Hepatocellular Carcinoma

Key clinical point: Hepatic arterial infusion chemotherapy is a safe and effective treatment option for patients with advanced hepatocellular carcinoma and portal vein tumor thrombosis (PVTT).

Major finding: Overall survival rates were 29.2 months, 4.55 months, and 11.52 months for HCC patients with PVTT who were treated with hepatic arterial infusion chemotherapy, best supportive care, and sorafenib, respectively.

Study details: The data come from a case-control study of 91 adults with advanced HCC and portal vein tumor thrombosis; 20 were treated with hepatic arterial infusion chemotherapy (HAIC), while 42 received best supportive care, and 29 received sorafenib.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Abdelmaksoud AHK et al. Clin Radiol. 2021 Jun 8. doi: 10.1016/j.crad.2021.03.022.

Key clinical point: Hepatic arterial infusion chemotherapy is a safe and effective treatment option for patients with advanced hepatocellular carcinoma and portal vein tumor thrombosis (PVTT).

Major finding: Overall survival rates were 29.2 months, 4.55 months, and 11.52 months for HCC patients with PVTT who were treated with hepatic arterial infusion chemotherapy, best supportive care, and sorafenib, respectively.

Study details: The data come from a case-control study of 91 adults with advanced HCC and portal vein tumor thrombosis; 20 were treated with hepatic arterial infusion chemotherapy (HAIC), while 42 received best supportive care, and 29 received sorafenib.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Abdelmaksoud AHK et al. Clin Radiol. 2021 Jun 8. doi: 10.1016/j.crad.2021.03.022.

Key clinical point: Hepatic arterial infusion chemotherapy is a safe and effective treatment option for patients with advanced hepatocellular carcinoma and portal vein tumor thrombosis (PVTT).

Major finding: Overall survival rates were 29.2 months, 4.55 months, and 11.52 months for HCC patients with PVTT who were treated with hepatic arterial infusion chemotherapy, best supportive care, and sorafenib, respectively.

Study details: The data come from a case-control study of 91 adults with advanced HCC and portal vein tumor thrombosis; 20 were treated with hepatic arterial infusion chemotherapy (HAIC), while 42 received best supportive care, and 29 received sorafenib.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Abdelmaksoud AHK et al. Clin Radiol. 2021 Jun 8. doi: 10.1016/j.crad.2021.03.022.

Key clinical point: The objective response rate and disease control rate for MPVTT was significantly higher and mortality significantly lower in HCC patients who received a combination of helical I-125 seed implantation plus TACE compared to those who received TACE only.

Major finding: The optimal objective response rate was 52.4% in the seed implantation plus TACE group vs. 4.0% in the TACE-only group; disease control rates were 85.7% vs. 32.0%, respectively.

Study details: The data come from 46 HCC patients with main portal vein tumor thrombus (MPVTT) who were randomized to helical I-125 seed implantation and transarterial chemoembolization (TACE) or TACE alone.

Disclosures: The study was supported by the Suzhou Science and Technology Bureau Project, Jiangsu Provincial Medical Talent funding, the National Natural Science Foundation of China, and the Suzhou People's Livelihood Science and Technology Project. The researchers had no financial conflicts to disclose.

Source: Wang W et al. Cardiovasc Intervent Radiol. 2021 Jun 11. doi: 10.1007/s00270-021-02887-1.

Key clinical point: The objective response rate and disease control rate for MPVTT was significantly higher and mortality significantly lower in HCC patients who received a combination of helical I-125 seed implantation plus TACE compared to those who received TACE only.

Major finding: The optimal objective response rate was 52.4% in the seed implantation plus TACE group vs. 4.0% in the TACE-only group; disease control rates were 85.7% vs. 32.0%, respectively.

Study details: The data come from 46 HCC patients with main portal vein tumor thrombus (MPVTT) who were randomized to helical I-125 seed implantation and transarterial chemoembolization (TACE) or TACE alone.

Disclosures: The study was supported by the Suzhou Science and Technology Bureau Project, Jiangsu Provincial Medical Talent funding, the National Natural Science Foundation of China, and the Suzhou People's Livelihood Science and Technology Project. The researchers had no financial conflicts to disclose.

Source: Wang W et al. Cardiovasc Intervent Radiol. 2021 Jun 11. doi: 10.1007/s00270-021-02887-1.

Key clinical point: The objective response rate and disease control rate for MPVTT was significantly higher and mortality significantly lower in HCC patients who received a combination of helical I-125 seed implantation plus TACE compared to those who received TACE only.

