Marc B. Garnick Archives

How Well Do You Know Doublets and Triplets? – A Pop Quiz

Posted by Marc B. Garnick, MD | Sep 2024

Marc B. Garnick, MD, tests knowledge on doublet and triplet therapies in prostate cancer. In this quiz-themed 13-minute presentation, he poses a series of questions. After each, he discusses the correct response.

Dr. Garnick begins by matching prostate cancer stages—such as non-metastatic castration-resistant, metastatic castration-sensitive, first-line castration-resistant, and castration-resistant post-docetaxel—with corresponding clinical trials. He incorporates key studies, including SPARTAN, PROSPER, ARAMIS, TITAN, and PREVAIL, and therapies like apalutamide, enzalutamide, daralutamide, and abiraterone in his questions. He also quizzes his audience on side effects and NCCN Guidelines for treating metastatic disease.

The presentation provides a unique comprehensive examination of the landscape of doublet and triplet therapies in prostate cancer, emphasizing the critical importance of personalized treatment approaches based on a detailed understanding of clinical trial data and drug-specific side effect profiles.

The Importance of Diagnosing and Treating Oligometastatic Prostate Cancer and ADT Usage

Posted by Marc B. Garnick, MD | Jun 2024

Dr. Marc Garnick explores the diagnosis and treatment of oligometastatic prostate cancer with the strategic use of androgen deprivation therapy (ADT). Advanced imaging techniques are essential for identifying oligometastatic disease, such as PET scans and advanced MRI. These technologies enhance the precision of detecting small metastatic lesions, facilitating timely and appropriate treatment decisions. By reducing androgen levels that fuel prostate cancer growth, the strategic use of ADT not only helps in controlling the primary tumor but also in managing metastatic lesions, thereby extending the therapeutic window and improving overall survival rates.
Dr. Garnick also addresses the timing and duration of ADT in the context of oligometastatic prostate cancer. He highlights individualized treatment plans based on patient-specific factors, including the extent of disease, patient health status, and response to initial therapies. This personalized approach ensures that patients receive the most effective treatment while minimizing potential side effects associated with prolonged ADT usage.

Cardiovascular Complications in Patients Undergoing ADT

Posted by Marc B. Garnick, MD | Mar 2023

E. David Crawford, MD, and Marc B. Garnick, MD, discuss cardiovascular complications in patients on androgen deprivation therapy (ADT).

Standard Treatments and Global Perspective

Posted by Marc B. Garnick, MD | Jan 2022

Marc B. Garnick, MD, the Gorman Brothers Professor of Medicine at Harvard Medical School and the Beth Israel Deaconess Medical Center, summarizes recent developments in nomenclature, disease states, and standard treatments for advanced prostate cancer. Using material from a chapter he wrote for ASCO-SEP with David J. Einstein, MD, Assistant Professor of Medicine at Harvard Medical School, Dr. Garnick begins by considering the new language used to describe different states of advanced prostate cancer, including non-metastatic castrate-sensitive prostate cancer (nmCSPC), non-metastatic castrate-resistant prostate cancer (nmCRPC), metastatic castrate-sensitive prostate cancer (mCSPC), and oligometastatic prostate cancer. He then discusses new standards of care for these different states, highlighting recent research indicating the benefits of using darolutamide, enzalutamide, and apalutamide in the nmCRPC setting, and explaining how to appropriately layer and sequence therapies across disease states. He briefly looks at the role of next-generation sequencing in informing the potential benefit of PARP or PD-L1 inhibitors and touches on bone considerations in mCRPC. Dr. Garnick concludes with some comments on the global inequities of prostate cancer treatment, citing data on the significant disparity in mortality-to-incidence rate of prostate cancer in high-income countries compared to low- to middle-income countries.

The Prostate – Highlights of Prostate Cancer Advances As Covered in ASCO-SEP

Posted by Marc B. Garnick, MD | Sep 2021

Marc B. Garnick, MD, the Gorman Brothers Professor of Medicine at Harvard Medical School and the Beth Israel Deaconess Medical Center, provides a capsulated summary of key references from the ASCO Self-Evaluation Program (ASCO-SEP) 7. He also distills information of interest for practice change related to urologic oncology, particularly prostate cancer, published over the last 12-18 months. Dr. Garnick covers topics including: the emerging role and trends of MRI following elevated PSA values; the introduction of the first oral GnRH antagonist (relugolix) for endocrine management of locally advanced, biochemical recurrence or de novo metastatic castration-sensitive prostate cancer; improvements in overall survival (OS) with the addition of androgen receptor antagonists to androgen deprivation therapy; and approvals of three drugs for improving metastasis-free survival and OS in non-metastatic castration-resistant prostate cancer. Dr. Garnick then reviews ASCO, European Association of Urology (EAU), and ASTRO guidelines published during the COVID-19 pandemic and concludes by sharing data from within the ASCO-SEP chapter on genitourinary cancers that offer a global perspective on mortality disparities for prostate, bladder, kidney, testicular, and penile cancers. He finishes the presentation by pointing out a “sobering” difference in mortality-to-incidence ratios, a parameter to estimate health system performance, between high- and low-to-middle-income countries worldwide.