ASCO GU 2018: Influence of CHAARTED, STAMPEDE, and LATITUDE eligibility criteria on utilization of abiraterone and docetaxel

San Francisco, CA (UroToday.com) The management of metastatic prostate cancer (PCa) continues to change in rapid succession. While we were once reliant on androgen-deprivation therapy for hormone-sensitive prostate cancer (hsPCa) and docetaxel alone for the treatment of metastatic castration-resistant PCa (mCRPC), the landscape of PCa treatment has drastically changed. The introduction of androgen axis targeting agents, specifically enzalutamide (ENZA) and abiraterone (ABI), have revolutionized the field.

ASCO GU 2018: A Phase 2 Study of Olaparib and Durvalumab in mCRPC in an Unselected Population

San Francisco, CA (UroToday.com)  Dr. Fatima Karzai provided results of a phase 2 study assessing the addition of durvalumab to olaparib for men with mCRPC at today’s prostate cancer. Previous studies suggest 25-30% of sporadic mCRPC has defects in DNA repair pathways which may confer sensitivity to PARP inhibition (PARPi) [1,2]. Furthermore, immune checkpoint blockade may increase the proportion of patients that respond to PARPi. The authors hypothesized that increased DNA damage by olaparib will complement anti-tumor activity of immune checkpoint blocking antibody, durvalumab, among mCRPC patients.

ASCO GU 2018: Blood-brain barrier penetration of darolutamide compared with enzalutamide using whole body autoradiography

San Francisco, CA (UroToday.com) Christian Zurth and colleagues presented results of their rat model study assessing blood-brain barrier penetration of darolutamide vs enzalutamide using whole body autoradiography at GU ASCO 2018. Darolutamide (ODM-201) is an investigational oral and high-affinity androgen receptor antagonist. In preclinical studies, penetration of darolutamide through the blood–brain barrier is negligible and in a retrospective safety analysis of the ARADES database for CNS-related adverse events, only one report of urinary incontinence was linked to darolutamide [1].

ASCO GU 2018: Best of Journals: Prostate - Surgery

San Francisco, CA (UroToday.com) Dr. Cooperberg presented key publications in prostate cancer in the past year. From his prior presentation in 2016, he had hoped for more development in three area: more treatment (surgery) for high-risk disease, less (or no) treatment for low risk disease, and smarter screening (based on the above two points). While we have made strides in the right direction, we still have work to go.

ASCO GU 2018: Addition of docetaxel to first-line long-term hormone therapy in prostate cancer (STAMPEDE)

San Francisco, CA (UroToday.com) Dr. Nicholas James presented results from the STAMPEDE trial for the addition of docetaxel to first-line hormonal therapy for patients with prostate cancer. Results from large randomized controlled trials (RCTs) have shown that adding docetaxel to standard of care in men initiating hormone therapy for prostate cancer prolongs survival for those with metastatic disease and prolongs time to treatment failure for those without metastatic disease [1-3]. The objective of this study was to establish whether adding docetaxel to standard of care represents a cost-effective use of healthcare resources in M0 and M1 among prostate cancer patients in the STAMPEDE trial.

ASCO GU 2018: Ability of multiparametric MRI to predict prostate tumor heterogeneity on targeted biopsy

San Francisco, CA (UroToday.com) Dr. Samuel Gold presented their teams research assessing the ability of multiparametric MRI (mpMRI) to predict prostate tumor heterogeneity on targeted biopsy. Indeed, prostate cancer can show heterogeneous histology within lesions. Although MRI-targeted biopsy of the prostate improves prostate cancer detection, sampling within lesions has yet to be standardized. Additionally, targeted biopsy results are often heterogeneous as evidenced by differing histologic grades of targeted biopsy cores within the same mpMRI lesion, introducing variability in biopsy results. The objective of this study was to characterize lesion heterogeneity and identify predictive mpMRI features.

ASCO GU 2018: Best of Journals 2017: Prostate Cancer – Radiotherapy

San Francisco, CA (UroToday.com) Dr. Bossi sought out to answer the following questions focusing on 3 separate publications during his presentation on the best of 2017 journal articles relating to radiotherapy for prostate cancer: 1) Is the rationale clinically relevant? 2) What did the study results show? 3) Will the results change my clinical practice?
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