
“It may well be that the high velocity in your case is not important,” he said. “But before you reach that conclusion, I would get a repeat P.S.A.” If there is still a spike after eliminating those other possible causes, he continued, a biopsy should be the next step.
Dr. Vickers, a researcher at Memorial Sloan-Kettering Cancer Center in New York City, agreed that prostate cancer was only one of many reasons for a high P.S.A. “A doctor sees a high P.S.A. and says, ‘Could this be cancer or some other reason?’ ” he said. “Well, the thought was that P.S.A. velocity could help you think this through” — that measuring the rate of change would be decisive.
But in practice, Dr. Vickers said, it does not work. If he had strictly applied the guidelines to the men in his study, he said, one in every seven would have had to have a biopsy. This would mean millions of American men would need biopsies, he said, with almost none of them revealing a cancer.
Dr. Vickers and his colleagues acknowledged that there might be better methods of calculating P.S.A. velocity that could lead to more accurate predictions, and that some effect might have been found if the patients had been followed for more than seven years.
But at this point, he is firmly against biopsies on the basis of velocity alone. “If your P.S.A. is in the normal range, you shouldn’t get a biopsy,” he said. “Changes or spikes in P.S.A. are not something to worry about if your P.S.A. is still normal.”
P.S.A., or prostate-specific antigen, rises with age, and what is considered normal varies. In general, a level under 4 nanograms per milliliter is considered safe. But even with a normal reading, an increase of 0.35 nanograms per year is widely believed to be high enough to require a biopsy.
Researchers examined the records of 5,519 men with a base-line P.S.A. under 3. They followed them for seven years with yearly tests and a biopsy if the level rose above 4.
They also analyzed P.S.A. velocity — the rate of change in readings from year to year. But after adjusting for age, base-line P.S.A. and other factors, they found little evidence that giving a biopsy to men whose velocity was greater than 0.35 helped find prostate cancer. And it was particularly useless in uncovering the most aggressive types of cancer, the ones most important to treat.
The researchers, writing in the March 16 issue of The Journal of the National Cancer Institute, concluded that using P.S.A. velocity for prostate cancer detection is ineffective, that it leads to unnecessary biopsies and that references to it should be removed from professional guidelines and policy statements.
Andrew J. Vickers, the lead author, drew an analogy: A basketball player’s height, he said, is important to his ability to play, and it correlates very closely with his shoe size. But once you know his height, his shoe size is irrelevant to judging his value as a player.
Similarly, it is easy to demonstrate a statistical relationship between sharp rises in P.S.A. and cancer, but the correlation reveals no more information than is already available with a P.S.A. reading, a digital examination and a family history. It is irrelevant in deciding whether a biopsy is needed.
Not all experts agree. Dr. Anthony V. D’Amico, a professor of radiation oncology at Harvard, said that the methodology of Dr. Vickers’s study was sound, but that the data gathered were almost certainly flawed.
The problem, Dr. D’Amico said, is that many factors that have nothing to do with prostate cancer can cause a rapid increase in prostate-specific antigen. Sexual activity, riding on a bicycle or on horseback, a recent colonoscopy, a bladder or prostate infection, even variations in the ways laboratories perform the test can radically affect the readings.
“It may well be that the high velocity in your case is not important,” he said. “But before you reach that conclusion, I would get a repeat P.S.A.” If there is still a spike after eliminating those other possible causes, he continued, a biopsy should be the next step.
Dr. Vickers, a researcher at Memorial Sloan-Kettering Cancer Center in New York City, agreed that prostate cancer was only one of many reasons for a high P.S.A. “A doctor sees a high P.S.A. and says, ‘Could this be cancer or some other reason?’ ” he said. “Well, the thought was that P.S.A. velocity could help you think this through” — that measuring the rate of change would be decisive.
But in practice, Dr. Vickers said, it does not work. If he had strictly applied the guidelines to the men in his study, he said, one in every seven would have had to have a biopsy. This would mean millions of American men would need biopsies, he said, with almost none of them revealing a cancer.
Dr. Vickers and his colleagues acknowledged that there might be better methods of calculating P.S.A. velocity that could lead to more accurate predictions, and that some effect might have been found if the patients had been followed for more than seven years.
