Beta-blocker use at surgery lowers prostate cancer recurrence risk

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Key clinical point: Use of nonselective beta-blockers at the time of radical prostatectomy is associated with a lower odds of treatment initiation for recurrence in patients with prostate cancer.

Major finding: The use of nonselective beta-blockers at the time of surgery was associated with a significantly lower odds of treatment for cancer recurrence (adjusted hazard ratio 0.64; P = .03). The most common nonselective beta-blockers used were carvedilol (56.9%) and propranolol (25.4%).

Study details: This was a retrospective cohort study of 11,117 patients with prostate cancer who underwent radical prostatectomy between 2008 and 2015.

Disclosures: This study was supported by the Norwegian Cancer Society. The authors received grants from the Norwegian Cancer Society during this work.

Source: Sivanesan S et al. JAMA Netw Open. 2022 (Jan 26). Doi: 10.1001/jamanetworkopen.2021.45230.

 

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Key clinical point: Use of nonselective beta-blockers at the time of radical prostatectomy is associated with a lower odds of treatment initiation for recurrence in patients with prostate cancer.

Major finding: The use of nonselective beta-blockers at the time of surgery was associated with a significantly lower odds of treatment for cancer recurrence (adjusted hazard ratio 0.64; P = .03). The most common nonselective beta-blockers used were carvedilol (56.9%) and propranolol (25.4%).

Study details: This was a retrospective cohort study of 11,117 patients with prostate cancer who underwent radical prostatectomy between 2008 and 2015.

Disclosures: This study was supported by the Norwegian Cancer Society. The authors received grants from the Norwegian Cancer Society during this work.

Source: Sivanesan S et al. JAMA Netw Open. 2022 (Jan 26). Doi: 10.1001/jamanetworkopen.2021.45230.

 

Key clinical point: Use of nonselective beta-blockers at the time of radical prostatectomy is associated with a lower odds of treatment initiation for recurrence in patients with prostate cancer.

Major finding: The use of nonselective beta-blockers at the time of surgery was associated with a significantly lower odds of treatment for cancer recurrence (adjusted hazard ratio 0.64; P = .03). The most common nonselective beta-blockers used were carvedilol (56.9%) and propranolol (25.4%).

Study details: This was a retrospective cohort study of 11,117 patients with prostate cancer who underwent radical prostatectomy between 2008 and 2015.

Disclosures: This study was supported by the Norwegian Cancer Society. The authors received grants from the Norwegian Cancer Society during this work.

Source: Sivanesan S et al. JAMA Netw Open. 2022 (Jan 26). Doi: 10.1001/jamanetworkopen.2021.45230.

 

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Prostate cancer: ACEi use during radiotherapy may protect against hematuria

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Key clinical point: Angiotensin-converting enzyme inhibitors (ACEi) use during radiotherapy is associated with a lower risk for hematuria in patients with prostate cancer. The effect was independent of clinical factors associated with late hematuria.

Major finding: The cumulative probability of hematuria at 4 years in patients receiving ACEi during radiotherapy was significantly lower vs. nonusers (4.8% vs. 16.5%). The risk for hematuria was significantly lower in patients receiving ACEi (adjusted hazard ratio 0.51; P = .030) after adjusting for clinical factors associated with hematuria.

Study details: This article reported on two multicenter observational studies, URWCI (n = 256) and REQUITE (n = 1,437), of patients with prostate cancer undergoing radiotherapy.

Disclosures: This work was supported by the National Cancer Institute, University of Rochester Wilmot Cancer Institute, Cancer Research UK, and others. The authors reported no competing interests.

Source: Kerns SL et al. Radiother Oncol. 2022;168:P75-82 (Jan 22). Doi: 10.1016/j.radonc.2022.01.014.

 

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Key clinical point: Angiotensin-converting enzyme inhibitors (ACEi) use during radiotherapy is associated with a lower risk for hematuria in patients with prostate cancer. The effect was independent of clinical factors associated with late hematuria.

