Prostate Cancer

"Clinicians have opportunities to reduce patient subjective and objective financial burden if they continue to self-educate and communicate with patients and consider [financial toxicitiy] an adverse effect of treatment," write Alexandria A. Spellman, MD, MS, and Deborah R. Kaye, MD, MS.

“We found some BRCA1 and BRCA2 mutations, as well as CDK12 mutations, in our cohort of patients with intraductal carcinoma of the prostate. Those are things that you could use now for clinical decision-making with PARP inhibitors with their approved indications,” says Benjamin Miron, MD.

“These are high-risk patients and they do have a high likelihood of having advanced or metastatic disease in the future,” says Benjamin Miron, MD.

The approval is based on findings from the phase 3 TALAPRO-2 trial.

Dr Cookson discusses the challenges of using PSMA-PET imaging in prostate cancer, including reimbursement and patient access.

Dr Sellinger details the range of clinical guidelines on the use of PSMA-PET imaging in prostate cancer and which he is most likely to follow.

"For one thing, we're really interested in looking at plant-based diets in patients who are at high genetic risk for prostate cancer," says Stacy Loeb, MD, MSc.

"Nonmetastatic castration-resistant prostate cancer remains an incurable disease state," says Alicia Morgans, MD.

"The most alarming finding is that there were 0 instances of DREs in the NAMCS dataset over the entire 5-year period, and there were no PSAs conducted in American Indian/Alaska Native men after 2014,” says Christopher M. Gillette, PhD.

"This [guideline]... is probably the most broad in scope and incorporates a lot of the things that were missing or not yet mature enough to be included in the previous guidelines," says Badrinath Konety, MD, MBA.

"We successfully demonstrated that the overexpression of TRAF4 prompts the conversion of androgen-sensitive prostate cancer cells into castration-resistant cells,” says Ping Yi, PhD.

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.