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After Prostate Cancer Surgery, Some Men May Not Need Hormone Therapy

A study suggests that men who have low prostate-specific antigen (PSA) levels after prostate cancer surgery do not need radiation. Hormone therapy, or androgen deprevation therapy, blocks male sex hormones that can cause tumors to grow. Studies show that for men with prostate cancer who have not had surgery, adding hormone therapy to radiation improves overall survival. But for men who have been treated with surgery, research has not shown a clear benefit from including hormone therapy. The study, which was published in the Lancet and presented at the American Society of Clinical Oncology (ASCO) Genitourinary Cancers Symposium in San Francisco, analyzed results from six clinical trials including 5,026 men who had surgery to remove the prostate and then received either radiation and hormone therapy or radiation alone. The study observed that 83.6% of men who received radiation alone were alive after 10 years, compared with 84.3% of those who had radiation with hormone therapy. But the study also found men who have high PSA results after surgery may still benefit from adding hormone therapy. Further analysis found hormone therapy prolonged survival in men with PSA levels above 0.5 nanograms per milliliter. “By better identifying who truly benefits from hormone therapy, we can make treatment smarter, reduce unnecessary interventions and focus on improving patients’ overall well-being,” Amar U. Kishan, a radiation oncologist at the UCLA Health Jonsson Comprehensive Cancer Center in Los Angeles and a study author, told HealthDay.

Colorectal Cancer Incidence Shifts to Younger Patients

In 1995, 27% of colorectal cancer cases were diagnosed in people younger than 65, but that number has risen to an estimated 45% today, according to a report from the American Cancer Society. “The landscape of colorectal cancer is changing rapidly—even more rapidly than I would have expected—and the shift toward more cancer in the younger population is happening swiftly,” Rebecca L. Siegel, an epidemiologist at the American Cancer Society and an author of the report, told Healio. The report, which was based on national data on colorectal cancer in the U.S. through 2023, found nearly 70% of colorectal cancers in people younger than 50 are diagnosed at an advanced stage, including 27% being metastatic, according to the report. In 2021, the U.S. Preventive Services Task Force lowered the recommended age from 50 to 45 for people to start screening for colorectal cancer. Doctors are working to educate people about colorectal cancer at a younger age to help reduce their risk and find cancers early, according to Siegel. Many people don’t know that screening can remove polyps before they become cancerous, and they are often uncomfortable discussing symptoms that may be a sign of cancer, such as bleeding from the rectum, Siegel told Healio. “If we have more of those conversations, we can absolutely reduce morbidity and mortality,” she said.

Targeted Therapy Improves Outcomes in Advanced Kidney Cancer

A combination of two targeted therapy drugs improved progression-free survival in people with advanced kidney cancer, according to a study presented at the American Society of Clinical Oncology (ASCO) Genitourinary Cancers Symposium in San Francisco. Doctors have several options to treat advanced renal cell carcinoma, the most common form of kidney cancer in adults, if it progresses after treatment with an immune checkpoint inhibitor, but they do not have head-to-head data comparing these options, according to an article in Healio. In the phase III LITESPARK-011 trial, 747 people with advanced kidney cancer that had progressed after immunotherapy received either Welireg (belzutifan) and Lenvima (lenvatinib) or Cabometyx (cabozantinib), a different kind of targeted therapy. People who received the Welireg-Lenvima regimen went a median of 14.8 months without disease progression, compared with 10.7 months for those who took Cabometyx. The combination also nearly doubled the median duration of treatment response from 12.3 months to 23 months. The groups had similar rates of side effects that required treatment, though which side effects differed between treatments. People who received Welireg and Lenvima had more instances of low red blood cell levels, decreased oxygen supply to healthy tissue and cardiac problems, while those who took Cabometyx had higher rates of diarrhea and skin side effects, including hand-foot syndrome. “These results present the highest evidence level to date about the optimal regimen after initial treatment with immunotherapy, and will help provide guidance to both physicians and patients in selecting regimens in this setting,” Brandon Manley, a urologic oncologist at Moffitt Cancer Center in Tampa, Florida, who was not involved in the study, wrote in a perspective for Healio.