Major finding: The optimal objective response rate was 52.4% in the seed implantation plus TACE group vs. 4.0% in the TACE-only group; disease control rates were 85.7% vs. 32.0%, respectively.

Study details: The data come from 46 HCC patients with main portal vein tumor thrombus (MPVTT) who were randomized to helical I-125 seed implantation and transarterial chemoembolization (TACE) or TACE alone.

Disclosures: The study was supported by the Suzhou Science and Technology Bureau Project, Jiangsu Provincial Medical Talent funding, the National Natural Science Foundation of China, and the Suzhou People's Livelihood Science and Technology Project. The researchers had no financial conflicts to disclose.

Source: Wang W et al. Cardiovasc Intervent Radiol. 2021 Jun 11. doi: 10.1007/s00270-021-02887-1.

Key clinical point: Overall survival and recurrence were not significantly different for patients with HCC when selection protocols expanded the criteria for tumor size and number and included alpha-fetoprotein levels.

Major finding: The 5-year overall survival in the UCSF and UCSF+ groups was 72% and 69%, respectively, (P = 0.7); the recurrence risk was 13% and 36%, respectively (P = 0.1). In addition, the 5-year overall survival rate was 85% among low-risk MVI patients.

Study details: The data come from a retrospective review of 244 adults with preoperative HCC who underwent living donor liver transplantation for HCC, including 159 who met the University of California San Francisco (UCSF) transplant criteria (single tumor ≤ 6.5 cm, up to 3 tumors ≤ 4.5 cm, total tumor diameter ≤ 8 cm), 58 patients whose largest tumor was 10 cm or less (described as UCSF+), and 27 who had macrovascular invasion.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.  

Source: Bhatti ABH et al. J Cancer Res Clin Oncol. 2021 June 12. doi: 10.1007/s00432-021-03665-9.

Key clinical point: Overall survival and recurrence were not significantly different for patients with HCC when selection protocols expanded the criteria for tumor size and number and included alpha-fetoprotein levels.

Major finding: The 5-year overall survival in the UCSF and UCSF+ groups was 72% and 69%, respectively, (P = 0.7); the recurrence risk was 13% and 36%, respectively (P = 0.1). In addition, the 5-year overall survival rate was 85% among low-risk MVI patients.

Study details: The data come from a retrospective review of 244 adults with preoperative HCC who underwent living donor liver transplantation for HCC, including 159 who met the University of California San Francisco (UCSF) transplant criteria (single tumor ≤ 6.5 cm, up to 3 tumors ≤ 4.5 cm, total tumor diameter ≤ 8 cm), 58 patients whose largest tumor was 10 cm or less (described as UCSF+), and 27 who had macrovascular invasion.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.  

Source: Bhatti ABH et al. J Cancer Res Clin Oncol. 2021 June 12. doi: 10.1007/s00432-021-03665-9.

Key clinical point: Overall survival and recurrence were not significantly different for patients with HCC when selection protocols expanded the criteria for tumor size and number and included alpha-fetoprotein levels.

Major finding: The 5-year overall survival in the UCSF and UCSF+ groups was 72% and 69%, respectively, (P = 0.7); the recurrence risk was 13% and 36%, respectively (P = 0.1). In addition, the 5-year overall survival rate was 85% among low-risk MVI patients.

Study details: The data come from a retrospective review of 244 adults with preoperative HCC who underwent living donor liver transplantation for HCC, including 159 who met the University of California San Francisco (UCSF) transplant criteria (single tumor ≤ 6.5 cm, up to 3 tumors ≤ 4.5 cm, total tumor diameter ≤ 8 cm), 58 patients whose largest tumor was 10 cm or less (described as UCSF+), and 27 who had macrovascular invasion.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.  

Source: Bhatti ABH et al. J Cancer Res Clin Oncol. 2021 June 12. doi: 10.1007/s00432-021-03665-9.

Key clinical point: A prognostic model based on immune-related genes showed promise as a predictor of overall survival in hepatocellular carcinoma patients; 7 genes were better prognosticators than the tumor/node/metastasis (TNM) staging system.

Major finding: Clinical outcomes in HCC patients were associated with 100 immune-related differentially-expressed genes (DEGs). The researchers identified 7 prognostic immune-related genes (IRGs) after combining data types from multiple databases: Fatty Acid Binding Protein 6 (FABP6), Microtubule-Associated Protein Tau (MAPT), Baculoviral IAP Repeat Containing 5 (BIRC5), Plexin-A1 (PLXNA1), Secreted Phosphoprotein 1 (SPP1), Stanniocalcin 2 (STC2) and Chondroitin Sulfate Proteoglycan 5 (CSPG5).

