CUOS 2019: High-Risk Prostate Cancer Debate: Surgery

Toronto, Ontario ( In this debate, Dr. Laurence Klotz presented his view and thought on why radical prostatectomy should be performed in patients with high-risk disease, as opposed to radiotherapy.

CUOS 2019: High-Risk Prostate Cancer Debate: Radiation

Toronto, Ontario ( Dr. Gerard Morton participated in the debate of 'High-risk Prostate Cancer Debate: Radiation vs Surgery" and explained why he believes that radiotherapy should be offered to patients with high-risk prostate cancer.

CUOS 2019: Sequencing Issues Around Androgen Receptor Pathway Inhibition

Toronto, Ontario ( Dr. Sebastien Hotte presented the latest research and expert opinions regarding the sequencing of agents in metastatic castrate-resistant prostate cancer (mCRPC).  There is currently no level one data to answer the question what the best sequence of therapy for mCRPC patients in this era is. However, based on previous analogous data, we can speculate on the next best logical steps in treatment in different scenarios:

CUOS 2019: Treating M0 or Non-metastatic Castration-resistant Prostate Cancer

Toronto, Ontario ( Dr. Neil Fleshner presented the question in debate of whether we should be treating non-metastatic castrate-resistant prostate cancer (nmCRPC) patients or wait until they have developed metastases.

He began his discussion stating the enormous changes that have occurred in the last 15 years in the field of advanced prostate cancer. Many new treatments have been added that extend survival. These include chemotherapy (docetaxel, cabazitaxel), Sipuleucel T, androgen axis inhibitors (abiraterone, enzalutamide, apalutamide) and Radium 223. Additionally, supportive agents have been added including bone-targeted therapies (denosumab and zoledronic acid).

CUOS 2019: Is There a Role for Treating the Primary in Metastatic Hormone-sensitive Prostate Cancer

Toronto, Ontario ( Dr. Robert Hamilton presented on the role of treatment of the primary tumor in the setting of metastatic hormone-sensitive prostate cancer (mHSPC).  He began his discussion providing the rationale for treating the primary tumor in mHSPC patients. This involves both clinical and biological factors. The biologic factors include:

CUOS 2019: Active Surveillance: Long-Term Data - We Continue to Learn

Toronto, Ontario ( Dr. Laurence Klotz presented on the current status of active surveillance for prostate cancer. Through the years there has been greater recognition of the overtreatment problem of prostate cancer patients, and the concept of active surveillance has been more accepted. We have also learned more about the nature of high-grade occult disease and the predictive value of baseline parameters. The flaws of PSA kinetics as a trigger have been recognized, and the incorporation of mpMRI has become very common. Currently, new modeling studies are being developed, with longer follow-up, and there are approximately 3000 publications on active surveillance.

CUOS 2019: Biomarkers: From Diagnosis to Risk Stratification

Toronto, Ontario ( Dr. Frédéric Pouliot presented an overview of the currently used biomarkers in prostate cancer.  A biomarker is defined as any substance, molecule, or reaction that can be measured in the organism or its products and that can influence or predict the incidence of a specific consequence or disease. Several such categories include susceptibility, diagnostic and prognostic markers.
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