Future perspective of focal therapy for localized prostate cancer
Luke P. O’Connora,Shayann Ramedanib,Michael Daneshvara,Arvin K. Georgec,Andre Luis Abreude,Giovanni E. Cacciamanide,Amir H. Lebastchide*()
a Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA b College of Medicine, The Pennsylvania State University, Hershey, PA, USA c Department of Urology, University of Michigan, Ann Arbor, MI, USA d Center for Image-Guided and Focal Therapy for Prostate Cancer, Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA e Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
Objective: To summarize the recent literature discussing focal therapy for localized prostate cancer. Methods: A thorough literature review was performed using PubMed to identify recent studies involving focal therapy for the treatment of localized prostate cancer. Results: In an effort to decrease the morbidity associated with prostate cancer treatment, many urologists are turning to focal therapy as an alternative treatment option. With this approach, the cancer bearing portion of the prostate is targeted while leaving the benign tissue untouched. Multiparametric magnetic resonance imaging remains the gold standard for visualization during focal therapy, but new imaging modalities such as prostate specific membrane antigen/positron emission tomography and contrast enhanced ultrasound are being investigated. Furthermore, several biomarkers, such as prostate cancer antigen 3 and prostate health index, are used in conjunction with imaging to improve risk stratification prior to focal therapy. Lastly, there are several novel technologies such as nanoparticles and transurethral devices that are under investigation for use in focal therapy. Conclusion: Focal therapy is proving to be a promising option for the treatment of localized prostate cancer. However, further study is needed to determine the true efficacy of these exciting new technologies.
. [J]. Asian Journal of Urology, 2021, 8(4): 354-361.
Luke P. O’Connor,Shayann Ramedani,Michael Daneshvar,Arvin K. George,Andre Luis Abreu,Giovanni E. Cacciamani,Amir H. Lebastchi. Future perspective of focal therapy for localized prostate cancer. Asian Journal of Urology, 2021, 8(4): 354-361.
-At 12 months follow-up, 100% of patients had evidence of coagulative necrosis in tumor and 14/16 patients had no cancer on biopsy.
None reported
Chopra et al., 2012 [52]
TULSA
8
-Treatment resulted in a temperature uncertainty was less than 2°C in all patients.
None reported
Chin et al., 2016 [56]
TULSA
30
-Reduction of median PSA to 0.8 ng/mL at 12 months with a 61% reduction in cancer length in positive biopsies.
Hematuria, UTI, acute urinary retention, and epididymitis
Bonekamp et al., 2019 [57]
TULSA
30
-Median prostate volume reduction was 88.8% which was best seen by delayed thermal ablation volume.
None reported
Zlotta et al., 1998 [61]
Bipolar RFA
15
-All patients showed evidence of coagulative necrosis with PSA becoming undetectable.
None reported
Ahmed 2009 [10]
Topsalysin
37
-10/37 patients saw clinically significant response to the first dose and 15 patients showed a partial response.
None reported
Yamada et al., 2019 [65]
Microwave
5
-80% of the subjects had a multifocal disease when ablation was performed; study is ongoing.
None reported
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