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PSMA PET-Positive Metastatic Castration-Resistant Prostate Cancer
In this video, Drs. Matthew R. Smith, Xin Gao, and Alicia K. Morgans discuss the emerging role of PSMA (prostate-specific membrane antigen)-targeted therapy in metastatic castration-resistant prostate cancer. Dr. Smith presents a case of a 67-year-old man with metastatic castration-resistant...
Metastatic Castration-Resistant Prostate Cancer and DNA Repair Gene Alterations
In this video, Drs. Matthew R. Smith, Xin Gao, and Alicia K. Morgans discuss the role of PARP inhibitors in the treatment of metastatic castration-resistant prostate cancer and homologous recombination repair deficiency, focusing on data from the PROfound trial. Dr. Smith presents a case of a...
High-Volume De Novo Metastatic Castration-Sensitive Prostate Cancer
In this video, Drs. Matthew R. Smith, Xin Gao, and Alicia K. Morgans discuss the management of metastatic castration-sensitive prostate cancer, focusing on data from the phase III PEACE-1 trial. The faculty present the case of a 61-year-old man with de novo metastatic high-volume...
Low-Volume Recurrent Metastatic Castration-Sensitive Prostate Cancer
In this video, Drs. Matthew R. Smith, Xin Gao, and Alicia K. Morgans discuss the management of metastatic castration-sensitive prostate cancer, focusing on data from the phase III TITAN trial. The faculty present the case of a 73-year-old man with recurrent, low-volume/low-risk metastatic...
Neeraj Agarwal, MD, on Treatment Patterns and Disparities in Patients With Prostate Cancer
Neeraj Agarwal, MD, of Huntsman Cancer Institute at the University of Utah, discusses three studies that examined real-world treatment patterns and utilization of advanced therapies in men with metastatic castration-sensitive prostate cancer, which served to highlight the ways in which Black men...
Neeraj Agarwal, MD, on Prostate Cancer: Androgen-Deprivation Therapy With Orteronel or Bicalutamide
Neeraj Agarwal, MD, of Huntsman Cancer Institute at the University of Utah, discusses phase III data from the SWOG S1216 trial, which evaluated the clinical benefit of using androgen-deprivation therapy with either orteronel (or TAK-700, a CYP17 inhibitor) or bicalutamide in patients with newly...
Peter C. Black, MD, on Prostate Cancer Health-Care Disparities: Expert Perspective
Peter C. Black, MD, of the Vancouver Prostate Centre, University of British Columbia, reviews three studies on early detection and treatment of Black patients with prostate cancer: a large-scale analysis of genomic profiling; the use of PSA screening; and integrating a patient-specific genomic...
Karim Fizazi, MD, PhD, on Prostate Cancer: Abiraterone Acetate, Prednisone, and Radiotherapy in Metastatic Disease
Karim Fizazi, MD, PhD, of Institut Gustave Roussy, discusses first results from the phase III PEACE1 trial, which showed that abiraterone plus androgen-deprivation therapy and docetaxel improves radiographic progression-free survival in men with de novo metastatic prostate cancer (Abstract 5000).
Michael J. Morris, MD, on Prostate Cancer: LuPSMA in the Metastatic Setting
Michael J. Morris, MD, of Memorial Sloan Kettering Cancer Center, discusses phase III results of the VISION study, which showed that lutetium-177–PSMA-617 (LuPSMA), a targeted radioligand therapy, plus standard-of-care treatment improves radiographic progression-free survival and extends overall...
Sandy Srinivas, MD, on Managing Metastatic Castration-Resistant Prostate Cancer
Sandy Srinivas, MD, of Stanford Cancer Institute, discusses the increasing number of ways to deliver life-prolonging therapy to patients with advanced prostate cancer, including more accurate imaging techniques; PET tracers to help better detect, diagnose, and treat disease; PARP inhibitors for...
