Prostate Cancer

"[This] could be a paradigm shift in prostate cancer,” says Eugene Shenderov, MD, PhD.

Alexandra Sokolova, MD, discusses unanswered questions and next steps with PARP inhibitors in the prostate cancer treatment paradigm.

Urologists weigh in on the challenges associated with whether, when, and how to treat these patients with prostate cancer.

Active surveillance is the preferred treatment option for men with low-risk prostate cancer and an option for some men with favorable intermediate-risk prostate cancer.

Apalutamide is approved by the FDA for the treatment of patients with non-metastatic castration-resistant prostate cancer or metastatic castration-sensitive prostate cancer.

"In our sample, nearly 10% of patients [with prostate cancer] had a gene variant that made them eligible for effective new therapies, with faster results than traditional referral for genetic testing and counseling,” said Maria I. Carlo, MD.

Patients received standard-of-care testosterone suppression with either oral enzalutamide or standard non-steroidal antiandrogen therapy.

Prostate cancer, bladder cancer, renal cell carcinoma were among the multitude of tumor types assessed in the analysis supporting the approval.

"The improvement in technologies could potentially assist radiation oncologists in making timely decisions,” said Himanshu Arora, PhD.

Michael S. Leapman, MD, MHS, highlights a study of patient experiences with tissue-based genomic testing during active surveillance for prostate cancer.

Researchers identified 9 novel susceptibility loci for prostate cancer, 7 of which were substantially more prevalent in patients of African ancestry.

The FORMULA-509 trial evaluated post-operative salvage radiotherapy and 6 months of GnRH agonist with or without abiraterone acetate/prednisone and apalutamide post-radical prostatectomy.

"These studies, taken together, offer important insight into the direction we should be heading in prostate cancer diagnosis: toward a targeted-only TP biopsy," write Tarik Benidir, MD, and Zeyad Schwen, MD.

"I've worked in 3 different countries, I've seen dozens of people doing robotic radical prostatectomy...so my current practice is kind of a “best of” what I have seen and learned," says Ricardo Soares, MD.

"With ARASTEP, we are optimistic about the potential to help patients at this earlier stage of [prostate cancer]," says Tara Frenkl, MD.

Amar Kishan, MD, highlights findings showing that MRI-guided SBRT is superior to CT-guided SBRT in localized prostate cancer.

Darolutamide increased overall survival compared to placebo in the overall patient population and patients with high-volume, high-risk mHSPC as well as in patients with low-risk metastatic hormone-sensitive prostate cancer.

“Vanderbilt researchers are participating in numerous projects related to PRS and disease risk; studies such as this highlight the importance of evaluating whether novel clinical tools actually enhance care,” said Kerry Schaffer, MD.

The enzalutamide/leuprolide combo also led to statistically significant improvements in time to PSA progression and time to start of new antineoplastic therapy.

Findings suggest many patients with localized disease can delay surgery or radiation without increasing their mortality risk.

“As the ability to target improved, what we really clearly saw was the idea that perhaps a treatment course could be shortened significantly, and that the term hypofractionation became commonly applied to men with prostate cancer,” said Walter J. Curran Jr, MD, FACR, FASCO.

“What is precision medicine? This is not just a vague term; it really looks at individual characteristics of a patient to decide treatment," said Leonard G. Gomella, MD, FACS.

“You can really see the difference with the patients who go for physical therapy and the ones who don't,” says Ricardo M. de Oliveira Soares, MD.

"The government is spending more in Medicare, we are getting more people with prostate cancer, more deaths with prostate cancer, [and] more metastasis with prostate cancer. While it is so simple: today, PSA is still there," says Navin Shah, MD, MS, FACS, FICS, FACIP.

"While past global studies have supported the use of Xtandi plus ADT in men with mHSPC, it is encouraging to see these results replicated for patients in mainland China," said Zhou Fangjian, MD.