Major finding: The cumulative probability of hematuria at 4 years in patients receiving ACEi during radiotherapy was significantly lower vs. nonusers (4.8% vs. 16.5%). The risk for hematuria was significantly lower in patients receiving ACEi (adjusted hazard ratio 0.51; P = .030) after adjusting for clinical factors associated with hematuria.

Study details: This article reported on two multicenter observational studies, URWCI (n = 256) and REQUITE (n = 1,437), of patients with prostate cancer undergoing radiotherapy.

Disclosures: This work was supported by the National Cancer Institute, University of Rochester Wilmot Cancer Institute, Cancer Research UK, and others. The authors reported no competing interests.

Source: Kerns SL et al. Radiother Oncol. 2022;168:P75-82 (Jan 22). Doi: 10.1016/j.radonc.2022.01.014.

 

Key clinical point: Angiotensin-converting enzyme inhibitors (ACEi) use during radiotherapy is associated with a lower risk for hematuria in patients with prostate cancer. The effect was independent of clinical factors associated with late hematuria.

Major finding: The cumulative probability of hematuria at 4 years in patients receiving ACEi during radiotherapy was significantly lower vs. nonusers (4.8% vs. 16.5%). The risk for hematuria was significantly lower in patients receiving ACEi (adjusted hazard ratio 0.51; P = .030) after adjusting for clinical factors associated with hematuria.

Study details: This article reported on two multicenter observational studies, URWCI (n = 256) and REQUITE (n = 1,437), of patients with prostate cancer undergoing radiotherapy.

Disclosures: This work was supported by the National Cancer Institute, University of Rochester Wilmot Cancer Institute, Cancer Research UK, and others. The authors reported no competing interests.

Source: Kerns SL et al. Radiother Oncol. 2022;168:P75-82 (Jan 22). Doi: 10.1016/j.radonc.2022.01.014.

 

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Obesity is linked to high-risk prostate cancer in multiethnic population

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Key clinical point: Obesity (body mass index of ≥30 kg/m2) is associated with high-risk prostate cancer in non-Hispanic Black (NHB) and Hispanic men.

Major finding: Obesity showed an independent association with high-risk prostate cancer (odds ratio [OR] 2.23; 95% CI 1.28-3.81). Compared with nonobese men without diabetes mellitus (DM), those with obesity and DM showed a higher risk for intermediate- (OR 1.93; P = .013) and high-risk prostate cancer (OR 2.40; P = .011).

Study details: This was a retrospective study of 1,303 patients with prostate cancer. The prevalence of obesity and DM was 29.3% and 28.3%, respectively. Most of the patients were of NHB (38%) or Hispanic ethnicity (31%).

Disclosures: This work was funded by the American Cancer Society. The authors declared no conflicts of interest.

Source: Zhu D et al. Clin Genitourin Cancer. 2022 (Jan 31). Doi: 10.1016/j.clgc.2022.01.016.

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Key clinical point: Obesity (body mass index of ≥30 kg/m2) is associated with high-risk prostate cancer in non-Hispanic Black (NHB) and Hispanic men.

Major finding: Obesity showed an independent association with high-risk prostate cancer (odds ratio [OR] 2.23; 95% CI 1.28-3.81). Compared with nonobese men without diabetes mellitus (DM), those with obesity and DM showed a higher risk for intermediate- (OR 1.93; P = .013) and high-risk prostate cancer (OR 2.40; P = .011).

Study details: This was a retrospective study of 1,303 patients with prostate cancer. The prevalence of obesity and DM was 29.3% and 28.3%, respectively. Most of the patients were of NHB (38%) or Hispanic ethnicity (31%).

Disclosures: This work was funded by the American Cancer Society. The authors declared no conflicts of interest.

Source: Zhu D et al. Clin Genitourin Cancer. 2022 (Jan 31). Doi: 10.1016/j.clgc.2022.01.016.