Felix Y. Feng, MD, on Prostate Cancer: Choosing Patients Who May Benefit From Apalutamide
Felix Y. Feng, MD, of the University of California, San Francisco, discusses study findings showing that molecular determinants may help clinicians select patients with nonmetastatic castration-resistant prostate cancer who may derive the most benefit from apalutamide and other androgen-signaling...
Neeraj Agarwal, MD, on Prostate Cancer: Apalutamide vs Placebo in Treatment of Metastatic Disease
Neeraj Agarwal, MD, of Huntsman Cancer Institute at the University of Utah, discusses final results of the phase III TITAN study, which showed apalutamide plus androgen-deprivation therapy improved overall survival, reducing the risk of death up to 48%. This combination treatment also delayed...
Christopher Sweeney, MBBS, and Thomas Powles, MD, PhD, on Treating GU Malignancies: Expert Views
A spirited discussion ensued when we asked Christopher Sweeney, MBBS, of Dana-Farber Cancer Institute, and Thomas Powles, MD, PhD, of Cancer Research UK Barts Centre, to compare notes on how they treat bladder, prostate, and kidney cancers.
Christopher Sweeney, MBBS, on Prostate Cancer: Analyzing Biomarkers, Ipatasertib Plus Abiraterone
Christopher Sweeney, MBBS, of Dana-Farber Cancer Institute, discusses phase III findings from the IPATential150 trial, which showed the effectiveness of ipatasertib plus abiraterone as first-line treatment in patients with metastatic castration-resistant prostate cancer vs placebo plus abiraterone. ...
Linda G.W. Kerkmeijer, MD, PhD, on Prostate Cancer: Adding a Focal Boost to External-Beam Radiotherapy
Linda G.W. Kerkmeijer, MD, PhD, of the University Medical Center Utrecht and Radboud University Medical Center, discusses results from the phase III FLAME trial, which explored the question of whether biochemical disease–free survival can be improved by adding a focal boost to the intraprostatic...
Justin Oh, MD, on Prostate Cancer: Brachytherapy vs External-Beam Radiation Therapy
Justin Oh, MD, of the University of British Columbia, discusses results from the ASCENDE-RT trial, which compared a low-dose–rate brachytherapy boost to a dose-escalated external-beam boost for patients with high- and intermediate-risk prostate cancers (Abstract 127).
Daniel E. Spratt, MD, on Prostate Cancer: Relugolix vs Leuprolide
Daniel E. Spratt, MD, of the University of Michigan Rogel Cancer Center, discusses phase III results of the HERO trial, which suggested benefits of the oral medication relugolix: a substantially faster time to castration with longer duration, fewer cardiac events, and a faster return to normal...
Daniel E. Spratt, MD, on Prostate Cancer: Short-Term Adjuvant vs Neoadjuvant Hormone Therapy
Daniel E. Spratt, MD, of the University of Michigan Rogel Cancer Center, discusses a pooled analysis of two phase III trials showing adjuvant androgen-deprivation therapy (ADT) improves biochemical control and reduces distant metastasis when compared with a neoadjuvant approach, with no difference...
Cynthia Menard, MD, on Prostate Cancer: PSMA PET- and CT-Guided Intensification of Radiotherapy
Cynthia Menard, MD, of the University of Montreal, discusses a study on the use of prostate-specific membrane antigen PET and CT to guide treatment. The scans led to high rates of new lesion detection and therefore intensification of radiotherapy for patients with prostate cancer, without an...
Paul Sargos, MD, on Prostate Cancer: Adjuvant or Early Salvage Radiotherapy Plus Androgen Deprivation
Paul Sargos, MD, of the Institut Bergonié, discusses phase III findings from the GETUG-AFU 17 study, which compared adjuvant vs early salvage radiotherapy, both combined with short-term androgen-deprivation therapy after radical prostatectomy for localized prostate cancer. Although lacking...
