Prostate Cancer

The panel reviews clinical data and provides real-world insight on how use of PSMA-PET imaging has impacted the management of patients with prostate cancer.

Experts discuss practical considerations on selection among available PSMA-PET tracer options for prostate cancer imaging, including regional availability, scheduling, and preparation requirements.

“Combined MRI-targeted and systematic biopsies were nearly twice as likely to result in downgraded pathology at prostatectomy compared [with] systematic biopsies," says Ilon C. Weinstein.

"It gives me a very rewarding experience…. I see patients with low-grade prostate cancer and when they become advanced prostate cancer, I already have a good relationship with them and don’t have to send them somewhere else," says Abhinav Sidana, MD, MPH.

"It pretty much has been adopted around the world so that about 80% of men who are diagnosed with low-risk prostate cancer go on active surveillance. In Sweden, it's about 80%. That's considered the goal. But the United States has been slow in adopting this," says William J. Catalona, MD.

The panel reviews the similarities and differences between the FDA-approved PSMA-PET tracer options for prostate cancer imaging.

Phillip Koo, MD, defines prostate-specific membrane antigen (PSMA) and explains the rationale for use as a target in PET-based prostate cancer imaging.

“We showed that genetic correction of PSA levels has the potential to both reduce unnecessary biopsies and improve our ability to detect tumors with a more aggressive profile," says Linda Kachuri, PhD, MPH.

"The emulation framework lends the design and conduct of observational analyses some of the rigor required for the planning of a randomized trial. In doing so, it provides an innovative and principled approach to improve the evidence base on the comparative effectiveness of interventions," writes Boris Gershman, MD, and Aaron Fleishman, MPH.

"Here, we've lowered the age to initiate screening to 45 to 50 years," says Badrinath R. Konety, MD, MBA.

The phase 3 PROpel trial provided the primary supporting data for the approval.

Men of African ancestry were less likely to be treated on clinical trials after undergoing comprehensive genomic profiling compared with men of European ancestry.

Scott Sellinger, MD, FACS, shares a historical perspective on use of conventional imaging modalities in prostate cancer.

Michael Cookson, MD, MMHC, explains the NCCN criteria used to stratify patients with clinically localized prostate cancer into risk groups.

Anthony V. D’Amico, MD, PhD, discusses key factors that determine his radiotherapy treatment selection in the management of patients following radical prostatectomy.

Increasing numbers of older patients with cancer necessitates adoption of an age-friendly approach to cancer care.

Closing out his discussion on prostate cancer, Michael S. Leapman, MD, MHS, highlights practical advice and shares hope for future improvements in the treatment landscape.

Focused discussion on the Decipher Prostate Genomic Classifier and real-world data from the American Urological Association (AUA) Annual Meeting in the setting of prostate cancer management.

Expert urologist Michael S. Leapman, MD, MHS, provides comprehensive insight to the classification of prostate cancer and current treatment modalities available to patients.

"One of the factors that goes into why transperineal [biopsies] aren't performed more readily in the US is lack of exposure," says Jim C. Hu, MD, MPH.

“These results validate the clinical value of bone biomarker assessment in the HSPC state," state the authors.

Men with high-risk prostate cancer who received immunotherapy treatment with enoblituzumab in the weeks leading up to surgery had favorable rates of disease remission and tumor downgrading after surgery.

"We anticipate that in the next decade, breakthroughs in genetic profiling of tumors for precision therapies will further reduce suffering and death from bladder cancer," writes Michael S. Cookson, MD, MMHC.

"It is unique given that in addition to providing prognostic information, it can serve as a marker to predict sensitivity to androgen deprivation therapy (ADT), which is the backbone of systemic therapy for men with prostate cancer," says Rana R. McKay, MD.

“I think, overall, nomograms are a really powerful tools just because there are so many different clinical variables that we consider when we talk to patients about whether to proceed with prostate biopsy,” says Eric Li, MD.

"The study demonstrated that AS rate in the MUSIC cohort, which in 2014 had been lower than in the SEER cohort, increased rapidly, from approximately 20% in 2014 to nearly 50% in 2019, whereas the SEER cohort showed only a modest increase," writes Badar M. Mian, MD.

The CDK4/6 inhibitor abemaciclib showed clinically activity in patients with heavily pretreated metastatic castration-resistant prostate cancer.

The addition of STAD did, however, improve secondary end points, including metastases rates, prostate cancer-specific mortality, and PSA failure.

The indication is restricted from the indication in the FDA supplemental New Drug Application for olaparib/abiraterone, which is for the population at-large in the BRCA–mutation positive setting.

The study is exploring the investigational N-terminal domain androgen receptor inhibitor EPI-7386 in combination with either apalutamide or abiraterone acetate.