Latest Videos Archives

Personalization of Prostate Cancer Care Through Integration of Data

Posted by Ilya Gipp, MD, PhD | Aug 2022

In this presentation, given during the 2021 Virtual Global Summit on Precision Diagnosis and Treatment of Prostate Cancer and supported by Philips, Ilya Gipp, MD, PhD, a medical officer and oncology solutions subject matter expert with Philips in Atlanta, Georgia, discusses solutions for integrating data to personalize prostate cancer care. He first describes positive trends and challenges in prostate cancer care, noting that data silos across service lines and service providers remain a key barrier to effective and efficient treatment. Dr. Gipp describes the prostate cancer service line as beginning with early detection, progressing to diagnosis and staging, treatment selection, therapy planning and deployment, and assessment and follow-up. He then focuses on the actionability and insightfulness of information, and how to synthesize data throughout the cancer care pathway using magnetic resonance imaging (MRI). Dr. Gipp remarks that while MRI is often used in diagnosis, to benefit from the data, MRI must be the modality used at all points from screening to post-therapy assessment. For example, MRI can generate images similar to CT scans for radiation dose planning as well as guiding dose painting to offer localized, non-uniform radiation dose distribution. He summarizes by comparing the traditional approach to cancer care with a state-of-the-art model that employs biomarker imaging, image-guided multi-modality navigated fusion biopsies, digital pathology, and focal therapies.

Experience with 18F-rhPSMA7.3 for Prostate Cancer

Posted by Wolfgang Weber, MD | Aug 2022

In this 6-minute presentation, presented during the 2021 Virtual Global Summit on Precision Diagnosis and Treatment of Prostate Cancer and supported by Blue Earth Diagnostics, Wolfgang Weber, MD, Professor and Chair of the Department of Nuclear Medicine at the Technical University of Munich in Germany (TUM), discusses 18F-rhPSMA7(.3) as a promising tracer for imaging prostate cancer for primary staging and in the case of biochemical recurrence, explaining that limited renal excretion facilitates evaluation of the prostate and the prostate bed before surgery. Dr. Weber explains that prospective registration trials have completed accrual, and the use of radiohybrid prostate-specific membrane antigen ligands (rhPSMAs) for therapy of prostate cancer is being evaluated preclinically.

Vitamin D for Preventing Fractures in Low-Risk Adults: What Can We Learn from the VITAL Study?

Posted by Mark A. Moyad, MD, MPH | Aug 2022

Mark A. Moyad, MD, MPH, the Jenkins/Pokempner Director of Preventive/Complementary and Alternative Medicine (CAM) in the Department of Urology at the University of Michigan Medical Center in Ann Arbor, Michigan, reviews ancillary data from the VITAL study on using supplemental vitamin D to prevent bone fractures. Dr. Moyad notes that while recent reporting indicated data from the study showed no benefit for reducing fractures, the focus was only on low-risk adults (those without vitamin D deficiency, low bone mass, nor osteoporosis). He stresses keeping vitamin D testing in perspective; due to public health efforts such as fortification in milk, multivitamins, and other products, severe vitamin D deficiency (<12 ng/ml=30 nmol/l) is a rare occurrence. While most adults are in the adequate threshold (>20 ng/ml=50 nmol/l), other studies have proven excessive levels (>50 ng/ml=125 nmol/l) can increase the risk of hypercalcemia and hypercalciuria, which can increase risk of stones, falls, or fractures. Dr. Moyad points to the baseline data from the study that showed the participants began with a vitamin D blood level that was healthy, at 30 ng/ml=75 nmol/l; therefore, he asserts it is not a surprise that increasing vitamin D from this level did not reduce the risk of fracture from falls. He explains that in oncology and urology vitamin D has a different role that is not discussed and that is in terms of counteracting hypocalcemia for patients on certain medications. He cites three drugs—Xgeva (denosumab), Zometa (zoledronic acid), and Reclast (zoledronic acid) and explains that treatment with any of these may worsen hypocalcemia and patients must be adequately supplemented with calcium and vitamin D. He emphasizes that for people at high risk for bone loss, vitamin D supplementation offers benefits; he cites data from the VITAL study that show a slight benefit of vitamin D supplementation for those taking osteoporosis medication. Dr. Moyad concludes by emphasizing extra vitamin D will work no better than a placebo in healthy patients and reiterating the comprehensive nature of the VITAL study.

Just the Beginning: What’s Next for Radiotheranostics in Prostate Cancer?

Posted by Geoffrey B. Johnson, MD, PhD | Aug 2022

Geoffrey B. Johnson, MD, PhD, Chair of the Division of Nuclear Medicine at the Mayo Clinic in Rochester, MN, discusses 177Lu-PSMA-617 treatment for castration-resistant metastatic prostate cancer (mCRPC) along with other advances in theranostics. He reviews how drug treatments target prostate-specific membrane antigen (PSMA) receptors, then highlights the VISION trial which tested 177Lu-PSMA-617 on patients who had previously undergone chemotherapy and hormone therapy. This trial found that patients with advanced prostate cancer had well-tolerated side effects, leading to studies like PSMAfore with patients who had not started chemotherapy. Dr. Johnson points out several drawbacks of 177LuPSMA-617, namely that it does not cure prostate cancer, there are dosing limitations, it is very expensive, and not all prostate cancer patients can be treated with it. He also notes that not all prostate cancer tumors express PSMA thereby reducing the benefit of 177LuPSMA-617. Dr. Johnson then describes combination therapies using hormonal therapy, chemotherapy, immunotherapy, external radiation, cocktail radionuclide therapy, and external radiation. Finally, he presents new technologies like PSMA post-therapy imaging, strategies to improve efficacy of cell binding, and targeting agents such as fibroblast activation protein (FAP) inhibitors.

wRVUs: Do They Really Measure the Workload and Complexity of What We Do?

Posted by Raj S. Pruthi, MD, MHA, FACS | Aug 2022

Raj S. Pruthi, MD, MHA, FACS, Professor in the Department of Urology at the University of California San Francisco, discusses how work Relative Value Units (wRVUs) correlate with the work urologists perform.