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.
"Many men are quite reluctant to go to a specialist, specifically the urologist, because of the fear or reluctance to undergo an invasive test, [such as] a rectal exam," says Shahrokh F. Shariat, MD.
“To the point where a child would come in and request to see a cartoon character was really quite interesting for me,” says Patrina H. Y. Caldwell, BMed, FRACP, PhD.
In this final episode, panelists conclude with reflections on the significant progress made in treating NMIBC over the past decade, particularly in the last 5 years. Looking ahead to 2024, experts in urology express excitement about investigational treatments (ie, cretostimogene grenadenorepvec and UGN 102), the potential for personalized medicine, emphasizing the need to understand molecular characteristics of the disease for better treatment customization. The session also highlights the importance of balancing quality of life with effective treatment strategies, and the prospect of utilizing emerging therapies early in the disease process.
This video segment explores various investigational strategies, including the use of agents like UGN 102, and recent clinical trials for intermediate-risk NMIBC. The conversation highlights the importance of balancing side effects with efficacy and the shift towards non-surgical management in treating intermediate-risk NMIBC and in the BCG-naive population.
"I think some of the biggest advances have come in the surgical space," says Vikas Desai, MD.
"We investigated and compared the risk of infection after transperineal MRI-targeted biopsy vs a transrectal MRI-targeted biopsy," says Jim C. Hu, MD, MPH.
“I definitely am more careful about who I offer Botox to in men,” says Gina M. Rooker, MD.
"I think that at any point, everyone is somewhere on that spectrum," says Anne M. Suskind, MD, MS, FACS, FPMRS.
"I like to tell my patients, one of the first kind of treatments is actually reassurance," says Miriam Harel, MD.
"I tried to cover the focal therapies, at least just review some of the new ones that are coming in, even though they're still not necessarily 100% mainstream," says Andrew L. Siegel, MD.
A group of urologists and radiation oncologists detail how they were trained on the utilization of rectal spacers and offer practical advice for other clinicians treating patients with prostate cancer.
The panel provides clinical insights on the placement of rectal spacers, the management of toxicities, and the counseling of patients with prostate cancer following rectal spacer placement.
"The main finding is that when you look at men with low testosterone, grouped 18 and above, we found that there is an association between low testosterone and kidney stone encounter diagnoses," says Austin Thompson.
“We want to serve as role models for pre-med students to come into the urology field [and] to explore what urology is, because there is a great need not only in general for urologists, but for Hispanic urologists. ,” says Pedro P. Maria, DO.
"In our multivariate analysis, we actually found that there was no significant difference between the groups," says Kevin Shee, MD, PhD.
"There's just a tremendous opportunity for telehealth and being able to increase delivery to patients in these areas or at least reduce their amount of travel time to get to see a urologist based on where they live," says Kara L. Watts, MD.
From a show dog to a family of cats, let's see who some of the top medical professionals are spending their time with when they're not in the clinic.
This video episode discusses various new therapies and strategies for treating patients with high-risk BCG-unresponsive NMIBC. It includes a review of nadofaragene firadenovec-vncg, its FDA approval, dosing schedule, and patient response rates. The conversation also explores the practical aspects of treatment, such as the balance between efficacy and treatment frequency, and the potential sequencing of therapies in clinical practice.
This video segment provides insights into various innovative trials and agents being explored for high-risk BCG-unresponsive NMIBC. The discussion covers a range of approaches including oncolytic immunotherapy, gene therapy, systemic IO agents, antibody-drug conjugates, and cytokine therapies. It emphasizes the need for personalized dosing regimens based on individual immune responses and highlights the significance of longer-term efficacy evaluations beyond initial three-month response rates.
"It's no surprise that there are many people interested in active surveillance and how we can be doing it better," says Kevin Shee, MD, PhD.
"This is just another way that we can exploit the body's own natural system to take care of cancer," says Daniel P. Petrylak, MD.
