Alan H. Bryce, MD

Alan H. Bryce, MD

City of Hope

Phoenix, Arizona

Alan H. Bryce, MD, is a medical oncologist and chief clinical officer at City of Hope in Phoenix, Arizona. Dr. Bryce holds an appointment as a professor with the Department of Medical Oncology & Therapeutics Research, with City of Hope, as well as an appointment as a professor of Molecular Medicine at Translational Genomics Research Institute (TGen), which is also part of City of Hope.

Prior to joining City of Hope, Dr. Bryce spent 12 years at the Mayo Clinic in Phoenix, where he served as chair of the Division of Hematology and Medical Oncology, as well as Director of the Mayo Clinic Arizona Comprehensive Cancer Center. Dr. Bryce received his medical degree from the Chicago Medical School, and then completed an internal medicine residency and a hematology and oncology fellowship at the Mayo Clinic in Rochester, Minnesota. During his time at Mayo, Dr. Bryce served as an international co-principal investigator on multiple clinical trials for prostate cancer, with his research focused on cancer genetics, novel therapies and immunotherapeutic approaches.

Disclosures:

Dr. Bryce has the following disclosures:
Consulting Fees: Astellas, Bayer, Novartis

Talks by Alan H. Bryce, MD

Perspectives in mCRPC in 2024

Alan H. Bryce, MD, reviews current research, perspectives and practices in the treatment of metastatic castration-resistant prostate cancer (mCRPC). Dr. Bryce begins with an overview of current treatment options and patterns of care and addresses the National Comprehensive Cancer Network (NCCN) Guidelines Version 4.2023 for prostate cancer.

Dr. Bryce asserts that in light of few patients receiving treatments beyond first-line, a key operational principle should be to use the best drugs as early as possible. He explains that the management of mCRPC has become increasingly complex as new treatment paradigms have developed and new drugs have been approved. He recommends thinking about classes of drugs and considering how switching or combining classes can have advantages from the perspective of disease evolution.

Dr. Bryce concludes with a brief overview of recent phase-three trial results including PSMAfore, SPLASH, and CONTACT-2. He acknowledges that after several years of continuous success, the development of new classes of drugs for prostate cancer has hit a lull but he asserts the pipeline is still full and since there is not yet a cure for prostate cancer, trials must continue.

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Novel Targeted Treatments for Metastatic Disease

Alan H. Bryce, MD, Medical Director of the Genomic Oncology Clinic at Mayo Clinic Arizona in Scottsdale, discusses the limitations of traditional treatments for metastatic prostate cancer, such as androgen deprivation therapy (ADT) and chemotherapy, which, while effective initially, often lead to resistance and progression. He emphasizes the need for innovative approaches that target specific molecular pathways involved in prostate cancer growth and metastasis.
He highlights several promising targeted therapies currently under investigation. One is the use of PARP inhibitors, such as olaparib and rucaparib, which target cancer cells with defective DNA repair mechanisms, particularly those with BRCA1/2 mutations. Dr. Bryce also discusses the role of androgen receptor (AR) pathway inhibitors, including novel agents like enzalutamide and enzalutamide, which provide more potent and selective inhibition of AR signaling than traditional ADT.
Dr. Bryce switches focuses to radiopharmaceuticals, such as lutetium-177 (Lu-177) PSMA-617, which deliver targeted radiation to prostate-specific membrane antigen (PSMA)-expressing cells. Clinical trials indicate that this approach can effectively reduce tumor burden and improve clinical outcomes in patients with advanced prostate cancer. Additionally, he explores the potential of immunotherapies, including immune checkpoint inhibitors and vaccines, in treating metastatic prostate cancer.

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Management of mHSPC-Singlets and Doublets and Triplets

Alan H. Bryce, MD, discusses metastatic hormone-sensitive prostate cancer (mHSPC) and the importance of early and effective treatment to improve patient outcomes. While singlet therapy, which typically involves androgen deprivation therapy (ADT) alone, has been the traditional approach, newer evidence supports the use of combination therapies.
Data on doublet therapy, combining ADT with either chemotherapy or a novel hormonal agent such as abiraterone, enzalutamide, or apalutamide, have demonstrated significant improvements in overall survival and progression-free survival compared to ADT alone. Key studies, including the LATITUDE and CHAARTED trials, have established the efficacy of these doublet regimens.
Dr. Bryce also explores adding a second novel agent or chemotherapy to the ADT and initial novel agent combination (triplet therapy). He notes that while triplet therapy may offer further survival advantages, it also carries an increased risk of side effects and requires careful patient selection and management.

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Updates in Advanced Prostate Cancer

Alan H. Bryce, MD, reviews the current landscape of advanced prostate cancer treatment. Dr. Bryce begins by addressing the dwindling access to second-line treatment options as patients progress through therapy lines.

He then reviews findings from the STAMPEDE study, which explored the use of combination therapy involving ADT and abiraterone for high-risk prostate cancer patients. Dr. Bryce endorses this kind of combination therapy, highlighting its effect on overall survival rates.

Finally, Dr. Bryce touches on treatment intensification for patients with MHSC-9 positivity. Using a data-driven approach, he recommends combination therapy and the potential role of triplet regimens.

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Results From TRITON3

Alan H. Bryce, MD, presents results from the TRITON3 study comparing the efficacy of a PARP inhibitor (rucaparib) against docetaxel in mCRPC treatment. Dr. Bryce reviews the study design, emphasizing the options presented to the study participants in both treatment arms. The study yielded evidence that rucaparib might be superior to docetaxel-containing treatments.

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