Key clinical point: Obesity (body mass index of ≥30 kg/m2) is associated with high-risk prostate cancer in non-Hispanic Black (NHB) and Hispanic men.

Major finding: Obesity showed an independent association with high-risk prostate cancer (odds ratio [OR] 2.23; 95% CI 1.28-3.81). Compared with nonobese men without diabetes mellitus (DM), those with obesity and DM showed a higher risk for intermediate- (OR 1.93; P = .013) and high-risk prostate cancer (OR 2.40; P = .011).

Study details: This was a retrospective study of 1,303 patients with prostate cancer. The prevalence of obesity and DM was 29.3% and 28.3%, respectively. Most of the patients were of NHB (38%) or Hispanic ethnicity (31%).

Disclosures: This work was funded by the American Cancer Society. The authors declared no conflicts of interest.

Source: Zhu D et al. Clin Genitourin Cancer. 2022 (Jan 31). Doi: 10.1016/j.clgc.2022.01.016.

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Prostate cancer: Active surveillance may be appropriate in selected intermediate-risk patients

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Key clinical point: The risk for metastasis and cancer-specific mortality is significantly higher in patients with favorable and unfavorable intermediate-risk vs. low-risk patients with prostate cancer managed with active surveillance.

Major finding: The risk for metastasis and prostate cancer-specific mortality was significantly higher in patients with favorable (subdistribution hazard ratios [SHR] 6.49 and 2.94, respectively; both P < .001) and unfavorable (SHR 14.45 and 7.90, respectively; P < .001) intermediate-risk disease vs. those with low-risk disease.

Study details: This was a retrospective study of 9,733 patients with low- or intermediate-risk prostate cancer undergoing active surveillance between 2001 and 2015.

Disclosures: This study was sponsored by the National Institutes of Health and U.S. Department of Defense. Several of the authors received consulting/speaker fees, honoraria, travel support, and other financial and nonfinancial interests, served on advisory boards, or were employed by pharmaceutical companies. The other authors had no conflicts of interest.

Source: Courtney PT et al. J Natl Compr Canc Netw. 2022;20(2):151-159 (Feb 1). Doi:  10.6004/jnccn.2021.7065.

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Key clinical point: The risk for metastasis and cancer-specific mortality is significantly higher in patients with favorable and unfavorable intermediate-risk vs. low-risk patients with prostate cancer managed with active surveillance.

Major finding: The risk for metastasis and prostate cancer-specific mortality was significantly higher in patients with favorable (subdistribution hazard ratios [SHR] 6.49 and 2.94, respectively; both P < .001) and unfavorable (SHR 14.45 and 7.90, respectively; P < .001) intermediate-risk disease vs. those with low-risk disease.

Study details: This was a retrospective study of 9,733 patients with low- or intermediate-risk prostate cancer undergoing active surveillance between 2001 and 2015.

Disclosures: This study was sponsored by the National Institutes of Health and U.S. Department of Defense. Several of the authors received consulting/speaker fees, honoraria, travel support, and other financial and nonfinancial interests, served on advisory boards, or were employed by pharmaceutical companies. The other authors had no conflicts of interest.

Source: Courtney PT et al. J Natl Compr Canc Netw. 2022;20(2):151-159 (Feb 1). Doi:  10.6004/jnccn.2021.7065.

Key clinical point: The risk for metastasis and cancer-specific mortality is significantly higher in patients with favorable and unfavorable intermediate-risk vs. low-risk patients with prostate cancer managed with active surveillance.

Major finding: The risk for metastasis and prostate cancer-specific mortality was significantly higher in patients with favorable (subdistribution hazard ratios [SHR] 6.49 and 2.94, respectively; both P < .001) and unfavorable (SHR 14.45 and 7.90, respectively; P < .001) intermediate-risk disease vs. those with low-risk disease.