Study details: The data come from 424 adults with hepatocellular carcinoma; the researchers integrated RNA sequencing profiles from the patients with immune-related genes to calculate immune-related differentially-expressed genes.

Disclosures: The study was supported in part by Guangzhou University of Chinese Medicine, Guangzhou University of Chinese Medicine National University Student Innovation and Entrepreneurship Training Project, and the First Affiliated Hospital of Guangzhou University of Chinese Medicine Innovation and Student Training Team Incubation Project. The researchers had no financial conflicts to disclose.

Source: Yan Q et al. BioData Min. 2021 May 7. doi: 0.1186/s13040-021-00261-y.

Key clinical point: A prognostic model based on immune-related genes showed promise as a predictor of overall survival in hepatocellular carcinoma patients; 7 genes were better prognosticators than the tumor/node/metastasis (TNM) staging system.

Major finding: Clinical outcomes in HCC patients were associated with 100 immune-related differentially-expressed genes (DEGs). The researchers identified 7 prognostic immune-related genes (IRGs) after combining data types from multiple databases: Fatty Acid Binding Protein 6 (FABP6), Microtubule-Associated Protein Tau (MAPT), Baculoviral IAP Repeat Containing 5 (BIRC5), Plexin-A1 (PLXNA1), Secreted Phosphoprotein 1 (SPP1), Stanniocalcin 2 (STC2) and Chondroitin Sulfate Proteoglycan 5 (CSPG5).

Study details: The data come from 424 adults with hepatocellular carcinoma; the researchers integrated RNA sequencing profiles from the patients with immune-related genes to calculate immune-related differentially-expressed genes.

Disclosures: The study was supported in part by Guangzhou University of Chinese Medicine, Guangzhou University of Chinese Medicine National University Student Innovation and Entrepreneurship Training Project, and the First Affiliated Hospital of Guangzhou University of Chinese Medicine Innovation and Student Training Team Incubation Project. The researchers had no financial conflicts to disclose.

Source: Yan Q et al. BioData Min. 2021 May 7. doi: 0.1186/s13040-021-00261-y.

Key clinical point: A prognostic model based on immune-related genes showed promise as a predictor of overall survival in hepatocellular carcinoma patients; 7 genes were better prognosticators than the tumor/node/metastasis (TNM) staging system.

Major finding: Clinical outcomes in HCC patients were associated with 100 immune-related differentially-expressed genes (DEGs). The researchers identified 7 prognostic immune-related genes (IRGs) after combining data types from multiple databases: Fatty Acid Binding Protein 6 (FABP6), Microtubule-Associated Protein Tau (MAPT), Baculoviral IAP Repeat Containing 5 (BIRC5), Plexin-A1 (PLXNA1), Secreted Phosphoprotein 1 (SPP1), Stanniocalcin 2 (STC2) and Chondroitin Sulfate Proteoglycan 5 (CSPG5).

Study details: The data come from 424 adults with hepatocellular carcinoma; the researchers integrated RNA sequencing profiles from the patients with immune-related genes to calculate immune-related differentially-expressed genes.

Disclosures: The study was supported in part by Guangzhou University of Chinese Medicine, Guangzhou University of Chinese Medicine National University Student Innovation and Entrepreneurship Training Project, and the First Affiliated Hospital of Guangzhou University of Chinese Medicine Innovation and Student Training Team Incubation Project. The researchers had no financial conflicts to disclose.

Source: Yan Q et al. BioData Min. 2021 May 7. doi: 0.1186/s13040-021-00261-y.

Treatment of hepatocellular carcinoma (HCC) benefits from a multidisciplinary approach. This month we will review some articles that address both localized and systemic therapies.

The first paper is a retrospective review of patients who underwent living donor liver transplantation (LDLT). Bhatti et al reviewed the outcomes of 244 patients with HCC who underwent LDLT at one center. All patients had AFP <1000 at time of LDLT. Out of those, 159 had tumors within UCSF criteria (single tumor ≤ 6.5 cm, up to 3 tumors ≤ 4.5 cm, total tumor diameter ≤ 8 cm), while 58 patients had tumors that were outside UCSF but <10cm, and 27 patients who were outside UCSF with macrovascular invasion (UCSF+). All patients within UCSF criteria were offered upfront LDLT. Patients outside UCSF criteria (UCSF+) were also considered for upfront LDLT, however patients with AFP >1000 ng/ml and UCSF + tumors were considered for downstaging. The authors reported that survival at 5 years was similar in the UCSF and UCSF+ groups (72% vs 69%, P = 0.7), while the rate of HCC recurrence was 13% vs 36% (P = 0.1). They concluded that carefully selected patients with HCC outside UCSF may benefit from LDLT.

