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PEER-TO-PEER CLINICAL CONVERSATION
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| Transforming The Standard of Care for Men With Advanced-Stage PSMA-Positive mCRPC, Published Results from the Phase III VISION Trial |
| Oliver Sartor, MD |
| Oliver Sartor joins Charles Ryan in a conversation about the New England Journal of Medicine publication "Lutetium-177–PSMA-617 for Metastatic Castration-Resistant Prostate Cancer" known as the VISION trial. |
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| Is Nuclear Medicine Taking over the Treatment of Metastatic Prostate Cancer? PRLT Could Do Much More If Applied Earlier and Repetitive
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| Christian La Fougere, MD
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| The European Association of Urology (EAU) 2021 Virtual Annual Meeting included a joint session of the EAU and the Canadian Urological Association and a presentation by Christian La Fougere discussing prostate radioligand therapy and its use earlier in the disease process. |
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| Is Nuclear Medicine Taking over the Treatment of Metastatic Prostate Cancer? PRLT Is Only a Tessera in the Treatment of CRPC |
| Frederic Pouliot, MD, Ph.D., FRCSC |
| In this presentation, Frederic Pouliot suggests that prostate radioligand therapy is only a tessera in the treatment of CRPC. Dr. Pouliot notes that theranostics is the combination of imaging and therapy, most commonly 177Lu-PSMA radioligand therapy. Radioligand therapy is promising, but Dr. Pouliot poses: is it really as simple as PSMA PET positive disease = PSMA radioligand targetable = PSA response = clinical benefits? |
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| PSA, Imaging and Beyond: Keep it Simple |
| Nicolas Mottet, MD, Ph.D. |
| The joint session of the European Association of Urology (EAU) and the Canadian Urological Association at the 2021 EAU annual meeting included a discussion on PSA, Imaging and Beyond for assessing men for prostate biopsy and a presentation by Dr. Nicolas Mottet about keeping the process simple. Dr. Mottet notes that an indication for biopsy should be reserved for when a diagnosis is needed, in an asymptomatic man with an abnormal DRE or elevated PSA, and occasionally in symptomatic men (if the symptoms are possibly related to prostate cancer). |
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| PSA, Imaging and Beyond: Make Indications for Biopsy as PRECISE as Possible |
| Antonio Finelli, MD |
| Antonio Finelli discusses the importance of making indications for prostate biopsy as precise as possible. Dr. Finelli notes that the question of who and how we should biopsy men is a difficult question to address. Ultimately, the takeaway from all of these additional tests and indicators is the shared decision-making process. The threshold for biopsy varies for each man and the biopsy decision must incorporate patient preferences and personal risk tolerance. |
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| PSMA In Diagnostics and Treatment
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| Karim Fizazi, MD, Ph.D.
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| Karim Fizazi presents the role of PSMA in diagnostics and treatment of metastatic prostate cancer. PSMA is a transmembrane protein that is often highly expressed by prostate cancer cells and not expressd by most normal tissues (exception = salivary glands). Expression correlates to advanced disease. It is less expressed by liver metastases. He notes that we need to better understand resistance to treatment. Perhaps earlier use may provide more meaningful benefits.
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| External Validation of a Nomogram for Predicting 68Ga-PSMA PET/CT Detection Rate in Patients with Prostate Cancer Recurrence: A Clinical Tool to Guide Physicians Before Suggesting 68Ga-PSMA PET/CT |
| Lorenzo Bianchi, MD, FEBU |
| Lorenzo Bianchi discussed the external validation of a nomogram for predicting 68Ga-PSMA PET/CT detection rate in patients with prostate cancer recurrence. PSMA functional imaging has proven to have a significant clinical impact in re-staging prostate cancer patients, however, a non-negligible proportion of exams have false-negative results. |
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| Diagnostic Accuracy of PSMA-PET-CT for Pelvic Lymph Node Staging in Men with Prostate Cancer Undergoing Radical Prostatectomy and Pelvic Lymph Node Dissection |
| Josias Grogg, MD |
| Josias Grogg presents the results of a study assessing the diagnostic accuracy of PSMA-PET-CT for pelvic lymph node staging in men with prostate cancer undergoing radical prostatectomy and pelvic lymph node dissection. This data suggests that in men with intermediate and high-risk prostate cancer staged with PSMA-PET-CT before radical prostatectomy, 1 out of 5 men with PSMA-PET-CT suspicious nodes may be staged as pN0 and do not need further treatment at least during short-term follow-up. |
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| Salvage Therapies for PSMA PET/CT-Positive Nodal-Only Recurrent Prostate Cancer: Impact on Survival, Functional Outcomes and Health-Related Quality of Life |
| Alexander Kretschmer, MD |
| Alexander Kretschmer analyzes oncological, as well as functional, outcomes of patients with nodal-only recurrent prostate cancer treated with salvage lymph node dissection or salvage lymph node radiation therapy in a single academic tertiary care center. Analysis was limited to patients that were diagnosed with nodal-only recurrent prostate cancer via PSMA-PET/CT. |
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| Preoperative Prediction of Lymph Node Invasion in Prostate Cancer: Ga-68 PSMA PET or Nomograms? |
| Yakup Kordan, MD |
| Yakup Kordan presents the results of a study assessing the impact of Ga-68 PSMA PET or nomograms for preoperative prediction of lymph node invasion in prostate cancer. The objective of this study was to compare the predictive performances of these aforementioned nomograms and Ga-68 PSMA PET in terms of pathological lymph node invasion in patients with prostate cancer. |
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