Publications by authors named "Mandel P"
Survival differences in rare histological prostate cancer (PCa) subtypes relative to age-matched population-based controls are unknown. Within Surveillance, Epidemiology, and End Results database (2004-2020), newly diagnosed (2004-2015) PCa patients were identified. Relying on the Social Security Administration Life Tables (2004-2020) with 5 years of follow-up, age-matched population-based controls (Monte Carlo simulation) were simulated for each patient.
View Article and Find Full Text PDFPurpose: No currently available phase III trial compared docetaxel vs. androgen receptor pathway inhibitors (ARPI) regarding cancer-control outcomes in metastatic hormone-sensitive prostate cancer (mHSPC). Moreover, few is known about the effect of sequential therapies in mHSPC and subsequent metastatic castration resistant prostate cancer (mCRPC).
View Article and Find Full Text PDFHormonal agents administered for metastatic castration-resistant prostate cancer (mCRPC) may lead to osteoporosis, skeletal events, reduced quality of life, and even reduced overall survival (OS). Bone-modifying agents may prevent those events but their effect on cancer-control outcomes remains uncertain. Relying on our institutional tertiary-care database, we explored the effect of bone-modifying agents (bisphosphonates such as zoledronic acid and denosumab) on OS and progression-free survival in patients with mCRPC with at least 1 bone metastasis using Kaplan-Meyer estimates and Cox regression models.
View Article and Find Full Text PDFThe treatment landscape for metastatic hormone-sensitive prostate cancer (mHSPC) has been extended by another phase 3 randomized control trial (ARANOTE) demonstrating favorable outcomes of a doublet therapy combining the androgen receptor pathway inhibitor (ARPI) darolutamide with androgen deprivation therapy (ADT) over ADT monotherapy. Owing to differences in trial designs, patient enrollment, and most notably different control treatment regimens, we hereby present an updated network meta-analysis (NMA) embedding the doublet therapy with darolutamide within the current treatment regimens. In NMA-derived ranking, darolutamide and ADT showed similar oncological efficacy to the already known doublet therapies for progression-free survival (p = 0.
View Article and Find Full Text PDFPurpose: Several tumor gene mutations are known for metastatic castration-resistant prostate cancer (mCRPC). The individual response to 177-lutetium prostate specific membrane antigen radioligand therapy (Lu-PSMA) is under current investigation regarding the genomic profile of patients with mCRPC.
Materials And Methods: We relied on the FRAMCAP database and compared progression-free survival (PFS) and overall survival (OS) rates of patients with mCRPC with breast cancer-related antigen () or tumor suppressor gene mutations (, , ).
Lu-vipivotide tetraxetan prostate-specific membrane antigen (Lu-PSMA) therapy is under current scientific investigation and aims to become established in the treatment of metastatic castration-resistant prostate cancer (mCRPC). However, real-world evidence in treatment comparison is scant. We relied on the FRAMCAP database and compared cabazitaxel versus Lu-PSMA therapy in mCRPC patients regarding progression-free survival (PFS) and overall survival (OS).
View Article and Find Full Text PDFArticle Synopsis
- The study investigated the relationship between lymphovascular invasion (LVI) and perineural invasion (PNI) in prostate cancer patients who underwent radical prostatectomy and their rates of biochemical recurrence (BCR).
- Results from 822 patients showed that those with LVI had a five-year BCR-free survival rate of 62%, while those with PNI had a rate of 64%, both lower than their counterparts without these invasions.
- After adjusting for factors like age, PSA levels, and tumor stage, the association between LVI and PNI with BCR became insignificant, indicating that tumor stage and Gleason Grade were more critical predictors of recurrence.
Article Synopsis
- The study focuses on understanding how different metastatic sites (lymph nodes, bones, and visceral organs) affect outcomes in patients with metastatic castration-resistant prostate cancer (mCRPC), specifically regarding progression-free survival (PFS) and overall survival (OS).
- Using data from the Frankfurt Metastatic Cancer Database, researchers classified 363 patients based on their metastatic sites and analyzed PFS and OS using Cox regression models.
