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PEER-TO-PEER CLINICAL CONVERSATIONS
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Extended Data Cut: CAN-2409 with Valacyclovir and Radiation for Localized Prostate Cancer
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Mark Garzotto, MD
Mark Garzotto presents an extended data cut from the CAN-2409 phase 3 trial evaluating aglatimagene besadenovec plus valacyclovir in combination with radiation for localized prostate cancer, including updated outcomes on recurrence, biochemical failure, metastasis, and salvage therapy.
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PROTEUS Trial: Neoadjuvant Apalutamide and Androgen Deprivation Therapy in High-Risk Localized Prostate Cancer
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Mary-Ellen Taplin, MD
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| Mary-Ellen Taplin presents PROTEUS trial results. The study enrolled 2,100 very high-risk localized prostate cancer patients undergoing radical prostatectomy, randomized to perioperative apalutamide plus ADT versus placebo plus ADT.
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Combining PSMA PET and Genomic Risk Assessment in High-Risk Prostate Cancer
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Sophia Coraci, BS
Sophia Coraci discusses an analysis of 104 treatment-naive prostate cancer patients correlating PSMA PET SUVmax with Decipher genomic classifier scores. PSMA PET imaging occurred within 35 days of biopsy. Fifty percent of patients had high-risk Decipher scores.
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| Extended Follow-up Shows Accumulating Benefit for Patients Treated with CAN-2409 + Prodrug in Combination with Standard of Care EBRT in Men with Localized Prostate Cancer – an Update from a Randomized, Placebo-Controlled Phase 3 Clinical Trial
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| Mark Garzotto, MD
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| Extended follow-up from the phase 3 CAN-2409 trial showed that adding aglatimagene plus valacyclovir to standard external beam radiotherapy reduced the risk of recurrence or death and delayed biochemical failure, metastasis, and need for salvage therapy. The regimen was generally well tolerated, suggesting it may offer a new way to extend prostate cancer control after radiation.
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| The PROTEUS Journey: Setting a New Course for High-Risk Prostate Cancer
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| Declan Murphy, MB, BCh, BaO, FRACS, FRCS Urol
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Declan Murphy reviews the PROTEUS trial and how perioperative treatment strategies are evolving for patients with very high-risk localized prostate cancer. The discussion highlights improvements in pathologic response, metastasis-free survival, and time to next therapy, while positioning perioperative apalutamide plus ADT as a potential option for selected patients undergoing radical prostatectomy. Treatment selection remains individualized based on patient and disease characteristics.
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| IRRADIANT: Irreversible Electroporation versus Radiation Boost for Intermediate-Risk Prostate Cancer
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| Himanshu Nagar, MD, MS
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| IRRADIANT is a randomized trial testing whether focal irreversible electroporation plus reduced-dose radiation can match standard radiation boost therapy for intermediate-risk prostate cancer while better preserving urinary, bowel, and sexual function. The main endpoint is the 2-year negative biopsy rate, with additional follow-up on cancer control, quality of life, and machine-learning predictors of response.
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| External Validation of New Prostate Cancer Risk Groups by PSMA-PET (PPP3)
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| Wolfgang Fendler, MD
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| Wolfgang Fendler’s ASCO 2026 presentation showed that the PSMA-PET-based PPP3 nomograms for prostate cancer risk groups were externally validated in a large, multi-site cohort, with good prognostic accuracy for 3–7-year overall survival. The simplified risk table performed similarly to the visual nomogram, supporting its use for practical risk stratification.
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| Assessing the Clinical and Biological Associations Between MMAI and 22-Gene GC in Localized Prostate Cancer
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| Boon Hao Hong
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| In this Singapore cohort of 144 men with localized prostate cancer, MMAI and the 22-gene genomic classifier were correlated but often disagreed on risk group, yet both were independently prognostic for metastasis-free survival. The genomic classifier showed broader pathway differences, while MMAI-high tumors were mainly linked to lower fatty acid metabolism, suggesting the tools capture overlapping but distinct biology.
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