Topic: Advanced Disease

Integrating Care in Advanced Prostate Cancer

by John W. Davis, MD | Sep 2024

John W. Davis, MD, addresses the economic burden and stress experienced by patients due to high treatment costs in advanced prostate cancer (APC) management. He stresses that this aspect of APC care often goes under-discussed.

In this 11-minute presentation, Dr. Davis 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.

John W. Davis, MD, highlights the different ways integrated care models can be adopted across healthcare systems to enhance the management of advanced prostate cancer. By fostering a collaborative approach and eliminating barriers, Dr. Davis believes that the future of advanced prostate cancer care will be strengthened.

PARPi in mCRPC

by Daniel P. Petrylak, MD | Sep 2024

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.

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

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.

International, Multi-Disciplinary Consensus on Treatment of Advanced Prostate Cancer

by Silke Gillessen, MD | Jun 2024

Silke Gillessen, MD analyzes the international, multi-disciplinary consensus on the treatment of advanced prostate cancer, emphasizing the collaborative efforts of experts from various medical fields. She highlights the critical importance of integrating diverse perspectives to develop effective treatment protocols.

The consensus process involves an extensive review of clinical data, expert opinions, and patient outcomes, ensuring that the recommendations are evidence-based and practical. Dr. Gillessen discusses key areas of agreement for treatment, including hormone therapy, chemotherapy, and novel targeted therapies.

Dr. Gillessen highlights the potential of new treatment modalities, such as PARP inhibitors and immunotherapies. Moreover, she advocates for treatment plans tailored to individual patient profiles, taking into account genetic, molecular, and clinical factors. This approach aims to enhance treatment efficacy and minimize adverse effects, aligning with the principles of precision oncology.

Understanding Metastatic Castration-Resistant Prostate Cancer

by Shell Liang, PhD | Jun 2024

Shell Liang, PhD, discusses metastatic castration-resistant prostate cancer (mCRPC), a form of prostate cancer that progresses despite androgen deprivation therapy (ADT). Dr. Liang emphasizes the critical need for advanced therapeutic strategies to manage this aggressive cancer subtype effectively.
The presentation reviews the current therapeutic landscape for mCRPC, focusing on second-generation AR pathway inhibitors such as abiraterone and enzalutamide. Additionally, the discussion includes the role of chemotherapeutic agents like docetaxel and cabazitaxel. Dr. Liang also explores emerging treatment modalities, including PARP inhibitors and immunotherapies.
Dr. Liang advocates using genomic profiling to identify actionable mutations and tailor treatments to individual patient profiles. This approach aims to optimize therapeutic efficacy and minimize adverse effects, aligning with the principles of precision medicine.

Choosing Systemic Therapy for Men with Metastatic Hormone Sensitive Prostate Cancer

by Andrew W. Hahn, MD | Jun 2024

Andrew W. Hahn, MD, analyzes systemic therapy choices for men with metastatic hormone-sensitive prostate cancer. His presentation delves into the critical factors influencing treatment decisions and the latest advancements in therapeutic options.
Dr. Hahn begins by outlining current systemic therapies, including androgen deprivation therapy (ADT) and its combination with other agents. By discussing the mechanisms of action and the efficacy of various therapeutic agents, Dr. Hahn provides a detailed examination of the available treatment options.
Dr. Hahn also addresses the role of personalized medicine in managing metastatic hormone-sensitive prostate cancer. He highlights the importance of genetic profiling and biomarker testing in tailoring treatment plans to individual patients.
Throughout the presentation, Dr. Hahn underscores the dynamic nature of prostate cancer treatment, with ongoing research continually informing and refining clinical practice.

Advanced Prostate Cancer: Sequencing of Treatment

by Arnulf Stenzl, MD | Jun 2024

Arnulf Stenzl, MD, discusses the challenges of appropriately sequencing advanced prostate cancer treatment and presents possible solutions. In his presentation, he addresses:

Recent and Anticipated Changes in Advanced Prostate Cancer Treatment
The Issue of Physician Information Overload
The Lack of Easily Accessible Comparative Data Between Agents
Possible Applications of Artificial Intelligence in Literature Searches

PSMA in Metastatic Prostate Cancer: Imaging as Biomarker

by Louise Emmett, MD | Jun 2024

Louise Emmett, MD, addresses prostate-specific membrane antigen (PSMA) in metastatic prostate cancer, focusing on imaging as a biomarker.

