Updates in Treatment Using ADT and Anti-Androgens

Posted by E. David Crawford, MD | May 2022

E. David Crawford, MD, presented “Updates in Treatment Using ADT and Anti-Androgens” during the 29th Annual Perspectives in Urology: Point-Counterpoint, on November 20, 2021, in Coronado Island, San Diego, California.

How to cite: Crawford, E. David. “Updates in Treatment Using ADT and Anti-Androgens.” November 20, 2021. Accessed Apr 2024. https://grandroundsinurology.com/guide-a-new-initiative-for-a-national-bio-repository/

Updates in Treatment Using ADT and Anti-Androgens

E. David Crawford, MD, Editor-in-Chief of Grand Rounds in Urology and Professor of Urology at the University of California, San Diego, discusses the state of androgen deprivation therapy (ADT) and anti-androgens as treatment methods for prostate cancer (PCa). He describes the mechanism of action of anti-androgens, stating that while they should be the best treatment for prostate cancer based on their ability to block tumor development without lowering testosterone levels, anti-androgens have some flaws. Dr. Crawford goes over the history of anti-androgens, beginning with Huggins demonstrating the efficacy of androgen ablation in 1941 and ending with apalutamide’s demonstrated efficacy in 2018. He suggests that anti-androgens are the backbone of treatment. Dr. Crawford discusses the safety of novel hormonal therapies based on data from PROSPER, SPARTAN, and ARAMIS that show adverse effects leading to death and discontinuation never increased by more than 8% relative to placebos. He then reviews discussions from the RADAR V group on how the transitional state from biochemically recurrent disease to advanced disease needs to be identified and managed in order to create better outcomes. Dr. Crawford also discusses the PEACE-1 trial which emphasized that combination therapy is key to treating specific forms of disease, as well as the SWOG S1216 trial which found that overall survival in the ADT treatment arm did not surpass the control arm’s overall survival of 70 months. Dr. Crawford concludes that anti-androgens are here to stay.

About the 29th Annual Perspectives in Urology: Point Counterpoint conference:
Presented by Program Chair and Grand Rounds in Urology Editor-in-Chief E. David Crawford, MD, this conference brought together leading experts in urology, medical oncology, and radiation oncology to discuss and debate the latest topics in genitourinary cancers, primarily prostate cancer and bladder cancer. This interactive conference offered topical lectures, pro/con debates, interesting-case presentations, interactive panel discussions, and interactive audience and faculty networking.

About The Author

E. David Crawford, MD

Researcher-physician E. David Crawford, MD, has devoted his career in medicine to educating the public about men's health issues and finding effective techniques and procedures to address prostate cancer, the most common malignancy affecting men in the United States. He is currently a Professor of Urology and Jack A. Vickers Director of Prostate Research at the University of California, San Diego. Dr. Crawford received his medical degree from the University of Cincinnati and his postgraduate training included an internship and residency in urology at the Good Samaritan Hospital in Cincinnati. He subsequently completed a genitourinary cancer fellowship at the University of California Medical Center in Los Angeles. Dr. Crawford is an internationally recognized expert in benign prostate hypertrophy, urologic cancers, and in particular, prostate cancer. He has conducted research in the treatment of advanced bladder cancer, metastatic adenocarcinoma of the prostate, hormone-refractory prostate cancer, and other areas of urological infections and malignancies. He has authored or coauthored over 810 scientific articles, has published seven textbooks, authored over 60 book chapters, and provided more than 2,200 educational talks for patients and physicians. In an effort to raise public awareness about prostate health, Crawford in 1989 founded the Prostate Conditions Education Council (PCEC). The non-profit organization is comprised of a consortium of leading physicians, health educators, scientists, and men's health advocates. PCEC's advocacy for free or low-cost prostate screening has affected the lives of millions of American men. He currently chairs the PCEC. Crawford is an active member of many national and international organizations, including the American Society of Clinical Oncology, the American Urological Association (AUA), and the American Association for the Advancement of Science. Within the AUA, he has been a member of the Committee to Study Urologic Research Funding and the prostate cancer clinical trials subcommittee. Crawford served on the board of governors, the scientific advisory board of the Southwest Oncology Group, and was chairman of the Genitourinary Cancer Committee for 27 years. This group is the largest clinical trials group in the world. Crawford's involvement in the national prostate cancer arena has been widely recognized. He has received many honors and awards, including the CAP Cure Annual Award for Scientific Presentation in 1999 In 1997, he was presented with a 'Freddie Award" at the AMA International Health and Medical Film Competition for the program, ITV: The Cutting Edge Medical Report (Prostate Cancer: Understanding, Diagnosing, and Defeating), which Crawford hosted with special guest, retired General Norman Schwarzkopf. Crawford again won a prestigious 'Freddie Award" 5 years ago... He is a member of Best Doctors of America and was named Healthcare Provider of the Year in the Denver Metro area by the Denver Business Journal. He has been recognized as one of the Best Doctors of America for the past two decades and is recognized as one of the top 20 urologists in the country, for men, by Men’s Health Magazine. In 2018 he received the honor of being named the Distinguished Alumnus of the Year from the University of Cincinnati School of Medicine. In May of 2019, he received the Presidential citation from the American Urological Association recognizing for his “tireless role in genitourinary cancer research that has benefited countless urologic cancer patients.” He accepted the position of Editor in Chief of Grand Rounds in Urology in June of 2019. In 2021, he was the recipient of the Merle Stringer, M.D. annual award for excellence in medicine by the Florida State Medical Association.

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