Study details: This was a retrospective study of 9,733 patients with low- or intermediate-risk prostate cancer undergoing active surveillance between 2001 and 2015.

Disclosures: This study was sponsored by the National Institutes of Health and U.S. Department of Defense. Several of the authors received consulting/speaker fees, honoraria, travel support, and other financial and nonfinancial interests, served on advisory boards, or were employed by pharmaceutical companies. The other authors had no conflicts of interest.

Source: Courtney PT et al. J Natl Compr Canc Netw. 2022;20(2):151-159 (Feb 1). Doi:  10.6004/jnccn.2021.7065.

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Prostate cancer: Salvage radiotherapy after surgery extends long-term survival

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Key clinical point: In patients with prostate cancer, salvage radiotherapy (SRT) for biochemical recurrence after radical prostatectomy is associated with improved survival in the long term.

Major finding: The median follow up was 95.9 months. At 15 years, SRT was associated with a significantly higher metastasis-free survival (84.3% vs. 76.9%; adjusted hazard ratio [aHR] 0.37; P < .001) and overall survival (85.3% vs. 74.4%; aHR 0.64; P = .03).

Study details: A propensity score-matched analysis of 874 patients with prostate cancer who experienced biochemical recurrence after radical prostatectomy and underwent SRT or observation between 1989 and 2016.

Disclosures: No external funding source was identified for this work. The authors declared no conflicts of interest.

Source: Tilki D et al. Cancers. 2022;14(3):740 (Jan 31). Doi: 10.3390/cancers14030740.

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Key clinical point: In patients with prostate cancer, salvage radiotherapy (SRT) for biochemical recurrence after radical prostatectomy is associated with improved survival in the long term.

Major finding: The median follow up was 95.9 months. At 15 years, SRT was associated with a significantly higher metastasis-free survival (84.3% vs. 76.9%; adjusted hazard ratio [aHR] 0.37; P < .001) and overall survival (85.3% vs. 74.4%; aHR 0.64; P = .03).

Study details: A propensity score-matched analysis of 874 patients with prostate cancer who experienced biochemical recurrence after radical prostatectomy and underwent SRT or observation between 1989 and 2016.

Disclosures: No external funding source was identified for this work. The authors declared no conflicts of interest.

Source: Tilki D et al. Cancers. 2022;14(3):740 (Jan 31). Doi: 10.3390/cancers14030740.

Key clinical point: In patients with prostate cancer, salvage radiotherapy (SRT) for biochemical recurrence after radical prostatectomy is associated with improved survival in the long term.

Major finding: The median follow up was 95.9 months. At 15 years, SRT was associated with a significantly higher metastasis-free survival (84.3% vs. 76.9%; adjusted hazard ratio [aHR] 0.37; P < .001) and overall survival (85.3% vs. 74.4%; aHR 0.64; P = .03).

Study details: A propensity score-matched analysis of 874 patients with prostate cancer who experienced biochemical recurrence after radical prostatectomy and underwent SRT or observation between 1989 and 2016.

Disclosures: No external funding source was identified for this work. The authors declared no conflicts of interest.

Source: Tilki D et al. Cancers. 2022;14(3):740 (Jan 31). Doi: 10.3390/cancers14030740.

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Localized prostate cancer: Add-on ADT delays metastasis

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Key clinical point: Adding androgen deprivation therapy (ADT) to radiotherapy in men with intermediate-/high-risk localized prostate cancer improves metastasis-free survival (MFS).

Major finding: At a median follow-up of 11.4 years, the addition of ADT to radiotherapy significantly improved MFS (hazard ratio [HR] 0.83; P < .0001). Prolonged adjuvant ADT also improved MFS (HR 0.84; P < .0001).

Study details: This was an individual patient data meta-analysis of 10,853 patients with localized prostate cancer from 12 randomized trials.

Disclosures: This work was funded by the University Hospitals Seidman Cancer Center, Prostate Cancer Foundation, and the American Society for Radiation Oncology. The authors received personal/consulting/advisory fees and research support or reported being a member of the clinical trial steering committee and holding stocks outside this work.