Chemoembolization is a common treatment used for patients with localized HCC. Postembolization syndrome (abdominal pain, nausea, vomiting, fever and/or infection) is a frequent complication that adversely affects the patient’s quality of life. Lu et al report the results of a retrospective study of the use of dexamethasone in patients undergoing transarterial chemoembolization (TACE). The course of 255 HCC patients who underwent TACE were reviewed. The patients were divided into 2 nonrandomized groups to receive TACE using lipiodol + chemotherapeutic emulsion group (133 patients) or TACE using lipiodol + dexamethasone 10 mg + chemotherapeutic emulsion group (122 patients). Incidence of postembolization syndrome was reduced in the dexamethasone group: abdominal pain, 55.6% vs 36.1% (P = .002); fever, 37.6% vs 13.1% (P < .05); nausea, 60.9% vs 41.0% (P = .001); vomiting, 48.1% vs 21.3% (P < .05). Incidence of infection was 1.5% vs 2.5% (P = .583). The authors concluded that the incidence of postembolization syndrome could be reduced by adding dexamethasone to TACE.

Hepatic arterial infusion (HAI) chemotherapy has been used in the treatment of several types of liver-dominant tumors. Abdelmaksoud et al report on their experience using HAI to treat HCC with portal vein thrombosis and compensated cirrhosis. In this case-controlled study, 20 patients were treated with HAIC (50 mg doxorubicin and 50 mg cisplatin infused into the hepatic artery), 42 patients received best supportive care, and 29 patients were treated with sorafenib. The authors report that patients who received HAI had the longest survival compared with the best supportive care and sorafenib groups (29.2 ± 21.8, 4.55 ± 11.41, and 11.52 ± 8.72 months respectively, P = 0.007), concluding that HAI is an effective option for selected patients with HCC and portal vein thrombosis.

Finally, Hiraoka et al reported a retrospective study of 171 adults with unresectable HCC who received systemic therapy with atezolizumab with bevacizumab. In this report, only 75 patients received this as their first-line systemic therapy. After 6 weeks of treatment, the overall response rate was 10.6% (9.7% for previously treated and 12.2% for previously untreated), and the disease control rate was 79.6%.  In 111 patients, the albumin-bilirubin score that assesses liver function was significantly worse at 3 weeks after starting treatment (−2.525 ± 0.419 vs −2.323 ± 0.445, P < .001), but then recovered at 6-weeks, confirming the efficacy and safety of this treatment regimen.

Treatment of hepatocellular carcinoma (HCC) benefits from a multidisciplinary approach. This month we will review some articles that address both localized and systemic therapies.

The first paper is a retrospective review of patients who underwent living donor liver transplantation (LDLT). Bhatti et al reviewed the outcomes of 244 patients with HCC who underwent LDLT at one center. All patients had AFP <1000 at time of LDLT. Out of those, 159 had tumors within UCSF criteria (single tumor ≤ 6.5 cm, up to 3 tumors ≤ 4.5 cm, total tumor diameter ≤ 8 cm), while 58 patients had tumors that were outside UCSF but <10cm, and 27 patients who were outside UCSF with macrovascular invasion (UCSF+). All patients within UCSF criteria were offered upfront LDLT. Patients outside UCSF criteria (UCSF+) were also considered for upfront LDLT, however patients with AFP >1000 ng/ml and UCSF + tumors were considered for downstaging. The authors reported that survival at 5 years was similar in the UCSF and UCSF+ groups (72% vs 69%, P = 0.7), while the rate of HCC recurrence was 13% vs 36% (P = 0.1). They concluded that carefully selected patients with HCC outside UCSF may benefit from LDLT.

Chemoembolization is a common treatment used for patients with localized HCC. Postembolization syndrome (abdominal pain, nausea, vomiting, fever and/or infection) is a frequent complication that adversely affects the patient’s quality of life. Lu et al report the results of a retrospective study of the use of dexamethasone in patients undergoing transarterial chemoembolization (TACE). The course of 255 HCC patients who underwent TACE were reviewed. The patients were divided into 2 nonrandomized groups to receive TACE using lipiodol + chemotherapeutic emulsion group (133 patients) or TACE using lipiodol + dexamethasone 10 mg + chemotherapeutic emulsion group (122 patients). Incidence of postembolization syndrome was reduced in the dexamethasone group: abdominal pain, 55.6% vs 36.1% (P = .002); fever, 37.6% vs 13.1% (P < .05); nausea, 60.9% vs 41.0% (P = .001); vomiting, 48.1% vs 21.3% (P < .05). Incidence of infection was 1.5% vs 2.5% (P = .583). The authors concluded that the incidence of postembolization syndrome could be reduced by adding dexamethasone to TACE.