- Results showed that M1c mCRPC patients have significantly worse outcomes, with higher risks for both progression and death compared to M1a patients, while M1a patients experienced the best outcomes overall.
: Progression to metastatic castration-resistant prostate cancer (mCRPC) is defined either biochemically, radiographically or both. Moreover, staging for mCRPC can be performed either conventionally or with molecular imaging such as prostate-specific membrane antigen computer tomography (PSMA-PET/CT). : We relied on the Frankfurt Metastatic Cancer Database of the Prostate (FRAMCAP) database to compare progression-free (PFS) and overall survival (OS) outcomes regarding the cause of castration resistance and the staging modality used.
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- Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) are severe, drug-induced skin conditions that can be life-threatening and are now viewed as different levels of the same disease known as epidermal necrolysis (EN).
- A new guideline has been created based on scientific literature and expert consensus to help medical professionals in diagnosing and treating EN.
- This guideline targets various specialists like dermatologists and intensive care doctors, as well as informing patients, families, insurers, and policymakers about EN and includes recommendations for acute care and follow-up treatment.
Article Synopsis
- Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are serious, mostly drug-related conditions that affect the skin and mucous membranes, categorized under the umbrella term epidermal necrolysis (EN), which varies in severity.* -
- A new guideline for diagnosing and treating SJS/TEN was created based on extensive scientific research and consensus among experts, involving various medical specialties to provide a comprehensive approach to patient care.* -
- The guideline is designed for healthcare professionals across multiple fields, as well as patients, their families, insurers, and policymakers, with the first part specifically addressing diagnosis, initial treatment, and systemic immunotherapy.*
Article Synopsis
- This study analyzed the clinicopathologic characteristics and treatment patterns of adult prostate sarcoma patients using data from the Surveillance, Epidemiology, and End Results database between 2004 and 2020.
- Among 125 patients, the most common subtype was leiomyosarcoma (36%), with rhabdomyosarcoma (14%) being more likely to present at a metastatic stage compared to other types.
- The overall median survival was 27 months, with treatment approaches differing significantly based on the subtype; metastatic disease was linked to higher mortality rates, while stromal sarcoma had a lower overall mortality risk.
Article Synopsis
- Prostate-specific antigen (PSA) testing is critical for monitoring prostate cancer patients after treatment, but there's uncertainty about PSA thresholds for identifying those at higher risk of biochemical recurrence (BCR).
- This study analyzed 4,639 prostate cancer patients who had undetectable PSA levels for at least 10 years post-surgery, finding that 5.2% later developed BCR, with some progressing to metastatic cancer.
- Key factors predicting late BCR included advanced tumor stage, Gleason score, and surgical margins, while age and initial PSA levels did not significantly predict outcomes.
Background And Objective: Currently available post hoc phase 3 trial-derived data suggest better cancer-control outcomes in apalutamide-treated metastatic hormone-sensitive prostate cancer (mHSPC) patients achieving an (ultra)low prostate-specific antigen (PSA) nadir. This study aims to validate ultralow PSA nadir cutoffs.
Methods: Relying on an institutional prostate cancer database, 107 eligible patients were yielded.
Epigenetic profiling of prostate cancer reveals potential prognostic signatures.
J Cancer Res Clin Oncol
August 2024
Purpose: While epigenetic profiling discovered biomarkers in several tumor entities, its application in prostate cancer is still limited. We explored DNA methylation-based deconvolution of benign and malignant prostate tissue for biomarker discovery and the potential of radiomics as a non-invasive surrogate.
Methods: We retrospectively included 30 patients (63 [58-79] years) with prostate cancer (PCa) who had a multiparametric MRI of the prostate before radical prostatectomy between 2014 and 2019.
Background: The treatment landscape of metastatic hormone-sensitive prostate cancer (mHSPC) has undergone fundamental changes in recent decades, moving away from the sole use of androgen deprivation therapy (ADT) and towards intensified combination therapies.
Purpose: To what extent have the data from prospective phase III studies influenced clinical practice in the management of mHSPC over the past 5 or 10 years?