Neha Vapiwala, MD, on Prostate Cancer: Imaging and the Decision to Treat With Radiation
Neha Vapiwala, MD, of the University of Pennsylvania, who served as a discussant for LBA1, summarizes her review of this study of patients with prostate cancer who had biochemical recurrence in the post-prostatectomy setting, who were candidates for salvage radiotherapy, and who received either...
Nicholas D. James, PhD, MBBS, on Prostate Cancer: Abiraterone Acetate Plus Prednisolone for Hormone-Naive Disease
Nicholas D. James, PhD, MBBS, of The Institute of Cancer Research, London, discusses long-term STAMPEDE trial results that showed patients with metastatic, hormone-naive prostate cancer benefited from abiraterone acetate plus prednisolone in terms of overall and failure-free survival, as well as...
Daniel P. Petrylak, MD, on Prostate Cancer: First-in-Human Study of ARV-110 Shows Antitumor Activity
Daniel P. Petrylak, MD, of the Yale Cancer Center, discusses early data on ARV-110, an androgen receptor proteolysis–targeting chimera degrader, demonstrating antitumor activity in metastatic castration-resistant prostate cancer after treatment with enzalutamide and abiraterone (Abstract 3500).
Michael J. Morris, MD, on Prostate Cancer: Impact of PSMA-Targeted Imaging on Clinical Management
Michael J. Morris, MD, of Memorial Sloan Kettering Cancer Center, discusses phase III data from the CONDOR trial, which showed that PSMA-targeted PET scans detected and localized occult disease in most men with biochemically recurrent prostate cancer presenting with negative or equivocal...
Neal D. Shore, MD, on Prostate Cancer: Relugolix vs Leuprolide for Advanced Disease
Neal D. Shore, MD, of the Carolina Urologic Research Center, discusses phase III results of the HERO study, which showed relugolix achieved castration as early as day 4 and was superior to leuprolide in sustained testosterone suppression, testosterone recovery after discontinuation, and reduction...
Rana R. McKay, MD, on Prostate Cancer: Intense Androgen-Deprivation Therapy Before Radical Prostatectomy
Rana R. McKay, MD, of the University of California, San Diego, discusses the results of a phase II trial of intense neoadjuvant hormone therapy followed by radical prostatectomy in men with high-risk prostate cancer. The data show that 21% of patients had a favorable pathologic response (Abstract...
David R. Wise, MD, PhD, on Novel Biomarkers in Prostate Cancer: Is Tissue the Issue?
David R. Wise, MD, PhD, of New York University Perlmutter Cancer Center, summarizes three important studies in prostate cancer: circulating tumor cell count as a prognostic marker of PSA response and progression in metastatic castration-sensitive disease; new phenotypic subtypes; and how...
Michael S. Hofman, MBBS, on Prostate Cancer: LuPSMA vs Cabazitaxel in Metastatic Castration-Resistant Disease
Michael S. Hofman, MBBS, of the Peter MacCallum Cancer Centre, discusses phase II results from the ANZUP 1603 trial, which showed that in men with docetaxel-treated metastatic castration-resistant prostate cancer, LuPSMA was more active than cabazitaxel, with relatively fewer grade 3 and 4 adverse...
Nicholas D. James, PhD, MBBS, on Adding Abiraterone to Hormone Therapy in Prostate Cancer: STAMPEDE Trial on Cost-Effectiveness
Nicholas D. James, PhD, MBBS, of The Institute of Cancer Research in London, discusses the health economics of adding abiraterone to first-line, long-term hormone therapy in prostate cancer, and what it means for long-term survival, quality-adjusted survival, and cost-effectiveness (Abstract 204).
Hannah L. Rush, MBChB, on Prostate Cancer: Comparing Quality of Life in Patients Receiving Docetaxel or Abiraterone
Hannah L. Rush, MBChB, of the Clinical Trials Unit at University College London, discusses an analysis of the STAMPEDE trial, which showed that patients treated with abiraterone had higher scores in global quality of life as well as in the physical, social, and role function domains and lower...
