Prostate Cancer

Panelists discuss how the treatment landscape for metastatic castration-resistant prostate cancer (mCRPC) is rapidly evolving through advancements in precision medicine and novel therapies, while emphasizing the importance of ongoing education for community oncologists to stay updated on these changes.

The panel explores promising biomarker research that has the potential to significantly impact patient care in prostate cancer.

Prostate cancer specialists share their insights on anticipated future advancements that could significantly influence prostate cancer management strategies.

"But for physicians considering chemotherapy for which there is equipoise, the Decipher test could be used to swing the decision one way or the other," says Gerhardt Attard, MD, PhD, FRCP.

Patients with at least 1 NE-positive marker were shown to have a worsened rPFS and OS.

“We already have very effective ARPIs available around the world, and this will add to those therapeutic options to try to tailor patients based on their needs [and] their particular profiles,” says Fred Saad, MD, FRCS.

According to the authors, data from the CONTACT-02 trial show that cabozantinib plus atezolizumab may benefit selected patients with mCRPC.

New data from ESMO 2024 support an initial dose of Radium223 prior to chemotherapy among patients with mCRPC.

New findings from the open-label SPLASH trial show patients with mCRPC achieved improved progression-free survival as well as response rates and antigen-specific reductions.

“Today, we're presenting the results of this analysis, and we show that patients who have a high Decipher score derive significant benefit from docetaxel,” says Gerhardt Attard, MD, PhD, FRCP.

Panelists discuss how to address the challenges in providing optimal care for mCRPC patients and how barriers may vary between different healthcare settings, such as rural vs. urban and private vs. public.

Panelists discuss how the dosing and administration of different abiraterone formulations vary, how food-related effects impact treatment efficacy, and strategies to manage these effects for optimal patient outcomes.

The key opinion leaders explore strategies for integrating newly available diagnostic tests into the existing treatment paradigm and patient journey.

The panel examines the significance of biomarkers in assessing therapy outcomes for prostate cancer patients, while also exploring the concept of absolute benefit in metastasis risk when adding androgen deprivation therapy (ADT) to radiation therapy for newly diagnosed cases.

"We see use of AI-generated cancer maps in the decision-making process of understanding who is the right patient for what therapy, as well as planning out the specific therapy," says Shyam Natarajan, PhD.

"The urgency to increase awareness about prostate cancer is underscored by our most recent data and analysis," says William L. Dahut, MD.

The panel explores the role of biomarkers in monitoring disease progression for prostate cancer patients on active surveillance, discussing how these tests aid in detecting changes that may warrant intervention.

The panel examines the challenges associated with effectively interpreting and applying biomarker test results in prostate cancer management and treatment decision-making.

“Our study reveals potential differences in tolerance and effectiveness of AR inhibitors in practice, which can help clinicians and patients with treatment decisions," says Daniel J. George, MD.

Olaparib plus abiraterone and prednisone or prednisolone was granted FDA approval in May 2023 for the treatment of adult patients with deleterious or suspected deleterious BRCA-mutated mCRPC.

Panelists discuss how criteria such as patient comorbidities, disease progression levels, and treatment goals should be considered when selecting the appropriate form of abiraterone for patients with mCRPC, and also explore the potential benefits and drawbacks of using micronized abiraterone in specific patient populations.

Panelists discuss how the STAAR study (Stein, 2018) indicates that the micronized abiraterone formulation results in lower average serum testosterone levels in 25% of patients compared to 17% with the originator formulation, potentially influencing treatment selection.

"The patients who received SBRT were more likely to be Caucasian. We observed that far fewer Black men were treated with SBRT in our cohort," says Michael Stencel, DO.

Treatment with an ARPI extended overall survival (OS), with a median OS of 38.7 months in the ARPI arm vs 21.7 months in the taxane arm and 21.8 months in the physician’s choice of treatment arm.

Data indicated that the test preferentially detected high-grade, clinically significant prostate cancer, with 93% of detected cancers being GG3-5 and 67% being stage 3 or 4.