The oncologists’ unmet clinical needs for imaging

Authors: Aurelius Omlin Joachim Mueller Silke Gillessen

Publish Date: 2016/08/04

Volume: 4, Issue: 6, Pages: 423-431

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Abstract

The management of men with advanced prostate cancer has become a dynamic field due to the approval of several agents in the castrationresistant state of the disease abiraterone acetate enzalutamide docetaxel cabazitaxel radium223 the technical advances of radiation therapy IMRT stereotactic body radiation and not at least due to significant innovations in the field of imaging modalities Several distinct disease states of prostate cancer can be identified with specific needs with regard to imaging modalities The manuscript will discuss the following disease states castrationnaïve metastatic prostate cancer oligometastatic prostate cancer castrationresistant prostate cancer nonmetastatic M0 and metastatic M1 Imaging in advanced prostate cancer generally consists of bone scintigraphy and contrast enhancedcomputed tomography CT Increasingly more sophisticated technologies including multiparametric MRI PET/CT with different tracers and hybrid PET/CTMRI techniques are discussed and in larger centres available also outside of clinical trials Many questions however are unsolved and as of now it is unclear whether the increased diagnostic sensitivity/specificity of these imaging technologies translates into a relevant clinical benefit for men with advanced prostate cancer in the sense of improvement of clinical outcome or guiding treatment decision This opinion piece will reflect some of the areas of unmet needs in the management of men with advanced prostate cancer that oncologists face in daily practice as perceived by the authorsThe following conflicts of interest have to be reported AO advisory boards compensated institutional Bayer Astellas Janssen Sanofi Pfizer Travel support Bayer Astellas Janssen Sanofi JM no conflicts of interest SG advisory boards compensated institutional Astellas Bayer Curevac Dendreon Janssen Cilag Janssen Diagnostics Millennium Novartis Orion Pharma Pfizer Sanofi Aventis Advisory Boards uncompensated ProteoMediX ESSA Pharmaceuticals Corp Speakers Bureau without honorarium Amgen Astellas Bayer Janssen Cilag Sanofi Aventis Patent Pending patent application for a method for biomarker WO 2009138392 A1

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