Hepatic arterial infusion (HAI) chemotherapy has been used in the treatment of several types of liver-dominant tumors. Abdelmaksoud et al report on their experience using HAI to treat HCC with portal vein thrombosis and compensated cirrhosis. In this case-controlled study, 20 patients were treated with HAIC (50 mg doxorubicin and 50 mg cisplatin infused into the hepatic artery), 42 patients received best supportive care, and 29 patients were treated with sorafenib. The authors report that patients who received HAI had the longest survival compared with the best supportive care and sorafenib groups (29.2 ± 21.8, 4.55 ± 11.41, and 11.52 ± 8.72 months respectively, P = 0.007), concluding that HAI is an effective option for selected patients with HCC and portal vein thrombosis.

Finally, Hiraoka et al reported a retrospective study of 171 adults with unresectable HCC who received systemic therapy with atezolizumab with bevacizumab. In this report, only 75 patients received this as their first-line systemic therapy. After 6 weeks of treatment, the overall response rate was 10.6% (9.7% for previously treated and 12.2% for previously untreated), and the disease control rate was 79.6%.  In 111 patients, the albumin-bilirubin score that assesses liver function was significantly worse at 3 weeks after starting treatment (−2.525 ± 0.419 vs −2.323 ± 0.445, P < .001), but then recovered at 6-weeks, confirming the efficacy and safety of this treatment regimen.

Treatment of hepatocellular carcinoma (HCC) benefits from a multidisciplinary approach. This month we will review some articles that address both localized and systemic therapies.

The first paper is a retrospective review of patients who underwent living donor liver transplantation (LDLT). Bhatti et al reviewed the outcomes of 244 patients with HCC who underwent LDLT at one center. All patients had AFP <1000 at time of LDLT. Out of those, 159 had tumors within UCSF criteria (single tumor ≤ 6.5 cm, up to 3 tumors ≤ 4.5 cm, total tumor diameter ≤ 8 cm), while 58 patients had tumors that were outside UCSF but <10cm, and 27 patients who were outside UCSF with macrovascular invasion (UCSF+). All patients within UCSF criteria were offered upfront LDLT. Patients outside UCSF criteria (UCSF+) were also considered for upfront LDLT, however patients with AFP >1000 ng/ml and UCSF + tumors were considered for downstaging. The authors reported that survival at 5 years was similar in the UCSF and UCSF+ groups (72% vs 69%, P = 0.7), while the rate of HCC recurrence was 13% vs 36% (P = 0.1). They concluded that carefully selected patients with HCC outside UCSF may benefit from LDLT.

Chemoembolization is a common treatment used for patients with localized HCC. Postembolization syndrome (abdominal pain, nausea, vomiting, fever and/or infection) is a frequent complication that adversely affects the patient’s quality of life. Lu et al report the results of a retrospective study of the use of dexamethasone in patients undergoing transarterial chemoembolization (TACE). The course of 255 HCC patients who underwent TACE were reviewed. The patients were divided into 2 nonrandomized groups to receive TACE using lipiodol + chemotherapeutic emulsion group (133 patients) or TACE using lipiodol + dexamethasone 10 mg + chemotherapeutic emulsion group (122 patients). Incidence of postembolization syndrome was reduced in the dexamethasone group: abdominal pain, 55.6% vs 36.1% (P = .002); fever, 37.6% vs 13.1% (P < .05); nausea, 60.9% vs 41.0% (P = .001); vomiting, 48.1% vs 21.3% (P < .05). Incidence of infection was 1.5% vs 2.5% (P = .583). The authors concluded that the incidence of postembolization syndrome could be reduced by adding dexamethasone to TACE.

Hepatic arterial infusion (HAI) chemotherapy has been used in the treatment of several types of liver-dominant tumors. Abdelmaksoud et al report on their experience using HAI to treat HCC with portal vein thrombosis and compensated cirrhosis. In this case-controlled study, 20 patients were treated with HAIC (50 mg doxorubicin and 50 mg cisplatin infused into the hepatic artery), 42 patients received best supportive care, and 29 patients were treated with sorafenib. The authors report that patients who received HAI had the longest survival compared with the best supportive care and sorafenib groups (29.2 ± 21.8, 4.55 ± 11.41, and 11.52 ± 8.72 months respectively, P = 0.007), concluding that HAI is an effective option for selected patients with HCC and portal vein thrombosis.

