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Highlights from the American Urological Association Annual Meeting
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| Identification of High-Risk Disease and Initial Management of Biochemical Recurrence
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| Stephen Boorjian, MD
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| Stephen Boorjian began this session with a talk focusing on the identification of patients with high-risk prostate cancer and the initial management of those with biochemical recurrence following therapy. Dr. Boorjian highlights the AUA/ASTRO guidelines on adjuvant and salvage radiotherapy after prostatectomy, and the AUA/ASTRO/SUO on advanced prostate cancer, as well as recent trials in this disease space.
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| Imaging of Advanced Prostate Cancer and Impact on Cancer Management
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| Kelly Stratton, MD
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| Kelly Stratton followed Dr. Boorjian’s initial talk with a discussion of the role of imaging in advanced prostate cancer. In terms of current guideline principles, he emphasized that imaging can be used to identify the presence of metastatic disease both at initial recurrence and then periodically thereafter. Currently, cross-sectional imaging and technetium bone scan are recommended. However, these studies have significant limitations in terms of both their accuracy and also the burden and radiation exposure. |
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| M0 CRPC: Treatment Options and Goals of Therapy
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| Michael Cookson, MD, MHA
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| Building on presentations from Stephen Boorjian and Kelly Stratton regarding biochemical recurrence and imaging, respectively, Michael Cookson discussed the management of patients with non-metastatic castration-resistant prostate cancer (nmCRPC). Dr. Cookson suggested that nmCRPC may represent a “window of opportunity, that closes quickly” to treat patients when their lower tumor burden may allow a better or more durable response.
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| Manipulating the Androgen Axis: New Agents in mHSPC and CRPC
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| David Jarrard, MD
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| In this presentation, David Jarrard provided an overview of the use of agents targeting the androgen axis. He highlights the plethora of treatment options available in advanced prostate cancer, ranging for targeting of the androgen axis, to cytotoxic chemotherapy, immunotherapy, checkpoint inhibitors, and radionuclide therapy. These agents may be suitable at many instances across the natural history of prostate cancer. |
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| Genetic Testing in Advanced Prostate Cancer |
| Leonard G. Gomella, MD, FACS |
| Leonard Gomella discussed genetic testing in advanced prostate cancer. Dr. Gomella notes that there have been rapid advances in prostate cancer genetic testing, reflected in changes made to the NCCN guidelines from 2016-2020. Clinicians should strongly consider referral for genetic testing and counseling for high-risk patients/family concerns. |
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| Bone Health and Radionuclide Therapy
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| Stephen Boorjian, MD
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| The American Urologic Association (AUA) annual meeting’s evolving landscape of advanced prostate cancer treatment session included a talk by Dr. Stephen Boorjian discussing bone health and radionuclide therapy. Dr. Boorjian notes that there are several clinically relevant aspects of bone health in CRPC. Future directions include assessing patient selection for sequencing of treatments, combination therapies, and the impact of novel imaging/enhanced lesion detection.
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| The Role of Immunotherapy and PARP Inhibitors
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| Deborah Kaye, MD, MS
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| The AUA annual meeting’s evolving landscape of advanced prostate cancer treatment session included a talk by Dr. Deborah Kaye discussing the role of immunotherapy and PARP inhibitors. Even with a plethora of options, there are still patients resistant to treatment. Thus, novel mechanisms are needed to target resistance, given that resistance mechanisms are thought to spread through metastasis-to-metastasis seeding.
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| The Role of Chemotherapy, Treatment Sequencing in mCRPC and Future Directions |
| Joshua M. Lang, MD, MS |
| The American Urologic Association (AUA) annual meeting’s evolving landscape of advanced prostate cancer treatment session included a talk by Dr. Joshua Lang discussing the role of chemotherapy and treatment sequencing in patients with mCRPC. Dr. Lang notes that there are a multitude of agents available, with many different sequence options. |
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| To view our full coverage of the 2021 AUA Annual Meeting, visit the Conference Coverage section on UroToday.com |
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