The panelist discusses how the ARANOTE trial demonstrated significant benefits of adding darolutamide to androgen deprivation therapy for patients with metastatic hormone-sensitive prostate cancer, showing improvements in radiographic progression-free survival and other key outcomes.
Panelists discuss how various factors, such as route of administration, duration of therapy, safety, efficacy, and cost, could influence the selection of different PD-1/PD-L1 agents once they receive approval, highlighting the importance of these considerations in optimizing patient care.
Fred Saad, CQ, MD, FRCS, FCAHS, discusses how darolutamide offers potential advantages over other androgen receptor–targeted therapies for metastatic prostate cancer, including its unique molecular structure, favorable safety profile, and efficacy in specific clinical scenarios.
Neal Shore, MD, FACS, emphasizes the significance of the VISION and TheraP trials in supporting the FDA approval of Lutetium-177 for patients with mCRPC who have undergone androgen receptor inhibitor and taxane treatments, highlighting the role of PSMA PET imaging in treatment sequencing and patient selection.
Panelists discuss how urologists and oncologists must collaborate to improve outcomes for high-risk non–muscle-invasive bladder cancer (NMIBC) patients receiving combination therapy with PD-1/PD-L1 inhibitors and BCG, emphasizing the need for clear communication and coordinated care strategies.
"Aquablation is like no other transurethral therapy that has come about in the last 100 years," says Ravi Munver, MD.
“So, we have all of this new technology that's about a year old, making surgery a lot safer for patients, making things more efficient, and [giving us] the ability to see stone removal happening from a perspective where we can visualize stone clearance in a way that we haven't been able to before,” says Marcelino E. Rivera, MD.
Tang discusses the limitations in available data, but nonetheless high potential, of SBRT in kidney cancer.
“We need to close that gap, and just as a general rule, screen our prostate cancer patients more closely for depression, especially those with androgen deprivation therapy,” says Mihir S. Shah, MD.
"[Aquablation] is the only therapy that offers the benefits of a true resective therapy, which is what it is, as well as a non-resective therapy," says Ravi Munver, MD.
Data from the phase 3 BART trial shows adjuvant radiotherapy is notably safe for patients with MIBC following radical cystectomy and chemotherapy.
“We noticed that if you were White and had prostate cancer and received androgen deprivation therapy, you were more likely to be diagnosed with depression compared to your Black counterparts,” says Mihir S. Shah, MD.
"Both AR and neuroendocrine marker expressions in mCSPC patients at baseline is associated with worse prognosis," says Cedric Pobel, MD.
Panelists discuss how combining BCG with PD-1/PD-L1 inhibitors may enhance antitumor activity compared with using each agent alone, emphasizing the rationale for this combination therapy and its potential to evolve treatment strategies for non–muscle-invasive bladder cancer (NMIBC) while also considering the implications for patient flow in urology practice and the necessity of a multidisciplinary approach.
The panelist discusses how patient characteristics, disease factors, and individual health status guide the decision to include or avoid chemotherapy in combination treatments for metastatic prostate cancer, weighing potential benefits against risks and quality of life considerations.
Panelists discuss how the PD-1/PD-L1 pathway plays a crucial role in cancer immunotherapy, outlining its mechanisms of action and highlighting the agents currently being investigated for patients who are BCG-naive or unresponsive, including gene therapy and intravesical options.
Neal Shore, MD, FACS, discusses how the patient profile in the VISION trial, which involved progression on multiple therapies, reflects typical cases for Lutetium-177 treatment, emphasizing the crucial role of PSMA PET imaging in determining treatment suitability.
Fred Saad, CQ, MD, FRCS, FCAHS, discusses how the inclusion of chemotherapy, particularly docetaxel, in combination therapies for metastatic prostate cancer alters the adverse event profile, noting that while the ARASENS trial found adverse effects to be largely consistent with previous docetaxel studies, they consider whether this aligns with observations in clinical practice.
"When we looked at the same phenotypic data, but focusing on each immunochemistry protein markers, we had 10 patients with AR negative tumor with clearly worse prognosis, and synaptophysin-positive and chromogranin A-positive patients also had a worse prognosis," says Cedric Pobel, MD.
"At the University of Michigan, we've actually started to offer prostate MRI without contrast for patients on active surveillance, which has been a really exciting change," says Benjamin Pockros, MD, MBA.
"I would say the take-home message is that we found that from a patient-centered orientation, telehealth for new and established patients have comparably high satisfaction scores but provide substantially lower costs compared with in-person visits for patients with urologic cancer," says Daniel Carson, MD, MS.
Pastuszak discusses the evolving nature of understanding how testosterone therapy post-radiation for prostate cancer may beneficial or harmful to patients, and how to navigate the decision.
Soumyajit Roy, MS, MBBS, explains how findings showing 5-year biochemical recurrence status may predict prostate cancer cure should alter the clinician-patient interaction.
Zaorsky discusses the patient safety misconceptions around radiotherapy for RCC, and considering patient-reported outcomes in future randomized controlled trials.
Findings from RAPTOR suggest 5-year biochemical recurrence may be a good indication of prostate cancer cure status.
Zaorsky discusses his team's ASTRO 2024 abstract showing clear benefit of radiotherapy and ablation in reduced kidney effects in patients with RCC.
"Patient-reported satisfaction scores were high for both telehealth and inpatient visits for both new and established encounters," says Daniel Carson, MD, MS.
Neal Shore, MD, FACS, discusses the progress of a 65-year-old patient with mCRPC through various treatments and evaluation for Lutetium-177 therapy based on his PSMA PET scan and MRI.
Panelists discuss how standard treatment options for non–muscle-invasive bladder cancer (NMIBC) include BCG therapy, exploring its mechanism of action in enhancing the immune response while also examining management strategies for intermediate and high-risk patients, optimal outcomes with single-agent BCG, and the discrepancies between observed rates of recurrence and progression in clinical practice and reported data.
Panelists discuss how non–muscle-invasive bladder cancer (NMIBC) presents with specific symptoms and diagnostic procedures, emphasize the significant economic burden on health care systems, and highlight key risk factors like smoking and occupational exposure while also addressing the critical importance of accurate staging for guiding treatment decisions and the potential consequences of incorrect staging on patient outcomes.