Finally, Hiraoka et al reported a retrospective study of 171 adults with unresectable HCC who received systemic therapy with atezolizumab with bevacizumab. In this report, only 75 patients received this as their first-line systemic therapy. After 6 weeks of treatment, the overall response rate was 10.6% (9.7% for previously treated and 12.2% for previously untreated), and the disease control rate was 79.6%.  In 111 patients, the albumin-bilirubin score that assesses liver function was significantly worse at 3 weeks after starting treatment (−2.525 ± 0.419 vs −2.323 ± 0.445, P < .001), but then recovered at 6-weeks, confirming the efficacy and safety of this treatment regimen.

Key clinical point: Insertion of a hydrogel spacer significantly reduced rectal doses in prostate cancer patients undergoing stereotactic body radiotherapy, and no severe adverse events related to the spacer procedure were observed.

Major finding: Rectal doses after spacer insertion were significantly lower than before spacer insertion. The primary endpoint of grade 2 acute gastrointestinal toxicity within 3 months occurred in 7 patients (18%), and a secondary endpoint of grade 2 acute genitourinary toxicity occurred in 17 patients. (44%).

Study details: The data come from a prospective, single-center, phase II safety and efficacy study including 40 men aged 20-80 years with prostate cancer. Patients received a hydrogel spacer inserted into the perirectal space between the prostate and rectum before undergoing stereotactic body radiotherapy (SBRT).

Disclosures: The study was funded by MEXT KAKENHI. The researchers had no financial conflicts to disclose.

Source: Ogita M et al. Radiat Oncol. 2021 Jun 12. doi: 10.1186/s13014-021-01834-1.

Key clinical point: Insertion of a hydrogel spacer significantly reduced rectal doses in prostate cancer patients undergoing stereotactic body radiotherapy, and no severe adverse events related to the spacer procedure were observed.

Major finding: Rectal doses after spacer insertion were significantly lower than before spacer insertion. The primary endpoint of grade 2 acute gastrointestinal toxicity within 3 months occurred in 7 patients (18%), and a secondary endpoint of grade 2 acute genitourinary toxicity occurred in 17 patients. (44%).

Study details: The data come from a prospective, single-center, phase II safety and efficacy study including 40 men aged 20-80 years with prostate cancer. Patients received a hydrogel spacer inserted into the perirectal space between the prostate and rectum before undergoing stereotactic body radiotherapy (SBRT).

Disclosures: The study was funded by MEXT KAKENHI. The researchers had no financial conflicts to disclose.

Source: Ogita M et al. Radiat Oncol. 2021 Jun 12. doi: 10.1186/s13014-021-01834-1.

Key clinical point: Insertion of a hydrogel spacer significantly reduced rectal doses in prostate cancer patients undergoing stereotactic body radiotherapy, and no severe adverse events related to the spacer procedure were observed.

Major finding: Rectal doses after spacer insertion were significantly lower than before spacer insertion. The primary endpoint of grade 2 acute gastrointestinal toxicity within 3 months occurred in 7 patients (18%), and a secondary endpoint of grade 2 acute genitourinary toxicity occurred in 17 patients. (44%).

Study details: The data come from a prospective, single-center, phase II safety and efficacy study including 40 men aged 20-80 years with prostate cancer. Patients received a hydrogel spacer inserted into the perirectal space between the prostate and rectum before undergoing stereotactic body radiotherapy (SBRT).

Disclosures: The study was funded by MEXT KAKENHI. The researchers had no financial conflicts to disclose.

Source: Ogita M et al. Radiat Oncol. 2021 Jun 12. doi: 10.1186/s13014-021-01834-1.

Key clinical point: Median lobe hyperplasia did not interfere with low-dose-rate brachytherapy, but seed migration and degree of cold spots was higher in patients with severe MLH.

Major finding: Migration of iodine-125 seeds occurred in 10 (31.5%) of 32 prostate cancer patients with MLH and 61 (31.6%) of 193 prostate cancer patients without MLH.

Study details: The data come from an analysis of 32 prostate cancer patients with median lobe hyperplasia (MLH) and 193 without MLH; all patients were treated with loose iodine-125 seeds. MLH patients were classified as mild (< 10 mm) or severe (≥ 10 mm) based on the distance between the posterior transitional zone and the prostatic tissue protruding into the bladder.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Muraki K et al. J Contemp Brachytherapy. 2021 Jun 13. doi: 10.5114/jcb.2021.105944.

Key clinical point: Median lobe hyperplasia did not interfere with low-dose-rate brachytherapy, but seed migration and degree of cold spots was higher in patients with severe MLH.

