“It's very helpful when we're looking at how we counsel patients about the stage of their disease,” says Brian F. Chapin, MD.
In this video, Brian F. Chapin, MD, discusses the FDA approval of flotufolastat F 18 (Posluma) will improve the care of patients with prostate cancer. Chapin is an associate professor of urology at the University of Texas MD Anderson Cancer Center in Houston.
It's very helpful when we're looking at how we counsel patients about the stage of their disease. Now, whether that's going to ultimately affect patient outcome as far as oncologic outcomes are concerned is a different story altogether. But when we look at better staging, we're able to identify patients who are perhaps node positive when we thought they were node negative based on conventional imaging, or identifying patients when they have biochemical recurrence, perhaps having disease outside of the pelvis. Now, that leads to controversial topics about what should be the treatment options for those patients in those scenarios. I don't want to get too much into the controversies that exist, but I would say that, for many, if you identify someone with lymph node involvement on clinical imaging, then perhaps an operation is not necessarily going to be as beneficial to patients [and] that they're likely to need to undergo additional radiation or systemic therapy post surgery.
Now, again, it's controversial. There are some that believe that doing all of these therapies might actually provide a benefit to patients over systemic therapy and radiation alone. I don't think that's the intent of today's discussion. But clearly, we are getting more information and with more information can give patients a more accurate description of what their treatment plan looks like, depending on what the starting point is. I think that basically, we are looking at situations in which we don't actually know if the oncologic outcomes can be improved based on the imaging studies alone. The challenges that exist there are that these imaging agents do better at identifying disease and so it's difficult for clinicians now to be agreeable to randomizing patients to conventional imaging vs PSMA PET scan imaging, and then ultimately, the subsequent therapies that go with that to look at true oncologic outcomes like metastasis-free survival, overall survival, and whatnot. So I do think we have some new challenges that we're facing.
We do need some additional study and I think what's going to happen with PET scan imaging is it's effectively going to be incorporated into most of our studies, and we're going to have to look at this as part of our new standard in trying to figure out how to best interpret whether the imaging has affected patient outcome, or if it's just altering the our ability to counsel patients and set expectations differently.
This transcription was edited for clarity.