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PEER-TO-PEER CLINICAL CONVERSATIONS |
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| Personalizing Salvage Radiation and Hormone Therapy for Biochemical Recurrence |
| Daniel Spratt, MD |
| Alicia Morgans speaks with Dan Spratt about his presentation on the management of biochemical recurrence in prostate cancer post-radical prostatectomy. Dr. Spratt explains the considerations for using hormone therapy alongside salvage radiation, emphasizing the variability in treatment needs based on PSA levels. |
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| hK2-Targeted Radioligand Shows Promise in Treating Advanced Prostate Cancer: Phase I Findings |
Michael Morris, MD
Michael Morris shares insights into his presentation on a novel hK2-targeting antibody radioconjugate, JNJ-6420, which uses an actinium radioisotope. Dr. Morris explains that hK2, akin to PSA, binds to prostate cancer cell membranes, making it an ideal target for this radioligand therapy.
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| Combining Lutetium-PSMA with Hormonal Therapy Enhances Prostate Cancer Treatment |
Oliver Sartor, MD, and Louise Emmett, MD, MBChB, FRACP, FAANMS
Oliver Sartor speaks with Louise Emmett about combination therapy approaches with lutetium-PSMA in prostate cancer. The discussion explores various combination strategies, including promising results from the ENZA-p trial combining lutetium-PSMA with enzalutamide, which shows notable response rates in first-line mCRPC. |
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| Using Artificial Intelligence to Optimize Systemic Therapy for Prostate Cancer
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| Irbaz B. Riaz, MD, MBBS
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| Irbaz Riaz discusses the use of artificial intelligence (AI) to optimize systemic therapy for prostate cancer, emphasizing AI's potential to assist in treatment decisions by integrating diverse data sources like radiology, pathology, and patient-specific features. He highlighted AI's ability to create living clinical practice guidelines that rapidly adapt to new evidence, and its role in developing digital biomarkers to predict treatment outcomes, such as the ArteraAI Prostate Test for short-term ADT benefits. Dr. Riaz concluded that AI is poised to provide individualized treatment insights and enhance clinical decision-making in prostate cancer care.
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| Genomic Classifiers and Artificial Intelligence as Predictors for Treatment Benefit
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| Daniel Spratt, MD
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| Daniel Spratt discusses the limitations of current prostate cancer risk stratification tools, particularly the Gleason Score, which has limited predictive value for treatment decisions. He highlighted the promising role of genomic classifiers like Decipher® and artificial intelligence (AI) tools in personalizing treatment, particularly in determining the benefits of adding androgen deprivation therapy (ADT) to radiotherapy for intermediate and high-risk patients.
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| Oncogenic Alteration Rates, Race, and Prostate Cancer Specific Mortality in Veterans with Metastatic Prostate Cancer Undergoing Somatic Tumor Next-Generation Sequencing
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| Luca Faustino Valle, MD
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| Luca Faustino Valle presents a study evaluating oncogenic alteration rates, race, and prostate cancer-specific mortality in veterans with metastatic prostate cancer undergoing somatic tumor next-generation sequencing (NGS). The study found significant differences in genomic alterations between Black and White veterans, with Black veterans showing higher frequencies of alterations in SPOP and BRAF, while White veterans had more alterations in the AKT/PI3K pathway, AR axis, and tumor suppressor genes.
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| When to Do Tumor Genomic Profiling in Advanced Prostate Cancer? |
| Niven Mehra, MD, PhD |
| Niven Mehra discusses the timing and rationale for tumor genomic profiling in advanced prostate cancer, emphasizing the importance of genomic testing in metastatic castration-resistant prostate cancer (mCRPC) and metastatic hormone-sensitive prostate cancer (mHSPC). He outlines the guidelines and strategies from major organizations like EAU, ESMO, NCCN, and APCCC, highlighting when and how to perform next-generation sequencing (NGS) based on disease state, treatment progression, and available resources. |
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| Prediction of Undetectable Circulating Tumor DNA by A Comprehensive Genomic Profiling Assay in Metastatic Prostate Cancer: The SCRUM-Japan MONSTAR SCREEN Project - Beyond the Abstract
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| Masaki Shiota, MD
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| The SCRUM-Japan MONSTAR SCREEN project evaluated factors predicting undetectable circulating tumor DNA (ctDNA) in metastatic prostate cancer patients using comprehensive genomic profiling. The study found that ctDNA detection was less likely in patients with more than four bone metastases, with an algorithm developed to predict ctDNA detection based on clinical factors like bone metastasis number, PSA levels, ISUP grade group, and castration resistance status. This algorithm could guide clinicians in determining the optimal timing for ctDNA-based genomic profiling in clinical practice.
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| Synchronous mHSPC: What Are the Treatment Options and What Are the Goals of Treatment? Germline Genetic Testing Necessary And/or Helpful? |
| Elena Castro, MD, MS, PhD |
| Professor Elena Castro discusses the importance of germline genetic testing in managing synchronous metastatic hormone-sensitive prostate cancer (mHSPC). She emphasizes that germline mutations, especially in genes like BRCA2, are prevalent in metastatic prostate cancer and can inform prognosis, treatment decisions, and familial cancer risk. Castro advocated for comprehensive testing, including both germline and somatic analysis, to optimize treatment with targeted therapies like PARP inhibitors, particularly for high-risk patients and those with a family history or cancer predisposition syndromes. |
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