In this episode, experts share their perspectives from their urology practices on addressing challenges such as insurance coverage, access issues, and the frequency of prior authorization (PA) denials and subsequent appeals. Co-panelists emphasize the need for additional information required by physicians to effectively appeal PA denials. Dr De La Cerda highlights the support his urology practice provides to meet the needs of his unique patient population.
"We could have had our expansion doses [at] 40 mg, but we made the clinical decision to go with 20 mg in expansion based on a hope for future clinical tolerability and longevity," says Jacqueline T. Brown, MD.
In this episode, Dr. Christopher M. Pieczonka and Dr. Jose De La Cerda discuss the nuances of prescribing abiraterone acetate related to strategies for patient counseling on prednisone and methylprednisolone use and managing steroid-related side effects, dosing adjustments in patients with liver issues, emphasizing the importance of close monitoring and individualized care in prostate cancer treatment.
“The co-primary end points are safety and overall response rate as measured via RESIST v1.1,” says Jonathan A. Chatzkel, MD.
Experts explore the clinical benefits and limitations of standard pharmacological options, like anti-muscarinic agents and beta-3 adrenergic agonists, and share their preferences and experiences in selecting and managing treatments for OAB, focusing on the effectiveness and patient-specific considerations in their clinical practice. In this episode, Dr. Kennelly, alongside Drs. Eilber and Benson, discusses the transition to second-line therapies for overactive bladder, focusing on medication classes like anticholinergics and beta-3 agonists. They explore patient-centered considerations such as medication compliance, cost, insurance coverage, and the chronic nature of overactive bladder management, emphasizing individualized treatment based on patient needs and health profiles.
Expert panelists review the AUA/SUFU guidelines for overactive bladder (OAB) treatment, discussing first-line behavioral strategies and the transition to pharmacological treatments.
“Medical oncologists, including academic and in the community, tend to order more genomic testing than urologic oncologists,” says Dalia Kaakour, MD, MS, MPH.
Dr. Kennelly, Dr. Kevin Benson, and Dr. Karyn Eilber delve into the significant impact of OAB on patients' quality of life, including its effects on daily activities and mental well-being, and how this burden shapes clinical decisions in the early stages of treatment and selection of appropriate therapeutic options.
"I think it's very interesting to see that we continue to see a survival benefit at 55-months follow-up," says Maria Teresa Bourlon, MD, MSc, MS.
“It's important to note as well that the kidney cancer biology is really distinct from a lot of other solid tumors, and particularly other immunotherapy response to solid tumors,” says David A. Braun, MD, PhD.
“If you put everything together, the cabo/atezo combination statistically significantly improved the progression-free survival and reduced the risk of progression or death by 35% in a patient population with very poor prognosis,” says Neeraj Agarwal, MD, FACSO.
“This will become a very attractive option if approved by the FDA because the treatment burden on patients will be significantly reduced, thus making it easier for patients to access it,” says Saby George, MD, FACP.
Expert oncologists give an overview of prostate-specific membrane antigen (PSMA) and discuss its utility for the treatment of prostate cancer.
A panel of expert oncologists in prostate cancer give an overview of the evolution of imaging techniques used for patients with prostate cancer.
"When we think about germline mutations, I think the number one thing that comes through for many urologists as well as oncologists is Lynch syndrome," says Laura Bukavina, MD, MPH, MSc.
“[It is] reassuring that in patients who had a prior novel hormonal agent, the combination of enzalutamide plus talazoparib is still effective [and] still an effective option,” says Arun Azad, MD.
"[This is] the first time ever since we started conducting randomized phase 3 studies in the adjuvant setting of kidney cancer that we see an overall survival benefit," says Toni K. Choueiri, MD.
"What we saw was it that there were a significant number of patients that did change their management based on the findings. Of those patients, 88% of them changed because of a positive test," says Benjamin H. Lowentritt, MD, FACS.
Andrea B. Apolo, MD, shares key interim findings from the AMBASSADOR Alliance trial.
In this episode, Dr. Christopher M. Pieczonka and Dr. Jose De La Cerda explores the differences in dosing and administration of abiraterone acetate products, including the impact of food effects, and optimizing therapy for special populations with comorbidities like diabetes, hypertension, and obesity. They share insights from their clinical experience on patient compliance, tolerability, and quality of life improvements with micronized abiraterone.
Dr. Christopher M. Pieczonka and Dr. Jose De La Cerda discuss the various formulations of abiraterone, including micronized and non-micronized forms in combination with prednisone or methylprednisolone, including safety and effectiveness. They share insights on the specific patient populations for whom micronized abiraterone is particularly beneficial, how patient specific needs or comorbidities influence treatment appropriateness. They also delve into the accessibility of these formulations, emphasizing the importance of proper diagnosis codes to enhance medication approval processes.
Dr. Jose De La Cerda and Dr. Christopher M. Pieczonka shed light on their approach to prescribing medicines for patients with metastatic castration-resistant prostate cancer (mCRPC). They highlight the importance of patient access to care, discuss the availability of various therapies, including novel hormonal agents and infusions, and anticipate a positive shift in treatment accessibility in the coming years due to government initiatives.
“We're really looking at a situation where most of the HRR testing is happening when patients have already exhausted all other standard options,” says Daniel J. George, MD.
"The key end points were observed response rate in the overall cohort, progression-free and overall survival from EV start in the overall cohort, and as an exploratory end point, overall survival from platinum-based chemotherapy start in the overall cohort," says Amanda Nizam, MD.
"What ARASTEP is asking is how effective of a biomarker is PSMA PET/CT?" says Alexander M. Chehrazi-Raffle, MD.
"What we found is that there was rapid adoption and uptake of PSMA PET almost immediately after these agents were first approved in the United States," says Michael S. Leapman, MD, MHS.
"These data really show that even in the patients who upgrade and have more severe disease than were initially expected, even if their surgery was delayed for 12 months after having this upgraded diagnosis, these patients did just as well from a recurrence perspective, compared to patients who got surgery right away," says Kevin Shee, MD, PhD.
The expert panel concludes their discussion with a look toward the future of prostate cancer treatment and the evolving role of rectal spacers.
"From a physician standpoint, [telemedicine] allows you to have a greater reach of patients that you can help, that you can educate, that you can help improve their quality of life," says Helen L. Bernie, DO, MPH.
"In general, the majority of patients were very satisfied with the treatment," says Nitya E. Abraham, MD.
