|
|
|
|
|
|
|
The 2026 Advanced Prostate Cancer Consensus Conference
|
|
|
|
|
|
|
|
Bone-Modifying Agents in Prostate Cancer: Distinguishing Osteoporosis from Skeletal-Related Events
|
|
Matthew Smith, MD, PhD
|
| Matthew Smith clarifies the distinction between osteoporotic fracture prevention and skeletal-related event prevention. All patients on ADT are at risk for osteoporotic fractures, while SRE prevention applies primarily to progressive bone-metastatic mCRPC; CALGB and STAMPEDE data showed no benefit for adding zoledronic acid in mCSPC.
|
|
|
|
|
|
|
|
|
|
| Update on De-Escalation Strategies in mHSPC: In Which Patients and When Can We Stop the Treatment?
|
| Mika Matikainen, MD, PhD
|
| Mika Matikainen said de-escalation in mHSPC is moving from older intermittent ADT approaches toward biomarker-guided treatment holidays, especially for deep PSA responders. He highlighted EMBARK as proof that PSA-guided suspension can preserve quality of life without obvious harm, while ongoing trials such as LIBERTAS, EORTC GUCC 2238, A-DREAM, and PEACE-6 are testing when treatment can safely be reduced or stopped.
|
|
|
|
|
|
| Which People with Metastatic Hormone-Sensitive Prostate Cancer Benefit More from ARPIs? STOPCAP Individual Participant Data Meta-Analysis
|
| David Fisher
|
| The STOPCAP individual participant data meta-analysis showed that adding an ARPI to ADT improves survival for most men with mHSPC, but the relative benefit appears to decrease with age. The clearest benefit was seen in younger patients and, among older men, abiraterone may carry more non-cancer mortality risk, so age and comorbidity should factor into ARPI selection
|
|
|
|
|
|
| Darolutamide in a Multi-Institutional Spanish Real-World Cohort of Prostate Cancer Patients: Early PSA Response, Tolerability and Treatment-Related Adverse Events
|
| Laura Resa-Forns, MD
|
| Laura Resa-Forns reported that in a Spanish real-world cohort of 198 patients treated with darolutamide, early PSA responses were common and were associated with better outcomes, especially when PSA fell to very low levels within 3 months. Darolutamide also showed a favorable tolerability profile despite substantial polypharmacy, with relatively low rates of grade 3 or higher adverse events and treatment discontinuation.
|
|
|
|
|
|
| ARPI + PARP Inhibition – In Which Patients?
|
| Elena Castro, MD, PhD
|
| Elena Castro argued that ARPI + PARP inhibitor combinations are most appropriate for first-line mCRPC patients with BRCA1/2 alterations, with the strongest evidence for BRCA2 and likely benefit also for PALB2 and possibly CDK12. She noted that benefit is much less convincing for ATM or CHEK2, and that patients without HRR alterations may get rPFS benefit but no clear OS benefit, so other therapies should often be prioritized.
|
|
|
|
|
|
| ARPI + PARP Inhibition in mCRPC: A Statistical View Across MAGNITUDE, TALAPRO-2 and PROpel
|
| Susan Halabi, PhD, FSCT, FASA, FASCO
|
| Susan Halabi’s statistical take was that the three first-line mCRPC PARP-combination trials are not directly comparable because they used different biomarker strategies: MAGNITUDE was biomarker-selected, while PROpel and TALAPRO-2 enrolled all-comers. She emphasized that the clearest and most reproducible benefit is in HRR-mutated disease, especially BRCA, and that all-comer results should not be used to argue that biomarker testing is unnecessary.
|
|
|
|
|
|
| Prevention and Management of Radioligand Therapy Induced Xerostomia
|
| Daniela Oprea-Lager, MD, PhD
|
| Daniela Oprea-Lager described xerostomia as one of the main quality-of-life toxicities of PSMA radioligand therapy, caused by salivary gland uptake of the agent and often appearing after just 1–2 cycles. She reviewed several mitigation strategies, including cooling, botulinum toxin, radioprotectors, and salivary stimulants, and stressed that better prevention is needed as radioligand therapy is used earlier in prostate cancer care.
|
|
|
|
|
|
|
|
|
|
|
| Real World Radium-223 Outcomes in Metastatic Castration-Resistant Prostate Cancer: Updated Spanish Tertiary Center Cohort to January 2024
|
| Pablo Alvarez-Ballesteros, MD
|
| Pablo Alvarez-Ballesteros presented an updated Spanish real-world cohort showing that radium-223 remains a reasonable life-prolonging option for symptomatic, bone-predominant mCRPC in heavily pretreated patients. Median overall survival was 15.7 months, and completing all six cycles was strongly associated with better survival, reinforcing the importance of careful selection and treatment completion.
|
|
|
|
|
|
|
|
|
|
|
