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STATE-OF-THE-INDUSTRY VIDEOS BY LEADING UROLOGY EXPERTS |
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| Prolonging Time to Metastatic Disease, The SPARTAN Study
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Matthew Smith, MD and Alicia Morgans, MD, MPH
In this conversation with Alicia Morgans, Matthew Smith shares a recap of his presentation from the 2019 ESMO meeting where he presented the updated survival results from SPARTAN, a study of apalutamide (ARN-509) in men with non-metastatic castration-resistant prostate cancer (nmCRPC), a pivotal study which led to the approval of apalutamide for men with nmCRPC.
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| Treating the Primary in High vs Low Volume Hormone Sensitive Disease
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Noel William Clarke, MD
Using various volume and risk criteria used worldwide for the treatment related to docetaxel and abiraterone in metastatic hormone-sensitive prostate cancer, Noel Clarke and colleagues have gathered and correlated large volumes of imaging data on treatment and outcomes from within the UK within the STAMPEDE trial.
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| The Management of Fatigue, Cognition, and Dementia in Prostate Cancer Patients Presentation
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| Charles J. Ryan, MD
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| Charles Ryan presented the management of fatigue and cognitive changes induced by androgen deprivation therapy (ADT) at the Advanced Prostate Cancer Consensus Conference (APCCC 2019). Dr. Ryan discusses the association between ADT and dementia, and also how combining ADT with abiraterone and prednisone can significantly improve fatigue in patients.
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SEARCHABLE DATA BASE OF CURRENTLY ENROLLING CLINICAL TRIALS |
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| Enzalutamide and Apalutamide Now Offer Survival Benefit for Patients with Metastatic Castration-sensitive Prostate Cancer, but How Do Things Change Now and What Should We Be Doing Next? |
| Evan Yu, MD
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| For patients with metastatic castration-sensitive prostate cancer, it is clear that early treatment intensification by adding agents like docetaxel or abiraterone acetate to androgen deprivation therapy (ADT) offers overall survival benefit. The CHAARTED and STAMPEDE trials both demonstrated a dramatic survival benefit with 6 cycles of docetaxel added to ADT. In the long term survival analysis of the CHAARTED trial, the benefit was confined to those patients with high volume disease, defined as ≥4 bone metastases with at least one in the appendicular skeleton and/or a visceral metastasis. |
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RECENT DATA FROM CONFERENCES WORLDWIDE |
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| Updated Results from the Phase 3 SPARTAN Study, Apalutamide and Overall Survival in Patients with Nonmetastatic Castration-Resistant Prostate Cancer
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| Matthew R. Smith, MD, Ph.D.
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| Dr. Matthew Smith, on behalf of the SPARTAN investigators, presented updated data from this phase III trial, specifically the second interim analysis for OS after 285 events
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| Docetaxel for Hormone-Naïve Prostate Cancer: Results from Long-term Follow-up of Non-metastatic Patients in the STAMPEDE Randomised Trial - A Medical Oncologist's Perspective |
| Nicholas James, MBBS, PhD |
| Dr. Nicholas James and colleagues present data for metastatic progression-free survival for patients who received docetaxel in addition to the STAMPEDE standard-of-care therapy of androgen-deprivation +/- radiation to the prostate for non-metastatic hormone-sensitive prostate cancer. A total of 460 men received the standard of care therapy, and 230 patients received standard of care plus docetaxel at standard dosing. |
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| Timing of ADT in the Era of STAMPEDE and LATITUDE
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| Mehmet Ali Nahit Sendur, MD
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| Dr. Mehmet Ali Nahit Sendur summarized the role of androgen deprivation therapy (ADT) in the era of the androgen receptor axis targeted therapy (ARAT). The critical role of androgens has been well established in stimulating prostate cancer growth. Therefore, ADT has been used in the treatment of metastatic prostate cancer. ADT can normalize serum levels of prostate-specific antigen in over 90% of patients and can produce objective tumor responses in 80-90% of patients.
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| Predictors of Falls and Fractures in Patients with Non Metastatic Castration-resistant Prostate Cancer Treated with Apalutamide Plus Ongoing Androgen Deprivation Therapy
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| YaoYao Guan Pollock, MD
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| This study demonstrated that Apalutamide significantly prolonged metastasis-free survival, time to symptomatic progression, and second progression-free survival, without any decline in health-related quality of life. Another interesting finding is that SPARTAN patients who received apalutamide, compared to those who received placebo had a higher rate of falls (15.6% vs. 9.0%) and fractures (11.7% vs. 6.5%). In the presented study, the authors performed an analysis to identify independent clinical characteristics associated with falls and fractures in patients who were treated with apalutamide.
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| Age-Related Efficacy and Safety of Apalutamide plus Ongoing Androgen Deprivation Therapy in Subgroups of Patients with Nonmetastatic Castration-Resistant Prostate Cancer: Post Hoc Analysis of SPARTAN |
| Julie Nicole Graff, MD |
| Elderly patients are at high risk of prostate cancer morbidity and mortality and have unique issues related to drug tolerability and metabolism. In this presented study, the benefit and safety profile of apalutamide was evaluated in patients aged < 65, 65-74, and ≥ 75 years. Cox proportional hazards models and Kaplan-Meier methods were used to analyze outcomes in the specified age groups. Additionally, the incidence of any treatment-emergent adverse events, serious adverse events and adverse events leading to treatment discontinuation or death, as well as death within 28 days of the last study treatment, were determined within each age subgroup by treatment group. |
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