Major finding: Migration of iodine-125 seeds occurred in 10 (31.5%) of 32 prostate cancer patients with MLH and 61 (31.6%) of 193 prostate cancer patients without MLH.

Study details: The data come from an analysis of 32 prostate cancer patients with median lobe hyperplasia (MLH) and 193 without MLH; all patients were treated with loose iodine-125 seeds. MLH patients were classified as mild (< 10 mm) or severe (≥ 10 mm) based on the distance between the posterior transitional zone and the prostatic tissue protruding into the bladder.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Muraki K et al. J Contemp Brachytherapy. 2021 Jun 13. doi: 10.5114/jcb.2021.105944.

Key clinical point: Median lobe hyperplasia did not interfere with low-dose-rate brachytherapy, but seed migration and degree of cold spots was higher in patients with severe MLH.

Major finding: Migration of iodine-125 seeds occurred in 10 (31.5%) of 32 prostate cancer patients with MLH and 61 (31.6%) of 193 prostate cancer patients without MLH.

Study details: The data come from an analysis of 32 prostate cancer patients with median lobe hyperplasia (MLH) and 193 without MLH; all patients were treated with loose iodine-125 seeds. MLH patients were classified as mild (< 10 mm) or severe (≥ 10 mm) based on the distance between the posterior transitional zone and the prostatic tissue protruding into the bladder.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Muraki K et al. J Contemp Brachytherapy. 2021 Jun 13. doi: 10.5114/jcb.2021.105944.

Key clinical point: Approximately half of the studies (16) in a systematic review showed no association between androgen deprivation therapy and reduced cognitive function in prostate cancer patients; however, 11 of the 31 studies showed a negative effect on cognitive functioning.

Major finding: A total of 18 studies used a prospective design to assess the impact of androgen deprivation therapy on cognitive function, totaling 968 individuals. Of these, 9 studies showed no significant effect of ADT on cognitive function.

Study details: The data come from a systematic review of 31 studies published up to February 2020.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Andela CD et al. Int J Urol. 2021 Jun 14.  doi: 10.1111/iju.14596. 

Key clinical point: Approximately half of the studies (16) in a systematic review showed no association between androgen deprivation therapy and reduced cognitive function in prostate cancer patients; however, 11 of the 31 studies showed a negative effect on cognitive functioning.

Major finding: A total of 18 studies used a prospective design to assess the impact of androgen deprivation therapy on cognitive function, totaling 968 individuals. Of these, 9 studies showed no significant effect of ADT on cognitive function.

Study details: The data come from a systematic review of 31 studies published up to February 2020.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Andela CD et al. Int J Urol. 2021 Jun 14.  doi: 10.1111/iju.14596. 

Key clinical point: Approximately half of the studies (16) in a systematic review showed no association between androgen deprivation therapy and reduced cognitive function in prostate cancer patients; however, 11 of the 31 studies showed a negative effect on cognitive functioning.

Major finding: A total of 18 studies used a prospective design to assess the impact of androgen deprivation therapy on cognitive function, totaling 968 individuals. Of these, 9 studies showed no significant effect of ADT on cognitive function.

Study details: The data come from a systematic review of 31 studies published up to February 2020.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Andela CD et al. Int J Urol. 2021 Jun 14.  doi: 10.1111/iju.14596. 

Key clinical point: Transgluteal CT-guided biopsy identified prostate cancer lesions in men without rectal access with no major complications reported.

Major finding: A total of 4 lesions were targeted using anatomic landmarks and 5 were targeted using contrast enhancement. All biopsies using transgluteal CT were technically successful and identified as prostate cancer. A total of 3 biopsies showed Gleason 6 cancer, and 6 biopsies showed clinically significant prostate cancers with Gleason 7 or above; a total of 7 patients underwent definitive treatment with surgery or radiation.

Study details: The data come from a retrospective study of 9 prostate cancer patients without rectal access who underwent transgluteal CT-guided biopsy between May 2016 and February 2021. The two targeting techniques were localizing with anatomic landmarks or localizing with contrast enhancement.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Patel N et al. Clin Imaging. 2021 Jun 9. doi: 10.1016/j.clinimag.2021.06.004.

Key clinical point: Transgluteal CT-guided biopsy identified prostate cancer lesions in men without rectal access with no major complications reported.

Major finding: A total of 4 lesions were targeted using anatomic landmarks and 5 were targeted using contrast enhancement. All biopsies using transgluteal CT were technically successful and identified as prostate cancer. A total of 3 biopsies showed Gleason 6 cancer, and 6 biopsies showed clinically significant prostate cancers with Gleason 7 or above; a total of 7 patients underwent definitive treatment with surgery or radiation.

