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This is Part 3 of Targeted Approaches to Metastatic Hormone-Sensitive Prostate Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Drs. Alicia Morgans, Charles Ryan, and David VanderWeele discuss the management of recurrent low-volume metastatic hormone-sensitive prostate cancer (mHSPC). The patient is a 62-year-old man with a history of localized prostate cancer treated with radical prostatectomy 3 years ago. His PSA has started to increase over the past 6 months and is now 0.7 ng/mL. His comorbidities include metabolic syndrome. A PSMA PET scan reveals several retroperitoneal lymph node metastases and a small pelvic lesion. In the conversation that follows, the faculty discuss whether systemic treatment or metastasis-directed therapy would be more appropriate for this patient with recurrent low-volume mHSPC, factors (including genetic testing) that influence the optimal duration of treatment, and managing cardiovascular risk factors.
This is Part 2 of Targeted Approaches to Metastatic Hormone-Sensitive Prostate Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Drs. Alicia Morgans, Charles Ryan, and David VanderWeele discuss the treatment of high-risk de novo metastatic hormone-sensitive prostate cancer (mHSPC). The patient is a 62-year-old man with benign prostatic hyperplasia who has noted worsening urinary symptoms over the past 12 weeks. His PSA is 9.3 ng/mL, and a prostate biopsy demonstrates Gleason 4+4, grade group 4 prostate adenocarcinoma. Conventional CT is negative for metastatic disease, but PSMA PET/CT reveals multiple areas of vertebral body involvement and retroperitoneal lymph node metastases. He has no actionable alterations. In the conversation that follows, the faculty discuss how the imaging findings impact treatment considerations for this patient with high-volume mHSPC, whether treatment options would change in the presence of an HRR mutation, and factors to consider when choosing an androgen receptor pathway inhibitor.
As reported in The Lancet Oncology by Agarwal et al, the phase III CONTACT-02 trial examined the survival benefit of cabozantinib plus atezolizumab vs switch of androgen receptor pathway inhibitor (ARPI) in patients with castration-resistant prostate cancer with extrapelvic soft-tissue metastases...
This is Part 1 of Targeted Approaches to Metastatic Hormone-Sensitive Prostate Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Drs. Alicia Morgans, Charles Ryan, and David VanderWeele discuss the treatment of de novo high-volume metastatic hormone-sensitive prostate cancer with PTEN deficiency. The patient is a 68-year-old man who presented with worsening back pain. X-rays demonstrated an area in L1 concerning for metastatic cancer, and he had a prostate-specific antigen of 23 ng/mL. After a staging workup, he was found to have multifocal bone metastases consistent with de novo high-volume metastatic hormone-sensitive prostate cancer. In the conversation that follows, the faculty discuss the importance of upfront germline and somatic genetic testing in patients with mHSPC, treatment options for patients with PTEN deficiency, managing adverse events associated with capivasertib, and more.
The 2025 ASCO Annual Meeting has officially concluded. Our sincere thanks to the global oncology community and ASCO for creating such a remarkable forum advancing cancer care. Here we highlight the most impactful updates in genitourinary tumors from this year’s meeting. Kidney Cancer: Long-Term...
Injection with botulinum toxin (BTX) type A (IncoA) plus transdermal scopolamine led to the reduction in radiation-induced salivary gland toxicity without compromising PSMA (prostate-specific membrane antigen) tumor uptake in patients with metastatic prostate cancer who were receiving...
In an analysis from a phase III trial (PACE-C) reported in The Lancet Oncology, Tree et al compared early toxicity rates with intensity-modulated moderately hypofractionated radiotherapy (MHRT) vs stereotactic body radiotherapy (SBRT) in patients with intermediate- and high-risk prostate...
The U.S. Food and Drug Administration (FDA) has approved a label expansion of a kit for the preparation of gallium Ga-68 gozetotide for injection (Illuccix) to include patient selection for radioligand therapy in the pre-taxane setting. The update applies to the imaging agent’s third indication,...
Gerhardt Attard, MD, PhD, of the Cancer Institute, University College London, presents findings from the phase III AMPLITUDE trial, which looked at the combination of niraparib and abiraterone acetate plus prednisone for patients with metastatic castration-sensitive prostate cancer with alterations in homologous recombination repair (HRR) genes (Abstract LBA5006).
In analyses from the phase III PSMAfore trial reported in The Lancet Oncology, Fizazi et al examined whether [177Lu]Lu–PSMA-617 (vipivotide tetraxetan; Lu-PSMA) improved patient-reported outcomes and delayed the time to first symptomatic skeletal events vs change of androgen receptor pathway (ARP)...
Stopping the widespread use of unnecessary, potentially harmful cancer screenings may take up to 13 years and potentially longer following the implementation of new guidelines, according to a recent study published by LeLaurin et al in BMJ Quality & Safety. Background The U.S. Preventive...
The American Association for Cancer Research (AACR) has issued the following statement regarding former President Joseph R. Biden’s prostate cancer diagnosis: “The American Association for Cancer Research (AACR) offers heartfelt support and well wishes to former President Biden and his family as...
