Select Page

Daniel P. Petrylak, MD

Daniel P. Petrylak, MD

Yale University Cancer Center

New Haven, Connecticut

Daniel P. Petrylak, MD, leads the genitourinary cancers medical oncology team at Smilow Cancer Hospital as director of the genitourinary cancer research group, professor, and co-director of the Cancer Signaling Network program. Dr. Petrylak joined Yale from Herbert Irving Cancer Center at Columbia University Medical Center with New York-Presbyterian Hospital, where he served as Professor of Medicine (Medical Oncology) and Urology and began his appointment in September of 2012. Dr. Petrylak is a member of the American Association for Cancer Research (AACR), American Society for Clinical Oncology (ASCO), American College of Physicians (ACP), American Association for the Advancement of Science (AAAS), American Urological Association (AUA), and the Southwest Oncology Group (SWOG). After serving for more than 20 years as the advanced bladder chair for SWOG, Dr. Petrylak is now the Vice Chair of the Genitourinary Committee. He additionally has led multiple national and international studies in prostate and bladder cancer.

Dr. Petrylak’s research interests span both prostate and bladder cancer. He led an investigator-initiated trial of docetaxel and estramustine in castration resistant prostate cancer. The results of this study supported a phase 3 trial of this combination in SWOG led by Dr. Petrylak, which in turn, supported the FDA approval of docetaxel for castration resistant prostate cancer. This was one of the first two trials to demonstrate a survival benefit in this state of disease. Dr. Petrylak has also been instrumental in the development of immunotherapy and targeted therapies for refractory bladder cancer. His work with Enfortumab Vedotin has supported the accelerated and full FDA approval of this drug.

Dr. Petrylak received his undergraduate degree from Columbia College and his medical degree from Case Western University School of Medicine. He completed his internship and residency at Albert Einstein College of Medicine and his fellowship in medical oncology at Memorial Sloan-Kettering Cancer Center. He has authored more than 200 peer-reviewed articles and book chapters on prostate and bladder cancer research outcomes.

Disclosures:

Dr. Petrylak has the following disclosures:

Consultant fees: *Ada Cap (Advanced Accelerator Applications), *Amgen, Astellas, AstraZeneca,
Bayer, *Bicycle Therapeutics, *Boehringer Ingelheim, Bristol Myers Squibb, *Clovis
Oncology, *Eli Lilly, Exelixis, Gilead Sciences, *Incyte, Infinity Pharmaceuticals,
Ipsen, *Janssen, Merck & Company Inc, *Mirati, Monopteros, Pfizer,
*Pharmacyclics, Regeneron, *Roche, Sanofi Aventis Pharmaceuticals, Seattle
Genetics, *Urogen

Grant Support: Ada Cap (Advanced Accelerator Applications), *Agensys Inc, Arvinas, Astellas,
AstraZeneca, *Bayer, BioXcel Therapeutics, Bristol Myers Squibb, Clovis Oncology,
Daiichi Sankyo Company Limited, *Eisai, *Eli Lilly, Endocyte, Ferring, Genentech,
Gilead Sciences, *Innocrin, *MedImmune, *Medivation, Merck, *Mirati, *Novartis,
Pfizer, *Progenics, *Replimune, *Roche, *Sanofi Aventis, Seattle Genetics

Ownership interest/investment: *Bellicum (Sold 7/2020), *Tyme (sold 10/2019)

*denotes relationships recently terminated

Talks by Daniel P. Petrylak, MD

PARPi in mCRPC

Daniel P. Petrylak, MD, Yale University Cancer Center, New Haven, Connecticut, summarizes the current and future role of PARP inhibitors in mCRPC, providing valuable insights into their clinical application and potential to improve patient outcomes.

In this 9-minute presentation, Dr. Henderson highlights direct costs such as medications, hospital stays, and physician fees, as well as indirect costs including lost income and travel expenses. He emphasizes that these financial strains can lead to treatment non-adherence, delayed care, and worsened clinical outcomes.

Dr. Henderson discusses various strategies and interventions to address these challenges, underscoring the importance of policy changes at the institutional and governmental levels to improve access to affordable care.

Read More

PET Tumor Board: Case #6

In this discussion, E. David Crawford, MD, Jack A. Vickers Director of Prostate Research and Professor of Urology at the University of California, San Diego, leads a discussion of the case study of a 63 year old patient with a strong family history of prostate cancer. He presents this case study to a panel of experts comprised of:

Wayne G. Brisbane, MD – Assistant Professor of Urology at the University of California, Los Angeles.
Phillip J. Koo, MD – Division Chief of Diagnostic Imaging and Northwest Region Oncology Physician Executive at the Banner MD Anderson Cancer Center.
Daniel P. Petrylak, MD – Director of Genitourinary Oncology, Professor of Medicine and Urology, Co-Leader of Cancer Signaling Networks, and Co-Director of the Signal Transduction Program at Yale University Cancer Center.