Study details: The data come from a retrospective study of 9 prostate cancer patients without rectal access who underwent transgluteal CT-guided biopsy between May 2016 and February 2021. The two targeting techniques were localizing with anatomic landmarks or localizing with contrast enhancement.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Patel N et al. Clin Imaging. 2021 Jun 9. doi: 10.1016/j.clinimag.2021.06.004.

Key clinical point: Transgluteal CT-guided biopsy identified prostate cancer lesions in men without rectal access with no major complications reported.

Major finding: A total of 4 lesions were targeted using anatomic landmarks and 5 were targeted using contrast enhancement. All biopsies using transgluteal CT were technically successful and identified as prostate cancer. A total of 3 biopsies showed Gleason 6 cancer, and 6 biopsies showed clinically significant prostate cancers with Gleason 7 or above; a total of 7 patients underwent definitive treatment with surgery or radiation.

Study details: The data come from a retrospective study of 9 prostate cancer patients without rectal access who underwent transgluteal CT-guided biopsy between May 2016 and February 2021. The two targeting techniques were localizing with anatomic landmarks or localizing with contrast enhancement.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Patel N et al. Clin Imaging. 2021 Jun 9. doi: 10.1016/j.clinimag.2021.06.004.

Key clinical point: No significant differences in prostate specific antigen PSA regression, PSA failure rate, and toxicity were noted between the different fraction schedules for patients treated with high-dose-rate mono-brachytherapy.

Major finding: Overall, the biochemical failure rate was 9.6%; biochemical failure rates for the 4F, 3F, and 2F groups 10.5%, 4.7%, and 14.6%, respectively, and 3.5% of patients demonstrated several grade 3-4 toxicity.

Study details: The data come from a retrospective study of 229 adults with prostate cancer treated consecutively at a single center between 2004 and 2012. Patients were treated with high-dose-rate mono-brachytherapy alone, using three different fractionation schedules of 92-95 Gy.

Group 4F had a single implant of 9.5 Gy in four fractions over 2 days. Group 3F had three separate implants of 11 Gy over 4 weeks. Group had two implants of 14 Gy over 2 weeks.

Disclosures: The study was funded by the Örebro County Council. The researchers had no financial conflicts to disclose.

Source: Johansson B et al. J Contemp Brachytherapy. 2021 May 5. doi: 10.5114/jcb.2021.105846. 

Key clinical point: No significant differences in prostate specific antigen PSA regression, PSA failure rate, and toxicity were noted between the different fraction schedules for patients treated with high-dose-rate mono-brachytherapy.

Major finding: Overall, the biochemical failure rate was 9.6%; biochemical failure rates for the 4F, 3F, and 2F groups 10.5%, 4.7%, and 14.6%, respectively, and 3.5% of patients demonstrated several grade 3-4 toxicity.

Study details: The data come from a retrospective study of 229 adults with prostate cancer treated consecutively at a single center between 2004 and 2012. Patients were treated with high-dose-rate mono-brachytherapy alone, using three different fractionation schedules of 92-95 Gy.

Group 4F had a single implant of 9.5 Gy in four fractions over 2 days. Group 3F had three separate implants of 11 Gy over 4 weeks. Group had two implants of 14 Gy over 2 weeks.

Disclosures: The study was funded by the Örebro County Council. The researchers had no financial conflicts to disclose.

Source: Johansson B et al. J Contemp Brachytherapy. 2021 May 5. doi: 10.5114/jcb.2021.105846. 

Key clinical point: No significant differences in prostate specific antigen PSA regression, PSA failure rate, and toxicity were noted between the different fraction schedules for patients treated with high-dose-rate mono-brachytherapy.

Major finding: Overall, the biochemical failure rate was 9.6%; biochemical failure rates for the 4F, 3F, and 2F groups 10.5%, 4.7%, and 14.6%, respectively, and 3.5% of patients demonstrated several grade 3-4 toxicity.

Study details: The data come from a retrospective study of 229 adults with prostate cancer treated consecutively at a single center between 2004 and 2012. Patients were treated with high-dose-rate mono-brachytherapy alone, using three different fractionation schedules of 92-95 Gy.

Group 4F had a single implant of 9.5 Gy in four fractions over 2 days. Group 3F had three separate implants of 11 Gy over 4 weeks. Group had two implants of 14 Gy over 2 weeks.

Disclosures: The study was funded by the Örebro County Council. The researchers had no financial conflicts to disclose.

Source: Johansson B et al. J Contemp Brachytherapy. 2021 May 5. doi: 10.5114/jcb.2021.105846.