The management of metastatic (CRPC) has rapidly accelerated in the past decade, giving oncologists a wider range of tools to work with and patients new opportunities for improving survival and maintaining quality of life. These significant advancements have prompted ASCO to release a guideline...
In a long-term follow-up of the phase III MD Anderson dose-escalated, hypofractionated prostate radiation study reported in the Journal of Clinical Oncology, Hassanzadeh et al compared hypofractionated intensity-modulated radiation therapy (HIMRT) vs conventionally fractionated intensity-modulated...
Eric Huttenlocher Bent, MD, PhD, of Memorial Sloan Kettering Cancer Center, reviews results from the phase II Metacure trial (cohorts B2 and the B2 expansion), which looked at the efficacy of stereotactic body radiotherapy for PSMA-PET–detected oligometastatic prostate adenocarcinoma (Abstract 5014).
Praful Ravi, MBBChir, MRCP, of Dana-Farber Cancer Institute, presents findings from an ICECaP individual patient-data meta-analysis of randomized controlled trials on a treatment strategy used in high-risk localized prostate cancer (Abstract 5013).
On June 3, 2025, the U.S. Food and Drug Administration (FDA) approved darolutamide (Nubeqa) for the treatment of metastatic castration-sensitive prostate cancer (mCSPC). The oral androgen receptor inhibitor had previously been approved by the FDA in combination with docetaxel for mCSPC. Efficacy...
Researchers have identified a gene that could play a key role in the transition to a more aggressive, treatment-resistant type of prostate cancer, according to a recent study published by Duan et al in the Journal of Clinical Investigation. The findings indicated that the gene may be indirectly...
Nicholas D. James, PhD, FRCP, MBBS, of The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, describes the use of a multimodal artificial intelligence (AI) model to identify benefit from second-generation androgen receptor pathway inhibitors in patients with high-risk nonmetastatic prostate cancer participating in the STAMPEDE trial (Abstract 5001).
Alicia K. Morgans, MD, MPH, FASCO, of Dana-Farber Cancer Institute, discusses health-related quality-of-life data from the phase III ARANOTE trial, which evaluated the androgen receptor inhibitor darolutamide in combination with androgen-deprivation therapy (ADT) vs ADT plus placebo for patients with metastatic hormone-sensitive prostate cancer (Abstract 5004).
Results from the international phase III AMPLITUDE clinical trial found that adding niraparib to abiraterone acetate plus prednisone (AAP) may help to slow cancer growth for people with metastatic castration-sensitive prostate cancer (mCSPC) with homologous recombination repair (HRR) gene...
Researchers may have uncovered factors contributing to poor outcomes among patients with prostate cancer, according to recent findings presented by Dall’Era et al at the 2025 ASCO Annual Meeting (Abstract 5104). The findings may lead to the development of novel targeted therapies, particularly in...
Andrew J. Armstrong, MD, MS, of Duke Cancer Institute Center for Prostate and Urologic Cancers, Duke University School of Medicine, discusses the 5-year overall survival analysis of the ARCHES trial, which investigated enzalutamide plus androgen-deprivation therapy in patients with metastatic hormone-sensitive prostate cancer (Abstract 5005).
Treatment options for aggressive-variant prostate cancer are limited, but a subset of patients have had promising long-term responses with a combination of carboplatin plus cabazitaxel chemotherapy, followed by PARP inhibitor maintenance. This novel combination treatment approach was the focus of a ...
In a phase II trial (RAVENS) reported in the Journal of Clinical Oncology, Wang et al attempted to determine whether the addition of the bone metastasis–targeting agent radium-223 to stereotactic ablative radiotherapy improved progression-free survival as metastasis-directed therapy in patients...
Investigators may have uncovered key differences in tumor biology but similarities in survival outcomes in instances of equal access to care between non-Hispanic Black and non-Hispanic White men with metastatic prostate cancer, according to a recent study published by Valle et al in JAMA Network...
According to his office, Former President Joseph R. Biden Jr has been diagnosed with an “aggressive” type of prostate cancer that has spread to his bones. The New York Times reported that Mr. Biden’s cancer “is characterized by a Gleason score of 9 with metastasis to the bone.” The American Cancer...
In a phase II trial (PEACE V–STORM) reported in The Lancet Oncology, Ost et al found that elective nodal radiotherapy (ENRT) to the pelvis was associated with longer metastasis-free survival vs metastasis-directed therapy (MDT) in patients with pelvic nodal oligorecurrences of prostate cancer....
Patients with human immunodeficiency virus (HIV) are less likely to receive potentially life-saving cancer treatment if they reside in communities with lower income levels and educational attainment, according to a recent study published by Islam et al in Cancer. Study Methods and Results...
The phase III HYPO-RT-PC trial has shown that a 2-week course of radiotherapy for localized prostate cancer—also known as ultra-hypofractionated radiotherapy—may be just as safe and effective as the traditional 8-week schedule—even 10 years after treatment. The findings were presented at the 2025...