Karim Fizazi, MD, PhD, on Prostate Cancer: Pain and Quality of Life in Patients Receiving Cabazitaxel vs Abiraterone or Enzalutamide
Karim Fizazi, MD, PhD, of the Institut Gustave Roussy, discusses results from the CARD study, which showed that cabazitaxel improved pain, time to pain progression, and symptomatic skeletal events, as well as quality of life in patients with metastatic castration-resistant prostate cancer. The...
Maha Hussain, MD, on Next-Generation Sequencing of Prostate Tumor Tissue: Results From the PROfound Study
Maha Hussain, MD, of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, discusses the first phase III clinical trial to demonstrate the feasibility of tissue-based genomic testing to preselect men with metastatic castration-resistant prostate cancer for targeted treatment...
Neeraj Agarwal, MD, on Castration-Resistant Prostate Cancer: Results From the COSMIC-021 Study of Cabozantinib and Atezolizumab
Neeraj Agarwal, MD, of the University of Utah Huntsman Cancer Institute, discusses trial findings that showed the combination of cabozantinib and atezolizumab had a tolerable safety profile and showed activity in men with metastatic disease. Further evaluation of cabozantinib and atezolizumab is...
David P. Dearnaley, MD, on Prostate Cancer: Conventional vs Hypofractionated High-Dose Radiotherapy
David P. Dearnaley, MD, of The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, discusses 8-year outcomes of the phase III CHHiP trial, which showed that modest hypofractionation is noninferior to conventional fractionation in localized prostate cancer, with no increase in side...
Julie N. Graff, MD, on Castration-Resistant Prostate Cancer: Results From KEYNOTE-199 on Pembrolizumab Plus Enzalutamide
Julie N. Graff, MD, of Oregon Health & Science University and Knight Cancer Institute, discusses study findings that show pembrolizumab plus enzalutamide after progression on enzalutamide produced clinical activity and can lead to durable responses, with a manageable safety profile. The phase...
Nicholas D. James, PhD, MBBS, on the STAMPEDE Trial: Long-Term Subgroup Analysis by Metastatic Burden in Hormone-Naive Prostate Cancer
Nicholas D. James, PhD, MBBS, of University Hospitals Birmingham NHS Trust, discusses results from a long-term follow-up of a cohort treated with docetaxel in the STAMPEDE randomized trial, confirming that the treatment showed benefit in patients with both high- and low-volume disease (Abstract...
Nicholas D. James, PhD, MBBS, on Prostate Cancer: STAMPEDE Trial M1|RT Comparison of Radiotherapy
Nicholas D. James, PhD, MBBS, of University Hospitals Birmingham NHS Trust, discusses the efficacy of prostate radiotherapy plus androgen-deprivation therapy with or without docetaxel in patients with prostate cancer with only lymph node metastases or less than four bone metastases (Abstract 844O).
Maha H.A. Hussain, MD, on Castration-Resistant Prostate Cancer: Olaparib/Enzalutamide/Abiraterone
Maha H.A. Hussain, MD, of Northwestern University Robert H. Lurie Comprehensive Cancer Center, discusses the phase III PROfound trial results on the efficacy of olaparib in men with metastatic castration-resistant prostate cancer whose tumors harbor alterations in DNA damage response genes and who...
Ronald de Wit, MD, PhD, on Prostate Cancer: Results of the CARD Trial on Cabazitaxel, Abiraterone, and Enzalutamide
Ronald de Wit, MD, PhD, of the University Medical Center Rotterdam, discusses study findings which showed that cabazitaxel improved radiographic progression-free survival as well as overall survival in patients with metastatic castration-resistant prostate cancer (Abstract LBA13).
Andrew Kneebone, MD, on an ANZUP Trial on Adjuvant vs Early Salvage Radiotherapy After Prostatectomy
Andrew Kneebone, MD, of Royal North Shore Hospital, discusses phase III study findings showing that at 5 years, biochemical control was similar between adjuvant and early salvage radiotherapies, the latter sparing half of the men potential side effects of radiotherapy without any significant...