Multi-Disciplinary Approach to Advanced Prostate Cancer Care

by Kelvin A. Moses, MD, PhD, FACS | May 2024

Kelvin A. Moses, MD, PhD, FACS, explores a multidisciplinary approach to advanced prostate cancer care and treatment.

The Role of Radiotherapy in Oligometastatic Prostate Cancer and How to Treat the Primary in De Novo Oligometastatic Disease

by Daniel A. Hamstra, MD, PhD, FASTRO, FASCO | Dec 2023

Daniel A. Hamstra, MD, PhD, FASTRO, FASCO, discusses the use of radiotherapy in oligometastatic prostate cancer treatment and how to approach treating the primary in de novo oligometastatic disease. In this presentation, Dr. Hamstra covers:

The history and definition of oligometastatic disease.
The history of radiation therapy in localized and metastatic prostate cancer.
Results from the STAMPEDE, PEACE-1, and STOMP and ORIOLE trials.
The Pros and Cons of including radiation therapy in systemic therapy.
Progression to Survival and Overall Survival rates in radiation therapy patients.

Dr. Hamstra concludes by highlighting the need for more data on low-volume versus high-volume patients, and he recommends enrolling eligible patients in the ongoing SWOG S1802 trial.

Novel Targeted Treatments for Metastatic Disease

by Alan H. Bryce, MD | Nov 2023

Alan H. Bryce, MD, Medical Director of the Genomic Oncology Clinic at Mayo Clinic Arizona in Scottsdale, discusses the limitations of traditional treatments for metastatic prostate cancer, such as androgen deprivation therapy (ADT) and chemotherapy, which, while effective initially, often lead to resistance and progression. He emphasizes the need for innovative approaches that target specific molecular pathways involved in prostate cancer growth and metastasis.
He highlights several promising targeted therapies currently under investigation. One is the use of PARP inhibitors, such as olaparib and rucaparib, which target cancer cells with defective DNA repair mechanisms, particularly those with BRCA1/2 mutations. Dr. Bryce also discusses the role of androgen receptor (AR) pathway inhibitors, including novel agents like enzalutamide and enzalutamide, which provide more potent and selective inhibition of AR signaling than traditional ADT.
Dr. Bryce switches focuses to radiopharmaceuticals, such as lutetium-177 (Lu-177) PSMA-617, which deliver targeted radiation to prostate-specific membrane antigen (PSMA)-expressing cells. Clinical trials indicate that this approach can effectively reduce tumor burden and improve clinical outcomes in patients with advanced prostate cancer. Additionally, he explores the potential of immunotherapies, including immune checkpoint inhibitors and vaccines, in treating metastatic prostate cancer.

Identifying Mutations and Optimizing Use of PARP Inhibitors

by William K. Oh, MD | Nov 2023

William K. Oh, MD, highlights the growing significance of precision medicine and the role of genetic profiling in tailoring therapeutic strategies. Dr. Oh begins by outlining the importance of identifying DNA repair gene mutations, particularly BRCA1 and BRCA2, in prostate cancer patients. These mutations, which impair the cell’s ability to repair DNA damage, render the cancer more susceptible to treatments targeting DNA repair mechanisms, such as PARP inhibitors.

Dr. Oh delves into the mechanisms of PARP inhibitors, which function by inhibiting the poly (ADP-ribose) polymerase (PARP) enzyme involved in DNA repair. By blocking this pathway, PARP inhibitors induce synthetic lethality in cancer cells harboring defective DNA repair genes, leading to cell death.

Dr. Oh discusses the importance of patient selection based on genetic profiling and the potential for combining PARP inhibitors with other therapies, such as androgen receptor signaling inhibitors and immune checkpoint inhibitors, to enhance their efficacy. He reviews ongoing clinical trials exploring these combination strategies and their preliminary results.

Join the GRU Community

- Why Join? -

Topic: Advanced Disease

Join the GRU Community

You have Successfully Subscribed!