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PEER-TO-PEER CLINICAL CONVERSATIONS
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AMPLIFY Trial of a Dual-Moiety Copper PSMA Ligand for Biochemical Recurrence
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James Kearns, MD
James Kearns describes the AMPLIFY trial evaluating a dual-moiety copper-based PSMA ligand for detection of biochemical recurrence in prostate cancer. The agent is designed to provide higher PSMA binding affinity and enable next-day imaging, with the potential to improve detection at low PSA levels; enrollment is permitted at a PSA ≥0.2 ng/mL following prostatectomy.
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Consensus Recommendations for PSMA PET Imaging and Treatment Strategies in Biochemical Recurrence
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Mary-Ellen Taplin, MD
Alan Bryce hosts Mary-Ellen Taplin to discuss key recommendations from the 2024 US Prostate Cancer Consensus Conference addressing PSMA PET imaging and treatment strategies in biochemical recurrence. They examine how imaging findings and clinical risk factors can inform treatment selection and management decisions across the BCR setting.
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Adjuvant Versus Early Salvage Radiotherapy After Prostatectomy
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Daniel Spratt, MD, and Piet Ost, MD, PhD
Piet Ost and Daniel Spratt recreate their APCCC debate on adjuvant versus early salvage radiotherapy after radical prostatectomy. They review the evidence informing treatment timing and patient selection, including which patients may benefit from earlier postoperative intervention.
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| PSA Persistence or Recurrence After Radical Prostatectomy – When and How to React?
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| Jochen Walz, MD
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| PSA persistence after radical prostatectomy signals poor outcomes and warrants postoperative treatment, whereas biochemical recurrence is heterogeneous and should be managed by estimating life expectancy and progression risk. Early salvage radiotherapy is most effective, with risk stratification guided by PSA doubling time, pathologic features, genomic classifiers, and PSMA PET/CT findings; low-risk patients may be monitored rather than immediately treated.
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| Genomic Risk Classifier Performance in PET-Guided Post-Prostatectomy Patients: Secondary Analysis of a Randomized Trial
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| Ashesh B. Jani, MD, MSEE, FASTRO
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| In this secondary analysis of post-prostatectomy patients undergoing PET-guided salvage radiotherapy, the Decipher genomic classifier remained strongly prognostic for event-free survival despite PET-guided treatment selection and dose escalation. The findings support the potential value of integrating genomic risk with molecular imaging to further refine adjuvant and salvage treatment decisions.
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| POSEIDON: Hormone Therapy Use and Duration with Post-Operative Radiotherapy for Recurrent Prostate Cancer – an Individual Patient Data Meta-Analysis
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| Amar Kishan, MD
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| In the POSEIDON individual patient data meta-analysis of six phase 3 trials, adding hormonal therapy to postoperative radiotherapy improved metastasis-free survival. Outcomes varied according to pre-radiotherapy PSA, while longer-duration hormonal therapy did not demonstrate a clear additional benefit for most patients, highlighting the importance of tailoring treatment intensity and duration to individual risk.
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| Baseline Features and MFS by Prior Definitive Treatment in Patients with High‑risk Biochemically Recurrent Prostate Cancer: EMBARK Post Hoc Analysis
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| Neal Shore, MD, FACS
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| Neal Shore discusses the EMBARK post hoc analysis of patients with high-risk biochemically recurrent prostate cancer, in which enzalutamide plus leuprolide improved metastasis-free survival versus leuprolide alone across prior definitive treatment subgroups. No significant treatment-by-subgroup interaction was observed, supporting consistent benefit across prior local treatment approaches.ross all prior definitive treatment subgroups, with hazard ratios of 0.36–0.57 and no significant treatment-by-subgroup interaction.
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