Multimodal Approach to Advanced Prostate Cancer
Martin E. Gleave, MD, FRCSC, FACS, presented “Multimodal Approach to Advanced Prostate Cancer,” with an introduction from E. David Crawford, MD.
Multimodal Approach to Advanced Prostate Cancer
Summary:
Martin E. Gleave, MD, FRCSC, FACS, discusses his views on improving advanced prostate cancer treatment approaches. Specifically, he emphasizes methods that integrate various treatment options beyond surgical castration and androgen deprivation therapy (ADT).
To further expand your knowledge of prostate cancer treatment with ADT, visit the Androgen Deprivation Therapy Next Generation Learning Center.
Androgen Action
Dr. Gleave explains the basic science behind androgen action driving prostate cancer carcinogenesis, proliferation, and cancer cell survival. Due to this, targeting the androgen receptor (AR) pathway can control the disease, lead to remissions, and cause prolonged survival. Naturally, this has made ADT been a mainstay of metastatic prostate cancer treatment methods in recent history.
Androgen Deprivation Therapy for Castrate Sensitive Prostate Cancer
Though ADT has proven its efficacy in recent years, Dr. Gleave believes urologists must explore the combination of ADT with systemic or regional therapies to further improve patient outcomes. As an illustration, he reviews clinical trials testing docetaxel/ADT and abiraterone/ADT combinations. He describes “maximizing ADT,” or in other words, targeting ligand production and antagonizing its effects. Furthermore, he compares and contrasts continuous vs. intermittent therapy. He recommends focusing on multimodal considerations when deciding to prescribe ADT for men with oligometastatic or low burden metastatic disease.
Emerging AR Pathway Inhibitors in Castrate Resistant Prostate Cancer
Dr. Gleave summarizes clinical trials for emerging AR pathway inhibitors and treatment methods. First, he reviews the STAMPEDE trial, which compared ADT monotherapy against ADT plus definitive treatments. Additionally, he discusses Best Systemic Treatment plus definitive treatment.
ABOUT THE AUTHOR
Dr. Gleave is a Distinguished Professor and Chairman of the Department of Urologic Sciences at the University of British Columbia in Vancouver, as well as a British Columbia Leadership Chair. He is Co-Founder and Director of the Vancouver Prostate Centre, now a UBC and National Centre of Excellence, publishing more than 560 papers with more than 47,000 citations, an H-Index of 111, and attracting more than $120M in research funding. Dr. Gleave is a clinician-scientist and urologic surgeon whose clinical practice focuses on urologic oncology in a multi-disciplinary environment spanning localized and advanced cancers. His research characterizes molecular mechanisms mediating treatment resistance in cancer, focusing on adaptive survival responses that drive acquired treatment resistance, and designing combination co-targeting strategies to create conditional lethality and improve cancer control. He patented several anti-cancer drugs and founded OncoGenex Pharmaceuticals to develop OGX-011 and OGX-427, inhibitors of cytoprotective chaperones clusterin and Hsp27 which progressed to Phase III and Phase II trials world-wide. OncoGenex was awarded Canadian Biotech Company of the Year in 2010. Dr. Gleave also co-founded TRiADD and Sustained Therapeutics.
Dr Gleave is the recipient of numerous awards, including the Dr. Chew Wei Memorial Prize in Cancer Research, the Huggins Medal from the SUO, the Richard Williams Award from the AUA, the Barringer Medal from the American Association of GU Surgeons, the Eugene Fuller Award from the American Urological Association in 2013, the Aubrey Tingle Prize from the Michael Smith Foundation for Health Research, and the NCIC William Rawls Award for contributions to cancer control in Canada. He was appointed a Distinguished University Scholar at UBC in 2003 and awarded a BC Leadership Chair in 2005. Dr Gleave was awarded the 2006 BC Biotech Award for Innovation and Achievement, and the 2007 BC Innovation Council Frontiers in Research Award.
In 2017, Dr. Gleave was appointed to the Order of Canada for his leadership role in developing new treatments for prostate cancer and for his research on mechanisms mediating treatment resistance in cancer.