Source: Kishan AU et al. Lancet Oncol. 2022;23(2):P304-16 (Jan 17). Doi: 10.1016/ S1470-2045(21)00705-1.

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Key clinical point: Adding androgen deprivation therapy (ADT) to radiotherapy in men with intermediate-/high-risk localized prostate cancer improves metastasis-free survival (MFS).

Major finding: At a median follow-up of 11.4 years, the addition of ADT to radiotherapy significantly improved MFS (hazard ratio [HR] 0.83; P < .0001). Prolonged adjuvant ADT also improved MFS (HR 0.84; P < .0001).

Study details: This was an individual patient data meta-analysis of 10,853 patients with localized prostate cancer from 12 randomized trials.

Disclosures: This work was funded by the University Hospitals Seidman Cancer Center, Prostate Cancer Foundation, and the American Society for Radiation Oncology. The authors received personal/consulting/advisory fees and research support or reported being a member of the clinical trial steering committee and holding stocks outside this work.

Source: Kishan AU et al. Lancet Oncol. 2022;23(2):P304-16 (Jan 17). Doi: 10.1016/ S1470-2045(21)00705-1.

Key clinical point: Adding androgen deprivation therapy (ADT) to radiotherapy in men with intermediate-/high-risk localized prostate cancer improves metastasis-free survival (MFS).

Major finding: At a median follow-up of 11.4 years, the addition of ADT to radiotherapy significantly improved MFS (hazard ratio [HR] 0.83; P < .0001). Prolonged adjuvant ADT also improved MFS (HR 0.84; P < .0001).

Study details: This was an individual patient data meta-analysis of 10,853 patients with localized prostate cancer from 12 randomized trials.

Disclosures: This work was funded by the University Hospitals Seidman Cancer Center, Prostate Cancer Foundation, and the American Society for Radiation Oncology. The authors received personal/consulting/advisory fees and research support or reported being a member of the clinical trial steering committee and holding stocks outside this work.

Source: Kishan AU et al. Lancet Oncol. 2022;23(2):P304-16 (Jan 17). Doi: 10.1016/ S1470-2045(21)00705-1.

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Niraparib shows activity in mCRPC

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Key clinical point: Niraparib is tolerable and shows activity in heavily pretreated patients with metastatic castration-resistant prostate cancer (mCRPC) and DNA repair gene defects (DRD).

Major finding: The median follow-up duration was 10 months and 8.6 months in the measurable BRCA and non-BRCA cohorts, respectively. The objective response rate was 34.2% in the measurable BRCA cohort and 10.6% in the measurable non-BRCA cohort. The most common grade 3 or higher adverse events were hematological (anemia, thrombocytopenia, and neutropenia). These adverse events were manageable with treatment interruptions, dose reductions, or supportive measures.

Study details: An open-label, single-arm, phase 2 GALAHAD study of 289 patients with histologically confirmed mCRPC and DRD who were treated with niraparib.

Disclosures: This study was sponsored by Janssen Research & Development. The authors received grants, contracts, payments, honoraria, travel support, and consulting/advisory/personal fees or reported being in a leadership role, holding stocks, or other ownership roles relative to Janssen Research & Development.

Source: Smith MR et al. Lancet Oncol. 2022 (Feb 4). Doi: 10.1016/S1470-2045(21)00757-9.

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Key clinical point: Niraparib is tolerable and shows activity in heavily pretreated patients with metastatic castration-resistant prostate cancer (mCRPC) and DNA repair gene defects (DRD).

Major finding: The median follow-up duration was 10 months and 8.6 months in the measurable BRCA and non-BRCA cohorts, respectively. The objective response rate was 34.2% in the measurable BRCA cohort and 10.6% in the measurable non-BRCA cohort. The most common grade 3 or higher adverse events were hematological (anemia, thrombocytopenia, and neutropenia). These adverse events were manageable with treatment interruptions, dose reductions, or supportive measures.