Results: A total of 1098 mHSPC patients with a median age at metastasis of 70 years and a median prostate-specific antigen (PSA) level of 43 ng/ml were included in the present study. Significant differences were observed in terms of PSA nadirs in mHSPC after stratification by year of metastatic onset.
Objective: To test for differences in recovery of lower urinary tract symptoms (LUTS) between patients with storage-positive vs -negative symptoms after laser enucleation of the prostate (LEP).
Patients And Methods: Consecutive storage-positive (severe storage symptoms, International Prostate Symptom Score [IPSS] storage subscore >8) vs storage-negative patients treated with LEP (November 2017-September 2022) within our tertiary-care database were identified. Mixed linear models tested for changes in IPSS and quality of life (QoL) at 1, 3 and 12 months after LEP.
Article Synopsis
- Metachronous metastatic prostate cancer (mmPCa) patients exhibit different characteristics and outcomes compared to DeNovo metastatic patients, influenced by primary cancer features like Gleason score (GS) and stage.
- A study of 341 mmPCa patients found that higher Gleason scores and more advanced stages were linked to earlier onset of metastatic disease and significantly affected overall survival (OS) rates.
- The research concluded that longer intervals between initial prostate cancer diagnosis and the onset of mmPCa are associated with better overall survival, highlighting the importance of grading and staging in treatment outcomes.
Article Synopsis
- The study investigates the differences in overall survival (OS) between patients with metastatic hormone-sensitive prostate cancer (mHSPC) based on whether their condition was "De Novo" (newly diagnosed) or "secondary" (progressed from previous conditions), and their disease volume (high vs. low).
- The research used a database of 504 mHSPC patients, finding that those with De Novo high volume mHSPC had shorter time to develop metastatic castration resistant prostate cancer (mCRPC) and worse OS compared to secondary and low volume cases.
- The results highlight that patients with De Novo high volume mHSPC have a more challenging prognosis even when treated with intensified combination therapies, and this trend
Background: To test for differences in organ-confined pathological tumor stage (pT) and intermediate International Society of Urological Pathologists (ISUP) grade vs. nonorgan confined pT stage and high ISUP grade and biochemical recurrence (BCR) after radical prostatectomy (RP).
Methods: Relying on a tertiary-care database, prostate cancer patients undergoing RP between January 2014 and December 2021 were stratified according to their combination of pT stage and ISUP grade in RP specimens (pT2 ISUP4/5 vs.
Article Synopsis
- Biochemical recurrence (BCR) is when prostate-specific antigen (PSA) levels rise after prostate cancer treatment, and this study aimed to examine factors like age, body mass index (BMI), and prostate volume related to BCR post-radical prostatectomy (RP).
- Within a group of 821 patients who had RP from January 2014 to June 2023, the study analyzed their characteristics and found that only higher prostate volume was significantly linked to increased BCR rates, while age and BMI showed no significant association.
- The results suggest that patients with higher prostate volume should receive more careful monitoring after surgery due to their increased risk of BCR.
Background And Objective: With approval of novel systemic therapies within the past decade for metastatic hormone-sensitive (mHSPC) and castration-resistant (mCRPC) prostate cancer, patients may receive several therapy lines. However, the use of these treatments is under an ongoing change. We investigated contemporary treatment trends and progression-free (PFS) and overall (OS) survival of different therapy lines.
View Article and Find Full Text PDFBackground: The first approvals of novel systemic therapies within recent years for metastatic hormone-sensitive (mHSPC) were mainly based on improved overall survival (OS) and time to castration resistance (ttCRPC) in mHSPC patients stratified according to CHAARTED low (LV) versus high volume (HV) and LATITUDE low (LR) versus high-risk (HR) disease.
Methods: Relying on our institutional tertiary-care database we identified all mHSPC stratified according to CHAARTED LV versus HV, LATITUDE LR versus HR and the location of the metastatic spread (lymph nodes (M1a) versus bone (M1b) versus visceral/others (M1c) metastases. OS and ttCRPC analyses, as well as Cox regression models were performed according to different metastatic categories.