But at this point, he is firmly against biopsies on the basis of velocity alone. “If your P.S.A. is in the normal range, you shouldn’t get a biopsy,” he said. “Changes or spikes in P.S.A. are not something to worry about if your P.S.A. is still normal.”
Wednesday, February 9, 2011
sequencing the complete DNA of an individual organism's genome.
Today’s announcement regarding the sequencing of whole prostate cancer genomes is an historic development in the fight against prostate cancer. The ability to sequence whole genomes will spare some patients from unnecessary treatments and side effects while eliminating an estimated $1.5 billion that is spent each year on overtreatment. The complete research findings will be published in the February 10 issue of Nature.
What is whole genome sequencing?
It is the process of sequencing the complete DNA of an individual organism's genome.
How much information is this?
If the DNA sequence of the human genome were compiled into books, it would fill 200 volumes of a Manahattan-sized phone book (or one 35-foot high phone book.) People won't be carrying this data around on flash drives either - it would still take a significant hard drive to store all of this information.
What did this research do?
Researchers mapped the complete genome of prostate cancer. They took the genetic material from the tumors of seven patients with advanced prostate cancer and then compared these cancer genomes to the normal genomes of these same patients. This information is visually presented using a Circos plot.
What is a Circos plot?
A Circos plot is a diagram created with Circos software for visualizing data in a circular layout. It was originally designed to aid in the visualization of genomic data.
Here are the Circos plots of the seven prostate cancer patients' genomes:
What does this mean for men diagnosed with prostate cancer?
The data expands our fundamental understanding of the disease’s biology and provides the technical and clinical roadmap for improving patient treatment and outcomes. Ultimately, every patient with prostate cancer will get a Circos plot with the whole genome sequencing of their biopsy as a unique portrait of the code that makes their prostate cancer manifest as it does.
How much does it cost to sequence a whole genome?
The current estimated cost of sequencing a whole genome is $25,000 or less. Experts predict that the cost of routine sequencing will ultimately be around $5,000 per genome. (This figure compares favorably to the cost of $90,000-$150,000 per patient for a radical prostatectomy followed by several years of androgen deprivation therapy using Lupron.)
Research Background
Work conducted by lead institutions, The Broad Institute, Dana-Farber Cancer Institute and Weill Cornell Medical College, along with 15 other collaborating institutions, completed this initial project ahead of a planned NIH effort.
Teleconference
The Prostate Cancer Foundation (PCF) hosted a teleconference to provide insight and commentary from leading professionals in the field. Click on the image above right to listen to the teleconference.
Listen to the Teleconference
Teleconference Participants:
Dr. Jonathan W. Simons (moderator)
President & CEO, PCF
Dr. Levi Garraway (Co-lead investigator)
Dana-Farber Cancer Institute, The Broad Institute
Dr. Michael Berger
Memorial Sloan-Kettering Cancer Center
Dr. Mark Rubin (Co-lead investigator)
Weil Cornell Medical College
Dr. Ash Tewari
Weill-Cornell Medical College
Dan Zenka
VP of Communications & Patient Advocate, PCF
© 2011 prostate cancer foundation
Media Center | Terms of Use | Privacy Policy | Site Map | Site Credit
What is whole genome sequencing?
It is the process of sequencing the complete DNA of an individual organism's genome.
How much information is this?
If the DNA sequence of the human genome were compiled into books, it would fill 200 volumes of a Manahattan-sized phone book (or one 35-foot high phone book.) People won't be carrying this data around on flash drives either - it would still take a significant hard drive to store all of this information.
What did this research do?
Researchers mapped the complete genome of prostate cancer. They took the genetic material from the tumors of seven patients with advanced prostate cancer and then compared these cancer genomes to the normal genomes of these same patients. This information is visually presented using a Circos plot.
What is a Circos plot?
A Circos plot is a diagram created with Circos software for visualizing data in a circular layout. It was originally designed to aid in the visualization of genomic data.
Here are the Circos plots of the seven prostate cancer patients' genomes:
What does this mean for men diagnosed with prostate cancer?