Study details: An open-label, single-arm, phase 2 GALAHAD study of 289 patients with histologically confirmed mCRPC and DRD who were treated with niraparib.

Disclosures: This study was sponsored by Janssen Research & Development. The authors received grants, contracts, payments, honoraria, travel support, and consulting/advisory/personal fees or reported being in a leadership role, holding stocks, or other ownership roles relative to Janssen Research & Development.

Source: Smith MR et al. Lancet Oncol. 2022 (Feb 4). Doi: 10.1016/S1470-2045(21)00757-9.

Key clinical point: Niraparib is tolerable and shows activity in heavily pretreated patients with metastatic castration-resistant prostate cancer (mCRPC) and DNA repair gene defects (DRD).

Major finding: The median follow-up duration was 10 months and 8.6 months in the measurable BRCA and non-BRCA cohorts, respectively. The objective response rate was 34.2% in the measurable BRCA cohort and 10.6% in the measurable non-BRCA cohort. The most common grade 3 or higher adverse events were hematological (anemia, thrombocytopenia, and neutropenia). These adverse events were manageable with treatment interruptions, dose reductions, or supportive measures.

Study details: An open-label, single-arm, phase 2 GALAHAD study of 289 patients with histologically confirmed mCRPC and DRD who were treated with niraparib.

Disclosures: This study was sponsored by Janssen Research & Development. The authors received grants, contracts, payments, honoraria, travel support, and consulting/advisory/personal fees or reported being in a leadership role, holding stocks, or other ownership roles relative to Janssen Research & Development.

Source: Smith MR et al. Lancet Oncol. 2022 (Feb 4). Doi: 10.1016/S1470-2045(21)00757-9.

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Metastatic CRPC: Autologous dendritic cell-based immunotherapy fails to extend survival

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Key clinical point: The addition of dendritic cell vaccine immunotherapy for prostate cancer (DCVAC/PCa) to chemotherapy followed by DCVAC/PCa maintenance therapy does not extend overall survival in patients with metastatic castration-resistant prostate cancer (mCRPC).

Major finding: The overall survival was not significantly different between the DCVAC/PCa and placebo groups (median 23.9 months vs. 24.3 months; hazard ratio 1.04; P = .60). The treatment-emergent adverse event rate was 9.2% in the DCVAC/PCa group and 12.7% in the placebo group.

Study details: A double-blind, parallel-group, placebo-controlled, phase 3 randomized VIABLE study of 1,182 patients with mCRPC who were randomly assigned to receive DCVAC/PCa plus chemotherapy followed by DCVAC/PCa (n = 787) or placebo (n = 395).

Disclosures: This study was sponsored by Sotio a.s. The authors received research funding, grants, personal/advisory/consulting fees, and nonfinancial support or had stock ownership or patents.

Source: Vogelzang NJ et al. JAMA Oncol. 2022 (Feb 10). Doi: 10.1001/jamaoncol.2021.7298.

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Key clinical point: The addition of dendritic cell vaccine immunotherapy for prostate cancer (DCVAC/PCa) to chemotherapy followed by DCVAC/PCa maintenance therapy does not extend overall survival in patients with metastatic castration-resistant prostate cancer (mCRPC).

Major finding: The overall survival was not significantly different between the DCVAC/PCa and placebo groups (median 23.9 months vs. 24.3 months; hazard ratio 1.04; P = .60). The treatment-emergent adverse event rate was 9.2% in the DCVAC/PCa group and 12.7% in the placebo group.

Study details: A double-blind, parallel-group, placebo-controlled, phase 3 randomized VIABLE study of 1,182 patients with mCRPC who were randomly assigned to receive DCVAC/PCa plus chemotherapy followed by DCVAC/PCa (n = 787) or placebo (n = 395).

