ASCO GU 2017: Best of Journals: Prostate Cancer - Medical Oncologist Perspective - Session Highlights
Orlando, Florida USA (UroToday.com) Joshua Lang, University of Wisconsin, presented review of new molecular information in prostate cancer. Metastatic castrate-resistant prostate cancer (mCRPC) now has a multitude of regimens and sequence of administration to consider. Clinical states of prostate cancer from hormone sensitive to mCRPC are of upmost importance. Defining disease contexts by Halabi et al. with lymph node only disease having superior survival outcomes over visceral disease. Loriot et al. in Cancer 2017 assessed the AFFIRM trial data which all shoed visceral metastases had inferior survival outcome when compared to non-visceral disease. Molecular drivers according to disease site noted AR pathway alterations in 71% according to Robinson et al. in Cell 2015. Henzler et al. in Nature Communications noted AR gene sequence rearrangements in the majority of mCRPC patients with unexpected splice variants. Beltran et al. in Nature Medicine noted differential genomic and epigenomic signatures in adenocarcinoma and neuroendocrine tumors. PIK3 and BRCA2 are commonly identified in patients with mCRPC patients as noted by Robinson et al. in Cell 2015. Pritchard et al. published in NEJM noted unique set of germline DNA-repair gene alterations among mCRPC patients. Evolving genomic landscape from localized to mCRPC and future targeted therapies according to these findings are on the horizon.
Presenter: Joshua Lang, University of Wisconsin
Contributed by Stephen B. Williams, MD, Assistant Professor, Division of Urology, The University of Texas Medical Branch at Galveston, Galveston, TX and Ashish M. Kamat, MD, Professor, Department of Urology, The University of Texas MD Anderson, Houston, TX