Jason Hafron, MD, on key trends that will shape prostate cancer care in 2025

In this video, Jason M. Hafron, MD, CMO, speculates on coming advancements in the field of prostate cancer. Hafron is the chief medical officer and the medical director of clinical research at Michigan Institute of Urology.

Video Transcript:

There are so many exciting things going on in research and care in 2025. I'm going to highlight a few key areas that I am excited about, specifically the elevated PSA population and management of elevated PSA or people at risk for prostate cancer. I think what's going to be exciting this year is we'll hopefully see FDA approval for a serum blood test called IsoPSA. IsoPSA is a very interesting test. It's indicated for men with a PSA above 4 ng/mL and at risk for prostate cancer. It can be used with or without finasteride, so a lot of flexibility there. What's interesting about IsoPSA is that it looks at not the PSA concentration per se, but at different proteins or different isoforms of PSA in solution that can predict, at a very high level, the likelihood that a patient has significant grade group 2 or higher prostate cancer. We've used it a lot in the in the past, and I think with the pending FDA approval, we'll see further expansion of IsoPSA throughout the country.

Another big area that we're seeing, and we've seen in last decade, is within prostate cancer. We're seeing a lot of exciting research and a lot of new trends that are going to develop and mature over the year. We have to start off in prostate cancer with PSMA-PET imaging. PMSA-PET imaging is disruptive technology that is improving the quality of care very quickly. What we're seeing is a lot of research being done in PET imaging, looking at new radioisotopes. At the end of last year, there were some publications looking at copper as another isotope and the advantages of using copper for diagnosis. There's a lot of research being done in PET imaging looking at alternative receptors. Currently, most of its PSMA-based, but are there other receptors that can be used for diagnostic or even diagnostic tools? And then [there’s] this concept of covalency. Can we change the interaction at the receptor, prolong that interaction, something you never really want to do in medicine, but something you want to do, potentially, in PET imaging. As we move through 2025, I think we're going to see more and more expansion of new ideas, new isotopes, and possibly improvement in PET imaging for the future.

Another big area that we're seeing changing in prostate cancer is looking at high-risk and very high-risk per NCCN guidelines in prostate cancer. Last year, I was part of a research team that presented the use of apalutamide in patients with high-risk or very high-risk prostate cancer. It was a phase 2 trial, called Apa-RP. In that trial, we gave patients 12 months of apalutamide after prostate cancer [surgery]. We saw a significant signal highlighting potentially that apalutamide in high-risk and very high-risk patients after surgery might be helpful. There are 2 ongoing trials looking in this space. There's the PROTEUS trial that I'm not exactly sure when will read out, but it's an exciting trial because it's looking at apalutamide 6 months before and apalutamide 6 months after surgery to determine if that improves performance, specifically metastasis-free survival in this patient population. If we see a positive trial from PROTEUS, hopefully late this year, that would potentially change the standard of care and be a nice option for these very difficult to treat patients.

Another area that we're seeing use of adjuvant medication is in radiation therapy. Again, in high-risk, very high-risk patients, if we add apalutamide—this is the ATLAS trial—will this improve outcomes? ATLAS hopefully will report out shortly, but that also could be a have a significant impact on clinical care, specifically the high-risk or very high-risk prostate cancer patient.

Another project that we're working on that we just launched, and we're very excited about, is a project called PC360 or Prostate Cancer 360. This project was developed with Dr. David Crawford and is supported by an educational grant from Tolmar Pharmaceuticals. What we're looking at is, can we use chronic care management to mitigate a lot of the side effects of androgen deprivation therapy? We are just starting the clinical evaluation. We are going to start evaluating whether we can use chronic care management again to lower the risk of cardiovascular disease or cardiac risk or MACE. Can we use chronic care management to improve nutrition within these patients, exercise, depression and all the negative things that we know are associated with androgen deprivation therapy? Can we use this model or this program to improve the care of these patients? So, more to come on that. We're excited about this project for 2025, and we'll see where the results take us.

This transcript was AI generated and edited by human editors for clarity.