In a U.K. study (BARCODE1) reported in The New England Journal of Medicine, McHugh et al found that screening for prostate cancer with a polygenic risk score was more accurate in diagnosis than screening with prostate-specific antigen (PSA) and magnetic resonance imaging (MRI). Study Details In...
In a phase I study reported in the Journal of Clinical Oncology, Aggarwal et al reported activity with the antibody-drug conjugate (ADC) FOR46 in patients with metastatic castration-resistant prostate cancer. As stated by the investigators, “FOR46, a fully human antibody conjugated to monomethyl...
Researchers have developed, and now validated, a biomarker test to predict for genitourinary (GU) adverse events induced by stereotactic body radiotherapy (SBRT) in patients with prostate cancer, according to the results of a study published by Kishan et al in Clinical Cancer Research. The test,...
In an analysis from the phase III TALAPRO-2 trial reported in The Lancet Oncology, Matsubara et al found that first-line talazoparib plus enzalutamide was associated with prolonged time to definitive deterioration in global health status/quality of life (GHS/QOL) vs placebo plus enzalutamide in...
In a U.K. trial (TRANSLATE) reported in The Lancet Oncology, Bryant et al found that local anesthetic transperineal (LATP) prostate biopsy detected more Gleason Grade Group (GGG) ≥ 2 prostate cancer compared with transrectal ultrasound (TRUS)-guided biopsy in previously biopsy-naive individuals who ...
On March 28, the U.S. Food and Drug Administration (FDA) expanded the indication for lutetium Lu-177 vipivotide tetraxetan (Pluvicto) to include adults with prostate-specific membrane antigen (PSMA)-positive metastatic castration-resistant prostate cancer (mCRPC) who have been treated with androgen ...
Biopsies guided by high-resolution ultrasound may be as effective as those using magnetic resonance imaging (MRI) in diagnosing prostate cancer, an international clinical trial has shown. The technology, called micro-ultrasound, is cheaper and easier to use than MRI. It could significantly speed up ...
A novel technique designed to improve the precision of prostate cancer surgery could preserve erectile function in nearly twice as many men compared with standard surgery, according to new findings presented by Almeida-Magana et al at the European Association of Urology (EAU) Congress 2025...
As a Native American and former president of the Seneca Nation of Indians, I am keenly aware of the disparities in cancer care we face in accessing screening and treatment, which results in worse survival rates compared with those of racial and ethnic populations.1 Native American and Alaska Native ...
Prostate carcinoma is the most common type of cancer among men in the United States, accounting for more than 299,000 estimated new cases and approximately 35,000 new deaths in 2024.1 A new ASCO guideline based on findings from a systematic review indicates that in metastatic cases of prostate...
A novel artificial intelligence (AI) tool, called Unfold AI, may help to determine which men with prostate cancer are most likely to benefit from partial gland cryoablation, according to a recent study published by Brisbane et al in BJUI Compass. The findings may play a key role in improving...
In a paper published in JAMA Oncology, Tilki et al reported that the current standard monitoring of prostate-specific antigen (PSA) following radical prostatectomy—1.5 to 2 months—is too short to accurately identify recurrence and inform treatment decisions. Rather, PSA levels should be measured...
Erectile dysfunction could be improved through regular exercise in men with prostate cancer, according to a recent study published by Galvão et al in JAMA Network Open. Background Sexual dysfunction is a critical adverse effect of prostate cancer treatment and a major survivorship issue among...
As reported in the Journal of Clinical Oncology by Petrylak et al, the phase III KEYNOTE-921 trial showed no benefit in outcomes with the addition of pembrolizumab to docetaxel in patients with previously treated metastatic castration-resistant prostate cancer. Study Details In the global...
In an Italian single-center phase II trial (RADIOSA) reported in The Lancet Oncology, Marvaso et al found that the addition of androgen-deprivation therapy (ADT) to stereotactic body radiotherapy (SBRT) improved progression-free survival in patients with hormone-sensitive oligorecurrent prostate...
A 5-year study on men that had primary partial-gland cryoablation shows that the procedure averted cancer recurrence in most patients while preserving urinary and sexual function. Led by researchers at New York University Grossman School of Medicine, the study tracked the patient outcomes after...
Researchers have uncovered several biomarkers that may predict how patients with metastatic castration-resistant prostate cancer will respond to the novel combination of ipatasertib and abiraterone, according to a recent study published by Bono et al in European Urology. Background Prostate cancer...
Testosterone recovery to normal levels after long-term term androgen-deprivation therapy and radiotherapy significantly improved overall survival in patients with high-risk prostate cancer, according to data presented at the 2025 ASCO Genitourinary Cancers Symposium.1 Long-term data from the phase...
In an analysis of an Australian phase II trial (ENZA-p) reported in The Lancet Oncology, Emmett et al reported that the addition of lutetium-177–labeled PSMA-617 (LuPSMA) to enzalutamide improved overall survival and several aspects of health-related quality of life (HRQOL) in the first-line...
Germline or somatic mutations in the BRCA1 gene might not be key to the initiation of prostate cancer, as previously thought, suggests the first study of its kind, published in BMJ Oncology. If confirmed in further studies, the findings suggest that it may be time to reassess current treatment...