Prostate Cancer

An explanation of the importance of clinical providers following a multidisciplinary approach for prostate cancer management.

Experts review ongoing clinical trials in PSMA PET technology.

Urology Times interviewed co-author Fred Saad, MD, FRCS, on the importance of the ARASENS trial and the potential of triplet therapy as the future standard of care for metastatic hormone-sensitive prostate cancer.

“People's concepts of immunotherapy are unfortunately quite distorted. It is not just about checkpoint inhibitors,” says Susan F. Slovin, MD, PhD.

William K. Oh, MD, discussed oligometastatic prostate cancer in a recent presentation at the 2022 New York GU Interdisciplinary Prostate Cancer Congress and Other Genitourinary Malignancies.

“One of the most exciting areas of research in sexual health are new improvements on penile implants,” says Marta Skrodzka, MD.

According to Dreicer, standard treatment in this setting for most patients should include androgen deprivation therapy (ADT) in combination with 1 or 2 other agents vs ADT therapy alone.

“I would suggest a discussion with your medical oncology colleagues, just so that you and your staff know what to expect in the short term and the long term,” says Susan F. Slovin, MD, PhD.

In the PROpel study, which was presented at the 2022 ASCO Genitourinary Cancers Symposium, Fred Saad, MD, FRCS, and a team of investigators evaluated the efficacy of olaparib plus abiraterone acetate in patients with metastatic castration-resistant prostate cancer.

The panel explains the science behind PSMA PET scans and reviews the different positron-emitters used in the scans.

A background on the available options and recent advances in prostate cancer imaging.

At the 15th Annual Interdisciplinary Prostate Cancer Congress® and Other Genitourinary Malignancies, Susan F. Slovin, MD, PhD, gave a presentation on immunotherapy in advanced prostate cancer.

“I think [this study] really addresses an unmet need for practicing urologists across the world,” says Fred Saad, MD, FRCS.

“We certainly need to move away from a model of care that is follow up driven by tumor markers or imaging alone,” says Netty Kinsella, RN, MSc, PhD.

Learning curve for technique is short, but capital expenditures are required.

“There are many studies now that have shown that these doublets and triplets seem to be better than just ADT alone,” says William K. Oh, MD.

“I think we need to change the mindset that chemotherapy is a bad thing. It is a very good thing when given appropriately and when patients are more likely to get long-term benefit,” says Fred Saad, MD, FRCS.

"If adequate cancer control can be achieved by focal or partial-gland treatment, then the favorable adverse event profile could make this a preferred option for a number of men with localized intermediate-risk (and possibly selected high-risk) prostate cancer," writes Badar M. Mian, MD.

“It’s not only about prescribing medications or advising how to use it. It’s about support. It’s about checking how things are going. It’s about motivation when things are primarily not working. It’s about knowledge that things tend to improve with time, and certain functions can just recover independently,” says Marta Skrodzka, MD, PhD.

In the phase 3 KEYLYNK-010 trial, pembrolizumab/olaparib did not improve overall survival versus either abiraterone or enzalutamide in heavily pretreated patients with metastatic castration-resistant prostate cancer.

“I think one of the problems is that we do run out of treatments in many of these patients at some point,” says William K. Oh, MD.

“As [nurse specialists], we are uniquely placed in terms of supporting these men through their prostate cancer treatments, and then, obviously, through to their recovery afterwards,” says Netty Kinsella, RN, MSc, PhD.

“I think the take home message is that [IsoPSA is] an easy test to use,” says Eric A. Klein, MD.

“We have new therapies, both AR-targeted therapies, as well as the use of SBRT, or targeted radiotherapy, that have changed the landscape,” says William K. Oh, MD.

Bobby Liaw, MD; Vivek K. Narayan, MD, MS; Ashley E. Ross, MD, PhD; and Neal Shore, MD, FACS, provide closing thoughts and advice for the optimal management of advanced prostate cancer.