Disclosures: This study was sponsored by Sotio a.s. The authors received research funding, grants, personal/advisory/consulting fees, and nonfinancial support or had stock ownership or patents.

Source: Vogelzang NJ et al. JAMA Oncol. 2022 (Feb 10). Doi: 10.1001/jamaoncol.2021.7298.

Key clinical point: The addition of dendritic cell vaccine immunotherapy for prostate cancer (DCVAC/PCa) to chemotherapy followed by DCVAC/PCa maintenance therapy does not extend overall survival in patients with metastatic castration-resistant prostate cancer (mCRPC).

Major finding: The overall survival was not significantly different between the DCVAC/PCa and placebo groups (median 23.9 months vs. 24.3 months; hazard ratio 1.04; P = .60). The treatment-emergent adverse event rate was 9.2% in the DCVAC/PCa group and 12.7% in the placebo group.

Study details: A double-blind, parallel-group, placebo-controlled, phase 3 randomized VIABLE study of 1,182 patients with mCRPC who were randomly assigned to receive DCVAC/PCa plus chemotherapy followed by DCVAC/PCa (n = 787) or placebo (n = 395).

Disclosures: This study was sponsored by Sotio a.s. The authors received research funding, grants, personal/advisory/consulting fees, and nonfinancial support or had stock ownership or patents.

Source: Vogelzang NJ et al. JAMA Oncol. 2022 (Feb 10). Doi: 10.1001/jamaoncol.2021.7298.

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Can first‐trimester HbA1c levels offer effective GDM diagnosis?

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Key clinical point: Although high first‐trimester glycated hemoglobin (HbA1c) levels are predictive of gestational diabetes mellitus (GDM), they cannot ensure effective GDM diagnosis owing to subpar sensitivity or specificity.

Main finding: An HbA1c cutoff value of 4.85% ruled out GDM with a diagnostic sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) of 92.2%, 32.8%, 95.5%, and 21.2%, respectively, whereas HbA1c cutoff value of 5.45% for diagnosing GDM decreased sensitivity (54.8%) while increasing specificity (96.8%), with the NPV and PPV being 91.5% and 76.8%, respectively.

Study details: The data are derived from a single-center prospective study including 700 singleton pregnant women over 18 years of age who did not have type I or II diabetes mellitus.

Disclosures: The study was not funded by any source. The authors reported having no conflicts of interest.

Source: Valadan M et al. BMC Pregnancy Childbirth. 2022;22:71 (Jan 27). Doi: 10.1186/s12884-021-04330-2.

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Key clinical point: Although high first‐trimester glycated hemoglobin (HbA1c) levels are predictive of gestational diabetes mellitus (GDM), they cannot ensure effective GDM diagnosis owing to subpar sensitivity or specificity.

Main finding: An HbA1c cutoff value of 4.85% ruled out GDM with a diagnostic sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) of 92.2%, 32.8%, 95.5%, and 21.2%, respectively, whereas HbA1c cutoff value of 5.45% for diagnosing GDM decreased sensitivity (54.8%) while increasing specificity (96.8%), with the NPV and PPV being 91.5% and 76.8%, respectively.

Study details: The data are derived from a single-center prospective study including 700 singleton pregnant women over 18 years of age who did not have type I or II diabetes mellitus.

Disclosures: The study was not funded by any source. The authors reported having no conflicts of interest.

Source: Valadan M et al. BMC Pregnancy Childbirth. 2022;22:71 (Jan 27). Doi: 10.1186/s12884-021-04330-2.

Key clinical point: Although high first‐trimester glycated hemoglobin (HbA1c) levels are predictive of gestational diabetes mellitus (GDM), they cannot ensure effective GDM diagnosis owing to subpar sensitivity or specificity.

Main finding: An HbA1c cutoff value of 4.85% ruled out GDM with a diagnostic sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) of 92.2%, 32.8%, 95.5%, and 21.2%, respectively, whereas HbA1c cutoff value of 5.45% for diagnosing GDM decreased sensitivity (54.8%) while increasing specificity (96.8%), with the NPV and PPV being 91.5% and 76.8%, respectively.

