Prostate Cancer

“One of the things that drives me to be a part of advanced prostate cancer care is that literally every 6 months, we are having major trials read out guideline-based changes in care,” says Jason Hafron, MD.

Panelists review the recent FDA approval of the PSMA-targeted therapy Lutetium Lu 177 vipivotide tetraxetan for patients with metastatic castration-resistant prostate cancer and discuss additional settings in which it, and other PSMA-targeted treatments, might be used in the future.

Drs Albala, Andriole, Ross, and Ulaner sum up recent advances and remaining unmet needs in the field of prostate cancer imaging and share hopes for the future.

“iQuest combines existing patient-specific diagnostic information and deep-learning algorithms to create a tailored [3D] map of where cancer is within the prostate,” according to Avenda Health.

Chad Tang, MD, discusses the EXTEND trial, which explored the addition of metastasis-directed therapy to intermittent hormone therapy in patients with oligometastatic prostate cancer.

Thought leaders discuss the possibility of using artificial intelligence to help interpret PSMA-PET results.

Panelists discuss how they typically document prostate cancer patient eligibility when ordering PSMA-PET imaging, and share strategies to optimize insurance coverage and reimbursement.

Approval of the treatment was based on the placebo-controlled phase 3 ARASENS trial, which showed that adding darolutamide to standard ADT and docetaxel boosted overall survival versus ADT/docetaxel alone in patients with metastatic hormone-sensitive prostate cancer.

Gary Ulaner, MD, PhD, FACNM provides practical advice for radiologists who are generating PSMA-PET imaging reports, as well as for the urologists who are interpreting PSMA-PET results.

Shared insight from the panel on how they typically select radiotracers when ordering PSMA-PET scans in their clinical practice.

“To our knowledge, this study represents the first time a significant association has been demonstrated between concurrent and adjuvant ADT sequencing and overall survival rates among prostate cancer patients," says Amar Kishan, MD.

The new data are from a randomized, double-blind, parallel, placebo-controlled phase 3 trial that enrolled patients experiencing ED after receiving a bilateral, nerve-sparing radical prostatectomy.

Citing recent guidelines recommendations, urologists share how they approach sequencing of conventional and PSMA-PET imaging for patients with prostate cancer, and discuss how use of each modality might affect subsequent patient management and treatment decisions.

Urologist Ashley Ross, MD, PhD leads a discussion of the benefits and limitations of PSMA-PET in patients with prostate cancer, as compared to older imaging modalities.

Silver also outlines an example of a patient who he would treat with high-intensity focused ultrasound.

The application for approval in the European Union is based on findings from the pivotal phase 3 PROpel trial.

Radiologist Gary Ulaner, MD, PhD, FACNM provides a comprehensive discussion on the FDA-approved PSMA radiotracer options that are available for use as part of PSMA-PET imaging.

Panelists consider how they have incorporated some newer imaging modalities, including PSMA-PET, into their clinical practice, and discuss the terminology that urologists and radiologists have recently used to describe these modalities.

“I think this trial will pave the way for patients with high-risk prostate cancer to be treated in 5 weeks instead of 8 weeks," said Tamim M. Niazi, MD.

A focused discussion on prostate-specific membrane antigen (PSMA) as a target for imaging and treatment for patients with prostate cancer.

“We do know that for these specific racial minorities, more time and more tools need to be invested in order to have both the rates of PSA discussion and PSA testing equal to those that White men have,” says Hanan Goldberg, MD, MSc.

Expert panelists review risk stratification strategies for patients with prostate cancer and summarize the evolving use of conventional versus newer imaging modalities for diagnosis, treatment selection, and monitoring of these patients.

“You can't just have all or none treatments. You've got to have a middle ground for people who are going to look for that,” says John R. Valvo, MD.

Leuprolide acetate injection is a sterile, aqueous, clear, colorless solution that is administered through subcutaneous injection.

Results from the phase 3 MIRAGE trial showed lower rates of genitourinary and gastrointestinal side effects with MRI guidance vs CT guidance when treating patients with stereotactic body radiotherapy.

Rezvilutamide is a novel androgen-receptor inhibitor with low blood–brain barrier penetration.

“MFS, as a predictive marker for survival, favored the addition of short term ADT plus iSRT in this population compared to iSRT alone,” said lead study author Igor Latorzeff, MD.

The trial prospectively included a subgroup analysis comparing patients who received SBRT using robotic non-coplanar radiotherapy (CyberKnife) compared with conventional linear accelerator.

"If men were aware that just because they have no symptoms doesn’t necessarily mean they are cancer free, then more might take up offers for tests," says Vincent Gnanapragasam, MD.

A Yale chemist and oncologist collaborated to create a new treatment for prostate cancer that tags specific proteins within the cancerous cells, making it easier for the body’s natural mechanisms to identify and destroy them.