@article{1da3e165a5174555bad4e1785a0efa6f,
title = "Patterns of Clinical Progression in Radiorecurrent High-risk Prostate Cancer[Formula presented]",
abstract = "The natural history of radiorecurrent high-risk prostate cancer (HRPCa) is not well-described. To better understand its clinical course, we evaluated rates of distant metastases (DM) and prostate cancer-specific mortality (PCSM) in a cohort of 978 men with radiorecurrent HRPCa who previously received either external beam radiation therapy (EBRT, n = 654, 67%) or EBRT + brachytherapy (EBRT + BT, n = 324, 33%) across 15 institutions from 1997 to 2015. In men who did not die, median follow-up after treatment was 8.9 yr and median follow-up after biochemical recurrence (BCR) was 3.7 yr. Local and systemic therapy salvage, respectively, were delivered to 21 and 390 men after EBRT, and eight and 103 men after EBRT + BT. Overall, 435 men developed DM, and 248 were detected within 1 yr of BCR. Measured from time of recurrence, 5-yr DM rates were 50% and 34% after EBRT and EBRT + BT, respectively. Measured from BCR, 5-yr PCSM rates were 27% and 29%, respectively. Interval to BCR was independently associated with DM (p < 0.001) and PCSM (p < 0.001). These data suggest that radiorecurrent HRPCa has an aggressive natural history and that DM is clinically evident early after BCR. These findings underscore the importance of further investigations into upfront risk assessment and prompt systemic evaluation upon recurrence in HRPCa. Patient summary: High-risk prostate cancer that recurs after radiation therapy is an aggressive disease entity and spreads to other parts of the body (metastases). Some 60% of metastases occur within 1 yr. Approximately 30% of these patients die from their prostate cancer.",
keywords = "Biochemical recurrence, Brachytherapy boost, EBRT, External beam radiation therapy, High-risk prostate cancer, Prostate cancer, Radiorecurrence, Recurrent prostate cancer",
author = "Philipson, {Rebecca G.} and Tahmineh Romero and Wong, {Jessica K.} and Stish, {Bradley J.} and Dess, {Robert T.} and Spratt, {Daniel E.} and Avinash Pilar and Chandana Reddy and Wedde, {Trude B.} and Lilleby, {Wolfgang A.} and Ryan Fiano and Merrick, {Gregory S.} and Stock, {Richard G.} and Demanes, {D. Jeffrey} and Moran, {Brian J.} and Michelle Braccioforte and Tran, {Phuoc T.} and Santiago Martin and Rafael Martinez-Monge and Krauss, {Daniel J.} and Abu-Isa, {Eyad I.} and Luca Valle and Natalie Chong and Pisansky, {Thomas M.} and Choo, {C. Richard} and Song, {Daniel Y.} and Stephen Greco and Curtiland Deville and Todd McNutt and DeWeese, {Theodore L.} and Ross, {Ashley E.} and Ciezki, {Jay P.} and Derya Tilki and Karnes, {R. Jeffrey} and Klein, {Eric A.} and Tosoian, {Jeffrey J.} and Boutros, {Paul C.} and Nickols, {Nicholas G.} and Prashant Bhat and David Shabsovich and Juarez, {Jesus E.} and Kupelian, {Patrick A.} and Rettig, {Matthew B.} and Alejandro Berlin and Tward, {Jonathan D.} and Davis, {Brian J.} and Reiter, {Robert E.} and Steinberg, {Michael L.} and David Elashoff and Horwitz, {Eric M.} and Tendulkar, {Rahul D.} and Kishan, {Amar U.}",
note = "Funding Information: Funding/Support and role of the sponsor: This work was supported by the American Society for Radiation Oncology and the Prostate Cancer Foundation, as well as the Jonsson Comprehensive Cancer Foundation and a charitable donation from the Rosenson Family Trust. The sponsor played a role in analysis of the data. Funding Information: Financial disclosures: Amar U. Kishan certifies that all conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript (eg, employment/affiliation, grants or funding, consultancies, honoraria, stock ownership or options, expert testimony, royalties, or patents filed, received, or pending), are the following: Nicholas G. Nickols has received grants from Veterans Affairs, Prostate Cancer Foundation, STOP Cancer Foundation, Janssen, Bayer, Progenics, and Varian; and personal fees from Gene Sciences, Inc. Matthew B. Rettig has received research grants from Novartis, Johnson & Johnson, Merck, Astellas, and Medivation; is a member of speaker bureaus for Johnson & Johnson and Bayer; and is a consultant for Constellation, Ambrx, and Amgen. Daniel E. Spratt is an advisory board member for Blue Earth Diagnostics, Janssen, and AstraZeneca. Jonathan D. Tward has received research funding from Bayer and Myriad; acts in a consulting role for Bayer, Blue Earth, Merck, and Astellas; and participates in a speaker bureau for Blue Earth. Jeffrey J. Tosoian holds a leadership role with equity interest in LynxDx, Inc. Paul C. Boutros is a member of the scientific advisory boards of BioSymetrics Inc. and of Intersect Diagnostics Inc. Amar U. Kishan has acted in an advisory role for Janssen and a consulting role for mPROS; has received grants from the Prostate Cancer Foundation; and has received honoraria from Varian and ViewRay. The remaining authors have nothing to disclose. Publisher Copyright: {\textcopyright} 2021 European Association of Urology",
year = "2021",
month = aug,
doi = "10.1016/j.eururo.2021.04.035",
language = "English (US)",
volume = "80",
pages = "142--146",
journal = "European Urology",
issn = "0302-2838",
publisher = "Elsevier",
number = "2",
}