Study details: The data are derived from a single-center prospective study including 700 singleton pregnant women over 18 years of age who did not have type I or II diabetes mellitus.

Disclosures: The study was not funded by any source. The authors reported having no conflicts of interest.

Source: Valadan M et al. BMC Pregnancy Childbirth. 2022;22:71 (Jan 27). Doi: 10.1186/s12884-021-04330-2.

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Copresence of amniotic fluid sludge and a short cervix affects preterm birth in women with cerclage

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Key clinical point: Presence of amniotic fluid sludge (AFS) in the midtrimester may serve as an additional ultrasound index for predicting preterm birth in women with a short cervical length (CL; 25 mm) who have undergone cervical cerclage.

Main finding: In patients who underwent cerclage, AFS and short CL were associated with preterm birth at <28 weeks and <36 weeks (all P < .05). In women with a short CL, the presence of AFS was significantly associated with short gestational age at delivery even after adjusting for possible confounders (adjusted hazard ratio 2.45; 95% CI 1.7-3.5).

Study details: This was a single-center retrospective cohort study involving 296 singleton pregnant women who underwent McDonald cerclage for cervical insufficiency, transvaginal ultrasound-diagnosed short CL, or cervical dilatation with amniotic sac bulging, followed by evaluation of the presence of AFS and CL at 14-24 weeks of gestation within 2 weeks after cerclage.

Disclosures: The authors reported no source of funding or conflict of interests concerning the study.

Source: Huang Y et al. J Ultrasound Med. 2022 (Feb 2). Doi: 10.1002/jum.15952.

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Key clinical point: Presence of amniotic fluid sludge (AFS) in the midtrimester may serve as an additional ultrasound index for predicting preterm birth in women with a short cervical length (CL; 25 mm) who have undergone cervical cerclage.

Main finding: In patients who underwent cerclage, AFS and short CL were associated with preterm birth at <28 weeks and <36 weeks (all P < .05). In women with a short CL, the presence of AFS was significantly associated with short gestational age at delivery even after adjusting for possible confounders (adjusted hazard ratio 2.45; 95% CI 1.7-3.5).

Study details: This was a single-center retrospective cohort study involving 296 singleton pregnant women who underwent McDonald cerclage for cervical insufficiency, transvaginal ultrasound-diagnosed short CL, or cervical dilatation with amniotic sac bulging, followed by evaluation of the presence of AFS and CL at 14-24 weeks of gestation within 2 weeks after cerclage.

Disclosures: The authors reported no source of funding or conflict of interests concerning the study.

Source: Huang Y et al. J Ultrasound Med. 2022 (Feb 2). Doi: 10.1002/jum.15952.

Key clinical point: Presence of amniotic fluid sludge (AFS) in the midtrimester may serve as an additional ultrasound index for predicting preterm birth in women with a short cervical length (CL; 25 mm) who have undergone cervical cerclage.

Main finding: In patients who underwent cerclage, AFS and short CL were associated with preterm birth at <28 weeks and <36 weeks (all P < .05). In women with a short CL, the presence of AFS was significantly associated with short gestational age at delivery even after adjusting for possible confounders (adjusted hazard ratio 2.45; 95% CI 1.7-3.5).

Study details: This was a single-center retrospective cohort study involving 296 singleton pregnant women who underwent McDonald cerclage for cervical insufficiency, transvaginal ultrasound-diagnosed short CL, or cervical dilatation with amniotic sac bulging, followed by evaluation of the presence of AFS and CL at 14-24 weeks of gestation within 2 weeks after cerclage.

Disclosures: The authors reported no source of funding or conflict of interests concerning the study.

Source: Huang Y et al. J Ultrasound Med. 2022 (Feb 2). Doi: 10.1002/jum.15952.

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