Prostate Cancer

Experts on prostate cancer discuss the heterogeneity of the disease and the rationale for using medications with different mechanisms of action, including androgen deprivation therapy.

Lawrence Karsh, MD, FACS, introduces a discussion on prostate cancer and androgen deprivation therapy with an overview of how the treatment landscape has changed in recent years.

"This study demonstrates that for up to 10 years after diagnosis, approximately 50% of men with low-risk prostate cancer can safely remain on AS, without cancer progression or treatment, since less than 1% died of prostate cancer," writes Badar M. Mian, MD.

"This study was looking at the incidence of cognitive impairment and/or manual dexterity disorder diagnoses in men who underwent an artificial urinary sphincter after treatment for prostate cancer," says Jacqueline Zillioux, MD.

"By using our technique, and really preserving that urethral length really well, it seems to help those patients in particular to have better outcomes," David I. Lee, MD, FACS.

“This highlights a need for physicians to better integrate patient preferences into their treatment recommendations," says Jonathan Bergman, MD, MPH.

Kyrollis Attalla, MD, describes the role of fusion-based biopsies in active surveillance for patients with prostate cancer and how this technology has improved monitoring and treatment strategies.

A urologic oncologist discusses how MRI- or fusion-guided biopsies have helped overcome the limitations of traditional prostate biopsies.

"Receiving the new CPT code and national payment rate for Unfold AI is an important development in making advanced personalized prostate cancer care accessible to more patients," said Brit Berry-Pusey, PhD.

"Going forward after this study, we hope to be able to expand and potentially look at patients undergoing either surgery or radiation therapy, and really try to determine the potential benefit," says Kelly L. Stratton, MD, FACS.

Tony Abraham, DO, MPA, outlines the limitations of PSMA-PET imaging and discusses the importance of multidisciplinary care in overcoming challenges surrounding the interpretation and reporting of imaging results.

"We will be looking not only at how well this software performs in a busy clinical setting and whether diagnostic accuracy and efficiency improves, but also assessing the experience of clinicians and patients, and looking at the impact on workflow," says Clare Verrill, BM, FRCPath, MMedEd.

"The incorporation of NGI into the BCR disease state definition necessitates a consensus within the medical community," write Spyridon P. Basourakos, MD, and Jack R. Andrews, MD.

A urologic oncologist discusses how MRI- or fusion-guided biopsies have helped overcome the limitations of traditional prostate biopsies.

Kyrollis Attalla, MD, shares his approach to imaging and biopsy in the diagnosis of prostate cancer and discusses the benefit of a good biopsy followed by appropriate imaging at initial diagnosis.

ORIC-944 was initially being evaluated as a monotherapy in the phase 1b trial.

Topline results from the phase 3 ARANOTE trial showed a statistically and clinically significant improvement in rPFS with the addition of darolutamide to ADT vs ADT alone.

A nuclear radiologist provides an overview of the gallium- and fluorine-based PSMA-PET tracer options, highlighting factors that influence tracer selection.

Tony Abraham, DO, MPA, discusses how the emergence of PSMA-PET imaging has impacted the staging and management of patients with prostate cancer.

All patients have now been enrolled in cohort 6 of the trial, and dosing with ONCT-534 has begun at the dose level of 1200 mg.

“Our findings suggest an impact of living in disadvantaged neighborhoods—which more commonly affects African Americans—on stress-related genetic pathways in the body. We believe this may increase an individual’s risk of aggressive prostate cancer and contribute to prostate cancer disparities by race,” says Kathryn Hughes Barry, PhD, MPH.

All 3 codes for the procedure will become effective on January 1, 2025.

“These allow us to treat just those areas of cancer, maintaining much better preservation of sexual function and less incontinence,” says Kevin R. Basralian, MD.

"The primary aim is looking at the dose-limiting toxicity of this drug combination," says Kelly L. Stratton, MD, FACS.

Looking to the future treatment landscape in prostate cancer, the panel provides closing thoughts on the trajectory of the utilization of PSMA-PET imaging and the unmet needs it might address.

"We found that over time, when you are controlling for possible competing risk of death because of age, that there was an estimated 44% incidence of cognitive impairment diagnosis at 15 years and 17% for manual dexterity diagnosis at 15 years," says Jacqueline Zillioux, MD.

“This study really bridges the gap between STAMPEDE and PROTEUS and provides the opportunity for patients to get either surgery or radiation therapy,” says Kelly L. Stratton, MD, FACS.

MK-5684/ODM-208 is a selective CYP11A1 inhibitor currently under investigation in the phase 3 OMAHA1 and OMAHA2a trials.