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Highlights from the American Society of Radiation Oncology (ASTRO) Annual Meeting |
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| Clinical Integration of Machine Learning for Curative-Intent Radiation Treatment of Patients with Prostate Cancer
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| Alejandro Berlin, MSc, MD
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| The 2022 ASTRO Annual Meeting featured a Presidential Symposium session on artificial intelligence opportunities in today’s patient journeys, including a presentation by Dr. Alejandro Berlin discussing clinical integration of machine learning for curative-intent radiation treatment of patients with prostate cancer.
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| State of the Art in Digital Pathology and AI: Progress in Prostate Cancer
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| Osama Mohamad, MD, PhD
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| The 2022 ASTRO Annual Meeting featured a Presidential Symposium session on artificial intelligence opportunities in today’s patient journeys, including a presentation by Osama Mohamad discussing artificial intelligence as a prognostic and predictive biomarker in prostate cancer. His group led an initiative to develop accurate and scalable tools to support therapy personalization with prognostic biomarkers.
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| Considerations for Treatment of PSMA-Staged High-Risk Patients |
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| PSMA PET Staging: Does This Change Everything?
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| Jeremy de Leon, BSc, M.B.B.S, FRANZCR
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| The 2022 ASTRO Annual Meeting featured a session on considerations for treatment of PSMA-staged high-risk patients, including a presentation by Dr. Jeremy de Leon discussing PSMA PET staging for high-risk patients.
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| Treatment of Local Regional Disease in the Era of PSMA PET
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| Leslie Ballas, MD
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| The 2022 ASTRO Annual Meeting featured a session on considerations for treatment of PSMA-staged high-risk patients, including a presentation by Dr. Leslie Ballas discussing treatment of local regional disease in the era of PSMA PET.
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| Approach to Prostate Oligometastasis in the PSMA PET/CT Era
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| Evan Thomas, MD, Ph.D.
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| In the session on considerations for the treatment of PSMA-staged high-risk patients, Evan Thomas discussed when occult metastases become oligometastatic disease with PSMA PET staging. With regards to PSMA PET, Dr. Thomas notes that there is a new sheriff in town. Indications for PSMA PET/CT include (i) upfront staging in the setting of suspected metastasis for potentially curable men, and (ii) suspected recurrence based on increasing PSA after prior therapy. However, there are several questions surrounding PSMA PET/CT.
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| Improving Prostate Cancer Survival |
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| Conditional Survival Probabilities in Recurrent Prostate Cancer (PCa) Patients Receiving Radiation ± Antiandrogen Therapy: Secondary Analysis of a Randomized Clinical Trial
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| James Assif, MD, PGY-3
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| Salvage radiation therapy and ADT are routinely used in patients with elevated PSA levels after radical prostatectomy. Although OS and biochemical-failure following salvage radiation therapy are useful when counseling patients at the time of treatment, the utility of survival data from time of diagnosis diminishes over time. The primary aim of this study presented by Dr. Assif and colleagues was to analyze conditional survival estimates for recurrent prostate cancer patients undergoing salvage radiation therapy ± ADT.
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| Tertiary Gleason Pattern 5 and a High Genomic Classifier Score Better Predicts Lymph Node Invasion at Radical Prostatectomy in 20,441 Intermediate-Risk Disease Patients
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| Skyler Johnson, MD
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| The improving prostate cancer survival session included a presentation by Dr. Skyler Johnson discussing the impact of tertiary Gleason pattern 5 and high Genomic Classifier Score on predicting lymph node invasion at the time of radical prostatectomy in patients with intermediate-risk disease. Dr. Johnson and colleagues hypothesized that tertiary Gleason pattern 5, and a Genomic classifier, could improve prognostication of lymph node invasion after radical prostatectomy over traditional clinicopathologic risk factors alone.
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| Conditional Survival of Patients with Prostate Cancer Undergoing External-Beam Radiotherapy on RTOG 0126 and 0415
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| Gregory Alexander, MD
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| Patients with low- and intermediate-risk prostate cancer treated with radiation alone have excellent outcomes with anticipated long overall survival. Although biochemical failure and OS rates are commonly reported from time of diagnosis, the relevance of such data diminishes over time for survivors. The primary objective of this study presented by Dr. Alexander and colleagues was to report conditional OS and biochemical failure in patients with low- and intermediate-risk prostate cancer treated with radiation.
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| PSMA PET Response Associates with MFS Following Stereotactic Ablative Radiation Therapy in Oligometastatic Castration-Sensitive Prostate Cancer
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| Philip Sutera, MD
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| Emerging data suggest metastasis-directed therapy improves outcomes in patients with oligometastatic castration-sensitive prostate cancer. PSMA-PET/CT can detect occult metastatic disease and has been proposed as a biomarker for treatment response. At ASTRO 2022, Dr. Sutera and colleagues presented data identifying and validating a PSMA-PET biomarker for clinical outcomes following metastasis-directed therapy in oligometastatic castration-sensitive prostate cancer.
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| Abdominal Aorto-Iliac Calcification Burden Assessment Using Deep Convolutional Neural Networks for Prediction of CV Risk Among Prostate Cancer Patients Undergoing SBRT
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| William C. Chen, MD
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| Patients undergoing radiotherapy for prostate cancer have historically been older, and by virtue of age and other factors, at greater risk of experiencing cardiovascular events. Assessment of cardiovascular risk could help guide treatment intensity for patients with prostate cancer. This study presented by Dr. Chen and colleagues at ASTRO 2022 aims to investigate the association between abdominal aorto-iliac calcification burden as measured qualitatively by physicians and quantitatively using a deep learning approach, and occurrence of major adverse cardiovascular events among prostate cancer patients undergoing stereotactic body radiotherapy.
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| Transcriptomic Features of Cribriform and Intraductal Carcinoma of the Prostate
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| Zaeem Lone, MD
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| Prostate cancer risk stratification has largely relied upon Gleason grade and PSA level. However, recent recommendations from the International Society of Urologic Pathologists has suggested modifying the Gleason grade system to include reporting of cribriform and intraductal carcinoma. The objective of this study presented at ASTRO 2022 was to identify any correlations between Decipher genomic risk score and cribriform and intraductal carcinoma status while also assessing prostate cancer transcriptomic features of these pathologic features.
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