Dr. Crawford informs the panel that the patient, a physician with a history of low-grade prostate cancer, initially presented with a PSA of 4.9 ng/ml, his germline test was negative, and his MRI revealed a 40g prostate with a PI-RADS 3 lesion at the left base. After a negative SelectMDx scan and low-risk OncotypeDX score, along with a course of finasteride which lowered his PSA to 1.43 ng/ml, Dr. Crawford asks the panel to weigh in on further steps.

Dr. Brisbane suggests exploring reclassifying the patient’s risk score, given his family history, in order to qualify them for a PSMA. Dr. Petrylak supports the suggestion, mentioning that it has been common practice to reimage patients after finasteride use.

Dr. Crawford shows the results from the patient’s POSLUMA scan which showed uptake in multiple foci. Dr. Koo digs into the results, noting that there are alternate explanations for the results showing multiple uptakes. Given the patient’s risk profile, the panel suggests a confirmatory biopsy of the prostate in the highest activity areas.

Dr. Crawford reveals that the patient’s confirmatory biopsies showed the presence of Gleason 6 (3+3) prostate cancer in the uptake areas. Given the discordance between the biopsies and the scans, the panel discusses possible next steps, including sending the biopsy samples for Decipher testing, treating the patient with targeted focal therapy, and options for whole-gland therapy. The panel also discusses the dangers of over-reliance on scan results in treatment selection and cautions against over-treatment.

This is the sixth in a series of discussions on PSMA PET supported by Blue Earth Diagnostics. For the first installment, click here. For the second installment, click here. For the third installment, click here. For the fourth installment, click here. For the fifth installment, click here.

Read More

PET Tumor Board: Case #5

In this discussion, E. David Crawford, MD, Jack A. Vickers Director of Prostate Research and Professor of Urology at the University of California, San Diego, leads a discussion of the case study of a healthy 69-year-old male with a history of multiple BPH treatments presenting with Gleason Grade 2 prostate cancer. He presents this case study to a panel of experts comprised of:

Wayne G. Brisbane, MD – Assistant Professor of Urology at the University of California, Los Angeles.
Phillip J. Koo, MD – Division Chief of Diagnostic Imaging and Northwest Region Oncology Physician Executive at the Banner MD Anderson Cancer Center.
Daniel P. Petrylak, MD – Director of Genitourinary Oncology, Professor of Medicine and Urology, Co-Leader of Cancer Signaling Networks, and Co-Director of the Signal Transduction Program at Yale University Cancer Center.

After reviewing the patient’s treatment history, Dr. Crawford informs the panel that the patient initially presented with a PSA of 4.55 ng/ml, his 12 core biopsies were negative after 6 months of treatment, and he was placed on active surveillance post-biopsies. However, the patient returned one year after initial presentation with a PSA of 8.5 ng/ml. Dr. Crawford asks the panel to weigh in on next steps.

Dr. Petrylak recommends pursuing active surveillance based on the patient’s 2.1% Decipher score and the patient’s preference of preserving his quality of life. Dr. Koo suggests using an mpMRI to resolve the discordance between the PSA level and the negative biopsies.

Dr. Crawford shows the results from the patient’s POSLUMA scan which showed focal uptake in the right base of the prostate. Dr. Koo acknowledges that the scan results are promising, but he reminds the panel to be cautious about the sensitivity of PSMA PET before definitive therapy.

Dr. Crawford reveals that the patient had an mpMRI and 12 core biopsies in addition to the POSLUMA scan, all of which confirmed the presence of prostate cancer in the right base. The panel recommends focal therapy as a next step, and discusses the available options for focal therapy.
This is the fifth in a series of discussions on PSMA PET supported by Blue Earth Diagnostics. For the first installment, click here. For the second installment, click here. For the third installment, click here. For the fourth installment, click here.

Read More

Advanced Prostate Cancer Challenging Case Discussion

Daniel P. Petrylak, MD, moderates this discussion panel on challenging prostate cancer case studies. Dr. Petrylak describes the first case whereby a patient had a prostate specific antigen (PSA) of 24 and underwent radical prostatectomy; his PSA never normalized and rose to 40. Androgen deprivation therapy (ADT) commenced and continued for five years until his PSA rose despite a castrate testosterone level. The patient’s bone scan demonstrated sacral metastases. Testing demonstrated no germline mutations and the patient received Sipuleucel T and began treatment with abiraterone/prednisone; PSA nadired at .4. A year and a half later the patient’s PSA rose to 4.8 and he was found to have stable bone metastases.

After the panel decides on a treatment plan for the first case, Dr. Petrylak moves to the second case, whereby a patient presented with celiac, para-aortic and iliac chain lymphadenopathy, early right-side hydronephrosis, a PSA of 19.4, and a biopsy of the left neck lymph node mass showed metastatic adenocarcinoma consistent with prostatic primary. Treatment included bicalutamide/leuprolide, switching to abiraterone/prednisone. In six months, PSA was undetectable. The patient progressed in terms of the soft tissue disease and required a stent for the hydronephrosis, began docetaxel with no response after five cycles, and started cabazitaxel with cycles three and four dose-reduced due to neuropathy.

Read More

Join the GRU Community

- Why Join? -