The data expands our fundamental understanding of the disease’s biology and provides the technical and clinical roadmap for improving patient treatment and outcomes. Ultimately, every patient with prostate cancer will get a Circos plot with the whole genome sequencing of their biopsy as a unique portrait of the code that makes their prostate cancer manifest as it does.
How much does it cost to sequence a whole genome?
The current estimated cost of sequencing a whole genome is $25,000 or less. Experts predict that the cost of routine sequencing will ultimately be around $5,000 per genome. (This figure compares favorably to the cost of $90,000-$150,000 per patient for a radical prostatectomy followed by several years of androgen deprivation therapy using Lupron.)
Research Background
Work conducted by lead institutions, The Broad Institute, Dana-Farber Cancer Institute and Weill Cornell Medical College, along with 15 other collaborating institutions, completed this initial project ahead of a planned NIH effort.
Teleconference
The Prostate Cancer Foundation (PCF) hosted a teleconference to provide insight and commentary from leading professionals in the field. Click on the image above right to listen to the teleconference.
Listen to the Teleconference
Teleconference Participants:
Dr. Jonathan W. Simons (moderator)
President & CEO, PCF
Dr. Levi Garraway (Co-lead investigator)
Dana-Farber Cancer Institute, The Broad Institute
Dr. Michael Berger
Memorial Sloan-Kettering Cancer Center
Dr. Mark Rubin (Co-lead investigator)
Weil Cornell Medical College
Dr. Ash Tewari
Weill-Cornell Medical College
Dan Zenka
VP of Communications & Patient Advocate, PCF
© 2011 prostate cancer foundation
Media Center | Terms of Use | Privacy Policy | Site Map | Site Credit
Saturday, February 5, 2011
Provenge Treatment Results to Date(Jan 2011)
Sipuleucel-T is an autologous active cellular immunotherapy used in the treatment of men with asymptomatic or minimally symptomatic metastatic castration-resistant prostate cancer (CRPC). It is the first therapeutic cancer vaccine to receive US FDA approval. Approximately 3 days prior to each infusion of sipuleucel-T, patients undergo a leukapheresis procedure for collection of autologous peripheral blood mononuclear cells. Preparation of sipuleucel-T involves enrichment for antigen-presenting cells from the leukapheresis product and activation ex vivo with a recombinant fusion protein (PA2024). In the randomized, double-blind, placebo-controlled IMPACT study in patients with metastatic CRPC, sipuleucel-T was associated with a 22% relative reduction in the risk of death (hazard ratio 0.78; p = 0.03), which was the primary endpoint of the trial. After a median follow-up period of 34.1 months, median survival was 4.1 months longer with sipuleucel-T than placebo (25.8 vs 21.7 months). There was no significant between-group difference for the median time to objective disease progression (a secondary endpoint). Almost all patients treated with sipuleucel-T in clinical trials reported an adverse event, although these were mild or moderate in severity (grade 1 or 2) in most patients. The most common adverse events (e.g. infusion-related events, such as chills and fever) generally occurred within the first day after administration of sipuleucel-T and resolved within 2 days.
Written by:
Plosker GL. Are you the author?
Reference: Drugs. 2011 Jan 1;71(1):101-8.
doi: 10.2165/11206840-000000000-00000
PubMed Abstract
PMID: 21175243
Written by:
Plosker GL. Are you the author?
Reference: Drugs. 2011 Jan 1;71(1):101-8.
doi: 10.2165/11206840-000000000-00000
PubMed Abstract
PMID: 21175243
RPP, the most cost-effective treatment for OCPCa.
Written by Lynda Coghlan
Wednesday, 02 February 2011 07:52
Urology Centre, Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.
sashurol@gmail.com
With the increasing prevalence of prostate cancer and evolving methods for the definitive treatment of OCPCa, health economic analyses will be critically important, albeit difficult to carry out. Preliminary studies point to RPP as the most cost-effective treatment for OCPCa. The quickest postoperative recovery, in experienced hands, occurs in RARP and RPP, with ORPP having a slightly, but statistically in significant, shorter hospital stay. It should be stressed that initial treatment costs are not the only important factor in healthcare costs. Readmission for early and late complications and the loss of productivity resulting from variation in time to return to work, need also to be considered. Loss of productivity may also vary in cost between different institutions and countries depending upon the proportion of patients employed. Further large-scale multicentre studies are necessary to assess this.