Ryan Phillips, MD, PhD, on Oligometastatic Prostate Cancer: ORIOLE Trial on Observation vs Stereotactic Ablative Radiation
Ryan Phillips, MD, PhD, of Johns Hopkins Medical Institutions, discusses phase II findings suggesting that treatment with stereotactic ablative radiation significantly decreased the risk of disease progression at 6 months and increased progression-free survival (Abstract LBA3).
Daniel E. Spratt, MD, on the Impact of Antiandrogen Treatment in Prostate Cancer: NRG Oncology/RTOG 9601 Trial
Daniel E. Spratt, MD, of the University of Michigan, discusses phase III study findings showing that 2 years of antiandrogen therapy increased cardiac and neurologic toxicities, as well as mortality from causes other than prostate cancer, in men with low levels of prostate-specific antigen after...
FDA Pipeline: Priority Reviews in Prostate Cancer, Mantle Cell Lymphoma
This week, the U.S. Food and Drug Administration (FDA) accepted new drug applications for enzalutamide in metastatic hormone-sensitive prostate cancer and zanubrutinib in relapsed or refractory mantle cell lymphoma, and granted both applications Priority Review. Priority Review for Enzalutamide in ...
Mortality Risk for Patients With Preexisting Cardiovascular Conditions Treated With Abiraterone Acetate or Enzalutamide
A new population-based study showed that novel oral androgen signaling–inhibitor therapies may be associated with an increased risk of death in patients with preexisting cardiovascular conditions. The research was published by Lu-Yao et al in European Urology. “Data from published ...
FDA Pipeline: Designation in CLL, New Drug Application in GIST, New Prostate Ablation System Receives 510(k) Clearance
Recently, the U.S. Food and Drug Administration granted Breakthrough Therapy designation to acalabrutinib in chronic lymphocytic leukemia (CLL), accepted a new drug application for avapritinib in some types of gastrointestinal stromal tumors (GIST), and granted 501(k) clearance to market the...
FDA Review Finds No Increased Risk of Prostate Cancer With Parkinson's Disease Treatments Containing Entacapone
A U.S. Food and Drug Administration (FDA) review of additional data found no increased risk of prostate cancer with the use of entacapone to treat Parkinson’s disease. The FDA conducted this review after an earlier trial—the Stalevo Reduction in Dyskinesia Evaluation–Parkinson's...
Are MRI-Assisted Biopsies More Effective Than Standard Ultrasound-Guided Biopsies Alone in the Detection of Prostate Cancer?
Using magnetic resonance imaging (MRI) to target biopsies is more effective at detecting prostate cancers that are likely to need treatment than standard ultrasound-guided biopsies alone, according to research published by Elwenspoek et al in JAMA Network Open. Prostate biopsies can cause side...
Comparison of Scans for Detection of Early Biochemical Recurrence of Prostate Cancer After Prostatectomy
In a single-center study reported in The Lancet Oncology, Calais et al found that the use of gallium Ga-68 prostate-specific membrane antigen-11 positron-emission tomography/computed tomography (PSMA PET/CT) resulted in higher detection rates of early biochemical recurrence of prostate cancer after ...
Androgen-Deprivation Therapy May Increase Risk for QT Prolongation and Torsades de Pointes
In a study published by Salem et al in Circulation, researchers examined how several testosterone-blocking drugs commonly used in the treatment of prostate cancer affect the heart's QT interval. The longer a QT interval—typically measured by an electrocardiogram—the more at risk a ...
Adjuvant Radiotherapy After Radical Prostatectomy vs Radical Prostatectomy Alone in Patients With Positive Margins or Extracapsular Extension
In patients with prostate cancer with surgical positive margins or extracapsular extension of their disease, the risk of disease recurrence postprostatectomy is higher than in cases where the cancer cells are confined within the prostate. The Finnish FinnProstataX study investigated...
