ASCO 2018: Optimal Patient Selection/Stratification Perspective

Chicago, IL (UroToday.com) Charles Ryan, MD, gave an excellent talk on the optimal patient selection for prostate cancer. When assessing early failure and early death in studies comparing abiraterone and androgen deprivation therapy (ADT), it is evident that approximately 22% of patients are dead 2 years after starting ADT + abiraterone. This death rate rises to 33% after 3 years of follow-up.

ASCO 2018: Ten Year Treatment Outcomes of Radical Prostatectomy Vs External Beam Radiation Therapy Vs Brachytherapy for 1,503 Patients With Intermediate Risk Prostate Cancer

Chicago, IL (UroToday.com) Comparison of definitive therapy of localized prostate cancer is of great interest to both urologists, radiation oncologists and medical oncologists. In this study the authors present data on 10-year treatment outcomes of radical prostatectomy (RP) vs. external beam radiation therapy (EBRT) vs. brachytherapy (BT) for patients with intermediate risk prostate cancer (IRPC).

ASCO 2018: Optimizing Androgen Receptor Targeting Strategies Perspective

Chicago, IL (UroToday.com) Mary Ellen Taplin, MD, discussed the clinician’s perspective on optimizing androgen receptor (AR) targeting strategies. The response to androgen deprivation therapy (ADT) is different between the state of hormone-sensitive prostate cancer (HSPC) and castrate-resistant prostate cancer (CRPC) (Figure 1). 

ASCO 2018: Approaches in Management of Refractory Germ Cell Cancer

Chicago, IL (UroToday.com) Anja Lorch, MD, gave a talk on how to approach and treat refractory germ cell tumors (GCTs). Most patients with metastatic GCTs will be cured by 3-4 cycles of BEP chemotherapy. However, some patients will be refractory to this treatment. For these patients, 1st line salvage therapy has a favorable response in 60-80% of patients, with long-term survival ranging between 30-70%. In 2nd  line salvage treatment, favorable response are seen in 30-40% of patients with long-term survival ranging between 15-25%.

ASCO 2018: Long-Term Patterns in Race-specific, Distant Metastasis-free Survival Following Radiation Treatment for Prostate Cancer

Chicago, IL (UroToday.com) It is known that prostate cancer (PC) outcomes vary according to race. African Americans (AA) have a 1.5-fold greater incidence of PC and 2-fold greater mortality than Caucasian Americans (CA).
The authors of this study aimed to compare distant metastasis free survival (DMFS) of AA and CA military health care beneficiaries treated with radiotherapy for prostate cancer over a 20-year period.

ASCO 2018: Impact of Treatment Sequence on the Outcomes of Metastatic Castration Resistant Prostate Cancer Patients With Germline BRCA2 Mutations: A Subanalysis of the PROREPAIR-B Study

Chicago, IL (UroToday.com) Approximately 3-5% of metastatic castrate resistant prostate cancer patients (MCRPC) have been shown to have BRCA2 germline mutations.
PROREPAIR-B (NCT03075735) [1] is the first prospective study to report a worse survival from MCRPC patients with these associated germline mutations. This study demonstrated significant interactions between treatment-type (androgen signaling inhibitors [ASI]/Taxanes) and BRCA2 status with an effect on cause-specific survival (CSS) from 1st line (p = 0.015) and 2nd line (p = 0.006).

ASCO 2018: Survivorship and Surveillance in Management of Germ Cell Cancer

Chicago, IL (UroToday.com) Christian Kollmannsberger, MD, gave an excellent talk on survivorship and long-term surveillance in the management of germ cell tumors (GCTs). All major types of cancer therapy can result in side effects that can impair well-being, physical and psychosocial functioning, and overall quality of life. These side effects may last long after the treatment ends. In GCTs the late effects affecting mortality do not show until 20+ years of follow-up.  Ironically, the mortality from long-term complications in good/intermediate risk patients may be higher than the mortality associated with the disease itself. In fact, 20 years after cisplatin-based chemotherapy, patients have a 50% higher risk of dying from unrelated GCT causes compared to the general population.[1]