Latest Videos Archives

A Better Abiraterone: The Backdoor Pathway for Intracrine Androgen Metabolism

Posted by James L. Mohler, MD | Jul 2020

James L. Mohler, MD, Associate Director and Senior Vice President for Translational Research and Professor of Oncology at Roswell Park Comprehensive Cancer Center in Buffalo, New York, discusses the cause of and potential solutions to androgen receptor expression in castration-recurrent prostate cancer. He explains that prostate cancer tissue in a patient with castration-recurrent disease actually has greater levels of testosterone than benign prostate tissue and that castration-resistant prostate cancer relies on a backdoor pathway of manufacturing testosterone by which dihydrotestosterone (DHT) is made from androstanediol. Abiraterone is intended to inhibit CYP17A1 and therefore prevent the manufacture of DHT, but Dr. Mohler suggests that abiraterone inhibits CYP17A1 that is too far from DHT synthesis to achieve long term response by inhibition. He then discusses current research about a promising drug that targets the catalytic domain shared by the five 3α-oxidoreductases associated with DHT production.

Molecular Imaging For Staging and Advanced Disease – Axumin and PSMA

Posted by Robert E. Reiter, MD, MBA | Jun 2020

Robert E. Reiter, MD, Bing Professor of Urology and Molecular Biology, Director of the Prostate Cancer Program, and Director of Urologic Research at the David Geffen School of Medicine at the University of California, Los Angeles, discusses the benefits of PSMA imaging in the context of biochemical recurrence. He reviews data from an Australian and an American study which both depict a positive correlation between PSA levels and PSMA prostate cancer detection rates, as well as high sensitivities for detection of recurrence based on pathologic confirmation. He then discusses the results of a study which compared PSMA with Axumin and found PSMA to be more than twice as effective in all areas but the prostate bed, which is most likely due to PSMA being excreted through the bladder. He argues that PSMA imaging can produce between a 29% and 76% change in prostate cancer management and allows for greater precision in treatment, resulting in fewer occurrences of unnecessary radiation therapy and long term systemic therapy.

Chemotherapy Trials

Posted by Daniel P. Petrylak, MD | Jun 2020

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 in New Haven, Connecticut, discusses data from recent chemotherapy trials for castrate-resistant prostate cancer (CRPC). Dr. Petrylak specifically examines trials evaluating drug combinations as treatment for CRPC patients. Additionally, he reviews the effectiveness of PARP inhibitors in patients with DNA repair mutations. Finally, he notes the apparent superiority of cabazitaxel to NG AA treatment after progression on docetaxel.

Changing Landscape of mHSPC: New Approaches to an Old Problem

Posted by Michael S. Cookson, MD, MMHC | Jun 2020

Michael S. Cookson, MD, MMHC, Professor and Chairman of the Department of Urology at the University of Oklahoma Health Sciences Center in Oklahoma City, gives an overview of the changing landscape of metastatic hormone-sensitive prostate cancer (mHSPC). He reviews the different treatment strategies that have undergone testing over the last eight decades, noting that although treatment options have progressed, there is still work to be done to continue improving results. He presents the findings of key studies that look to improve survival through the use of more potent androgen-targeting techniques, among other cutting edge treatments. These new treatments show promising results in lowering risk of spread and death, bolstering Dr. Cookson’s key point: that the landscape is rapidly changing, and urologists need to adapt quickly.

Home for Dinner (Part 2 of 2)

Posted by Neil H. Baum, MD | Jun 2020

In Part 2 of his presentation on efficiency in the urologic practice, Neil H. Baum, MD, Clinical Professor of Urology at Tulane Medical School in New Orleans, Louisiana, offers five more ideas about how urologists can be more productive. He reviews the current problems facing urologists which make them less efficient. He explains why patients should complete their forms at home before coming into the office, as well as why it is important to obtain prior authorization. He emphasizes the benefits of using scribes and discusses the best way to use them. He also highlights how telemedicine can help improve efficiency by using it to fill no-show gaps in a urologist’s schedule. Finally, Dr. Baum talks about how important improving scheduling is and explains that the best way to stay on time is to build a 15-minute buffer into the schedule that can be used to deal with any emergencies that crop up.