Written by:
Kommu SS, Eden CG, Luscombe CJ, Golash A, Persad RA. Are you the author?
Reference: BJU Int. 2011 Jan;107(1):1-3.
doi: 10.1111/j.1464-410X.2010.09885.x
PubMed Abstract
PMID: 21176067
UroToday.com Prostate Cancer Section
Wednesday, 02 February 2011 07:52
Urology Centre, Guy's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.
sashurol@gmail.com
With the increasing prevalence of prostate cancer and evolving methods for the definitive treatment of OCPCa, health economic analyses will be critically important, albeit difficult to carry out. Preliminary studies point to RPP as the most cost-effective treatment for OCPCa. The quickest postoperative recovery, in experienced hands, occurs in RARP and RPP, with ORPP having a slightly, but statistically in significant, shorter hospital stay. It should be stressed that initial treatment costs are not the only important factor in healthcare costs. Readmission for early and late complications and the loss of productivity resulting from variation in time to return to work, need also to be considered. Loss of productivity may also vary in cost between different institutions and countries depending upon the proportion of patients employed. Further large-scale multicentre studies are necessary to assess this.
Written by:
Kommu SS, Eden CG, Luscombe CJ, Golash A, Persad RA. Are you the author?
Reference: BJU Int. 2011 Jan;107(1):1-3.
doi: 10.1111/j.1464-410X.2010.09885.x
PubMed Abstract
PMID: 21176067
UroToday.com Prostate Cancer Section
Active Surveillance & Ffocal Therapy Treat PCa
Written by Lynda Coghlan
Thursday, 03 February 2011 03:12
USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Active surveillance and focal therapy for prostate cancer have been proposed as treatment alternatives for prostate cancer. In this review, we track the emerging technologies that will support the viability of such management strategies.
Widespread prostate-specific antigen (PSA) testing and extended prostate biopsy practice patterns have resulted in a significant increase in the diagnosis of low-risk prostate cancer. As most low-risk prostate cancers may not require radical treatment, alternatives for appropriately selected patients have been proposed and implemented - namely, active surveillance and focal therapy. Both alternatives to radical therapy require accurate mapping and precise targeting of lesions within the prostate, for which current technological shortfalls limit their clinical utility. The emerging tools that will help overcome these challenges include refined imaging modalities, three-dimensional modeling for planning and tracking intervention, elastic fusion image technology, and automated mechanical delivery of the intervention needle.
Current prostate biopsy technologies have largely advanced as separate entities. Further refinement of these innovations continue, but the ultimate challenge will be integrating them into one comprehensive platform.
Written by:
Ukimura O, Hung AJ, Gill IS. Are you the author?
Reference: Curr Opin Urol. 2011 Mar;21(2):115-20.
PubMed Abstract
PMID: 21178631
UroToday.com Prostate Cancer Section
Last Updated ( Thursda
Thursday, 03 February 2011 03:12
USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Active surveillance and focal therapy for prostate cancer have been proposed as treatment alternatives for prostate cancer. In this review, we track the emerging technologies that will support the viability of such management strategies.
Widespread prostate-specific antigen (PSA) testing and extended prostate biopsy practice patterns have resulted in a significant increase in the diagnosis of low-risk prostate cancer. As most low-risk prostate cancers may not require radical treatment, alternatives for appropriately selected patients have been proposed and implemented - namely, active surveillance and focal therapy. Both alternatives to radical therapy require accurate mapping and precise targeting of lesions within the prostate, for which current technological shortfalls limit their clinical utility. The emerging tools that will help overcome these challenges include refined imaging modalities, three-dimensional modeling for planning and tracking intervention, elastic fusion image technology, and automated mechanical delivery of the intervention needle.
Current prostate biopsy technologies have largely advanced as separate entities. Further refinement of these innovations continue, but the ultimate challenge will be integrating them into one comprehensive platform.
Written by:
Ukimura O, Hung AJ, Gill IS. Are you the author?
Reference: Curr Opin Urol. 2011 Mar;21(2):115-20.
PubMed Abstract
PMID: 21178631
UroToday.com Prostate Cancer Section
Last Updated ( Thursda
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