Thomas Keane, MD provides a concise and well-balanced update on the use of androgen deprivation therapy (ADT) for the evaluation and treatment for advanced prostate cancer patients. As Keane describes, ADT has been the mainstay for initiating the treatment of advanced and metastatic disease since the 1940s — today, more than half of all prostate cancer patients will undergo ADT. In his update, Keane discusses the toxicities related to ADT including an important focus upon cardiovascular health, and thus considers how outcomes may differ by various patient characteristics, for example, age and ethnicity, and thereby suggests processes for improved risk management. He also expounds his discussion with a review of the STAMPEDE and LATITUDE groundbreaking trials and the combinatorial use of both docetaxel and abiraterone acetate with ADT.
Phillip Koo, MD provides his expert commentary on next-generation imaging (NGI) techniques and the future application of NGIs for evaluation of advanced PCa progression and management. Koo reviews the use of various PET scan advances as well as MRI for advanced PCa patients, inclusive of recent trial data, for example, the recent PRECISION study. He also comments on available radiotherapeutics and the role of radium 223 for its survival benefit and its application with novel hormonal agents. He also discusses the practical challenges associated with accessibility and reimbursement for NGI advances.
Finally, we conclude this issue with a review of October’s ESMO 2018 Congress in Munich, Germany. This ESMO Spotlight includes coverage of Dr. Cora Sternberg’s presentation on the use of immunotherapy for the treatment of renal and bladder cancers, results from the phase III study IMmotion151 for metastatic renal cell carcinoma, preliminary results from the TRITON study for metastatic castration-resistant prostate cancer, and the coverage of other presentations impacting the role of chemotherapy in GU cancer treatment.
As 2018 concludes, I look forward to the pending important trial readouts which will assuredly impact the field of GU Oncology. I look forward to sharing this issue of Everyday Urology - Oncology Insights with you. Thank you for readership and your feedback. Happy Holidays and Happy New Year!
Written by: Neal Shore, MD, FACS is an internationally recognized expert in systemic therapies for patients with advanced urologic cancers and innovative therapies to treat patients suffering from prostate enlargement symptoms. Dr. Shore was recently appointed President-Elect of the Large Urology Group Practice Association (LUGPA), which seeks to provide urologists with all the tools they need to effectively care for patients. Neal D. Shore, MD, FACS, is the Medical Director of the Carolina Urologic Research Center. He practices with Atlantic Urology Clinics in Myrtle Beach, South Carolina. Dr. Shore has conducted more than 100 clinical trials, focusing mainly on prostate and bladder disease.