ASCO 2017: A secondary analysis of PSA response in NRG Oncology/RTOG 9902: A phase III trial of adjuvant chemotherapy with androgen suppression and radiation for high-risk prostate cancer

Chicago, IL (UroToday.com) Over the past several years, we have seen a remarkable shift towards multiple treatment regimens at the onset of high-risk prostate cancer (PCa) diagnosis, particularly in subsets of populations that likely derive the greatest benefit from up front aggressive therapy. Dr. Stephen Mihalcik presented his group’s work of a post-hoc secondary analysis of RTOG 9902, a phase III trial of adjuvant chemotherapy with androgen suppression and radiation for high-risk prostate cancer. The objective of this analysis was to assess a subset of patients by post-radiation PSA that may identify patients that benefit from treatment intensification with chemotherapy. 

ASCO 2017: Identification of low prostate-specific antigen, high Gleason prostate cancer as a unique hormone-resistant entity with poor survival: A contemporary analysis of 640,000 patients

Chicago, IL (UroToday.com) Dr. David Yang and colleagues presented results from their study assessing patients with low PSA and high Gleason score prostate cancer as a unique hormone-resistant entity with poor survival at the prostate cancer poster sessions at the ASCO 2017 annual meeting. This is an understudied area and the outcomes of these patients are poorly described. The objective of this study was to examine the prognostic and predictive value of a low PSA in high-grade prostate cancer.

ASCO 2017: PSA doubling time and proximal PSA value predict metastasis-free survival in men with biochemically recurrent prostate cancer (BRPC) after radical prostatectomy

Chicago, IL (UroToday.com) Dr. Mark Markowski and colleagues from Johns Hopkins University presented their study assessing the implications of PSA doubling time (PSADT) and proximal PSA value for predicting metastasis free survival (MFS) among men with biochemical recurrence after radical prostatectomy (RP) at the prostate cancer poster session at the 2017 ASCO annual meeting. The objective for this study was to identify men with PSADT<12 months and identify a PSA cut-point (proximal PSA) that indicates the imminent emergence of metastasis (M+).

ASCO 2017: Association of risk of clinical recurrence and prostate cancer death with a 17-gene genomic prostate score value

Chicago, IL (UroToday.com) In the era of improving detection of clinically meaningful prostate cancer, while not overtreating men who will not derive benefit from treatment, there is increased interest in risk stratification including genomic risk stratifiers. Dr. Phillip Febbo and colleagues presented their study assessing the risk of clinical recurrence (CR) and prostate cancer death (PCD) among patients with genomic prostate score (GPS) value <20 at the prostate cancer poster sessions at the 2017 ASCO annual meeting.

ASCO 2017: Development and external validation of a novel risk score to identify insignificant prostate cancer

Chicago, IL (UroToday.com) Dr. Lorenzo Dutto and colleagues presented their work on developing a novel risk score to identify insignificant prostate cancer at the prostate cancer poster sessions at the 2017 ASCO Annual meeting in Chicago. Active surveillance (AS) is increasingly being used for monitoring men with low grade disease that is unlikely to be life-threatening. The objective of the current study was to evaluate the accuracy of nine separate tools to identify patients harboring insignificant prostate cancer using a novel risk score.

ASCO 2017: Emerging Biomarkers of Chemotherapy Resistance

Chicago, IL (UroToday.com) Dr. Karen Knudsen gave a summary of abstracts 5012, 5013, and 5014. She began with a short introduction on metastatic castrate resistant prostate cancer (mCRPC), emphasizing that strategies are needed to personalize medicine in this entity. At this point in time all mCRPC patients are treated similarly. Importantly, one should know that mCRPC is incurable and that resistance to first line hormonal therapy ultimately develops. The key questions are: Who is the right patients to receive novel therapy? What is the optimal sequencing of these agents and does it matter? For how long are these agents to be given and if they are beneficial? Why is there still relapse?

ASCO 2017: Clinical Implications of Genomic Sequencing in Prostate Cancer

Chicago, IL (UroToday.com) Dr. Heather Cheng gave a short introduction before giving an excellent summary of abstracts 5009, 5010 and 5011. Nowadays there are many life prolonging treatments for metastatic castrate resistant prostate cancer (mCRPC), and more in development. Genomic sequencing is advancing in tremendous steps but is still not a standard in prostate cancer. It is however known, that mCRPC has >20% defects in DNA repair genes (BRCA1-2, ATM and more) and >10% of DNA repair defects are germline (heritable). Lastly, treatment with androgen receptor (AR) targeted agents can select for more aggressive variants. 
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