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Highlights from the 2023 American Society of Clinical Oncology Annual Meeting
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Oral Abstract Session: Genitourinary Cancer--Prostate and Testicular Cancer
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| Prostate Irradiation in Men with De Novo, Low-Volume, Metastatic, Castration-Sensitive Prostate Cancer (mCSPC): Results of PEACE-1, a Phase 3 Randomized Trial with a 2x2 Design
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| Alberto Bossi, MD
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| Alberto Bossi presents late-breaking results from the phase III PEACE-1 trial evaluating prostate irradiation in men with de novo, low-volume, metastatic castrate-sensitive prostate cancer (mCSPC). Combining prostate radiotherapy with intensified systemic treatment (abiraterone +/- docetaxel) was associated with improved rPFS and CRPC free-survivals in men with low volume, de novo mCSPC.
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| AI-Derived Digital Pathology Biomarker Predicts Benefit of Long-Term ADT with Radiotherapy in Localized High-Risk Prostate Cancer |
| Andrew J. Armstrong, MD |
| Andrew Armstrong presents the results of a pooled analysis of multiple phase III NRG/RTOG trials aimed at developing and subsequently validating an AI-derived digital pathology-based biomarker to predict the benefit of long-term ADT addition to radiotherapy in men with localized, high-risk prostate cancer. |
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| Prognostic Impact of PSA Nadir (N) ≥0.1 ng/mL Within 6 Months After Completion of Radiotherapy for Localized Prostate Cancer: An Individual Patient-Data Analysis of Randomized Trials from the ICECaP Collaborative
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| Praful Ravi, MB, MRCP, MBBChir
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| PSA ≥0.1 ng/ml within 6 months of radiotherapy completion is highly prognostic for MFS, PCSM, and OS in men receiving radiotherapy +/- ADT for localized prostate cancer. These results aid in counselling of patients treated with radiotherapy +/- ADT in routine practice. These results have implications for adjuvant trial designs evaluating novel systemic therapies with radiotherapy + ADT or intensification/de-intensification approaches.
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| Discussant: Hitting the Sweet Spot with Radiation and Androgen Deprivation |
| Karen Hoffman, MD, MHSc, MPH |
| Following earlier presentations by Dr. Alberto Bossi (PEACE-1 radiotherapy results), Dr. Andrew Armstrong (ArteraAI long-term ADT predictive biomarker), and Dr. Praful Ravi (prognostic value of 6-months PSA level post-radiotherapy from ICECaP), Dr. Karen Hoffman delivered the discussant session for these studies. |
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| Presence of Somatic/Germline Homologous Recombination Repair Mutations and Outcomes in Metastatic Castration-Resistant Prostate Cancer Patients Receiving First‑line Treatment Stratified by BRCA Status
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| David Olmos, MD, Ph.D.
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| David Olmos presents the results of an analysis evaluating the association between presence of somatic/germline homologous recombination repair (HRR) gene alterations and outcomes in metastatic castrate-resistant prostate cancer (mCRPC) patients receiving 1st line treatment, stratified by BRCA mutational status.
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| TALAPRO-2: Phase 3 Study of Talazoparib + Enzalutamide Versus Placebo + ENZA as First-Line Treatment for Patients with Metastatic Castration-Resistant Prostate Cancer (mCRPC) Harboring Homologous Recombination Repair (HRR) Gene Alterations |
| Karim Fizazi, MD, Ph.D. |
| Karim Fizazi presents updated results of TALAPRO-2, concurrently published in The Lancet. In this large, randomized trial involving mCRPC patients with HRR gene alterations, talazoparib plus enzalutamide resulted in a statistically significant and clinically meaningful improvement in rPFS by BICR, compared to placebo plus enzalutamide. |
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| LuPARP: Phase 1 Trial of 177Lu-PSMA-617 and Olaparib in Patients with Metastatic Castration-Resistant Prostate Cancer (mCRPC)
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| Shahneen Sandhu, MBBS, FRACP
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| Shahneen Sandhu presents the results of LuPARP, a phase 1 trial of 177Lu-PSMA-617 plus olaparib in mCRPC patients. The investigators observed high rates of total and PSMA+ CTCs in this cohort of PSMA-expressing mCRPC. Total and PSMA+ CTCs declined with combined olaparib and 177Lu-PSMA-617 treatment. Early declines in total and PSMA+ CTCs including 12-week CTC clearance paralleled PSA responses.
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| Discussant: DDR and PARP Inhibition: What's the Damage? |
| David James VanderWeele, MD, Ph.D. |
| Following presentations by Dr. Olmos (CAPTURE 1 Cohort: Genetic mutations in mCRPC patients treated in the 1st line setting), Dr. Fizazi (TALAPRO-2), and Dr. Sandhu (LuPARP), David VanderWeele delivered the discussant for these studies. |
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| Long-Term Follow-up Analysis of Plasma miR371 Expression to Detect Early Relapse in Patients with Clinical Stage I Testicular Germ Cell Tumors on Surveillance
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| Lucia Nappi, MD, Ph.D.
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| In this presentation, Lucia Nappi discusses long-term follow-up analysis of plasma miR371 expression to detect early relapse in patients with clinical stage I testicular germ cell tumors on surveillance. Micro-RNAs are small non-coding RNA regulating oncogenes and oncosuppressor transcription.
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| Primary RPLND in Seminoma Stage IIA-IIC ≤3cm: Combined Results of the SWENOTECA (Swedish Norwegian Testicular Cancer Group) and Cologne
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| Torgrim Tandstad, MD, Ph.D.
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| Torgrim Tandstad discusses the combined results of the SWENOTECA and Cologne experience of primary retroperitoneal lymph node dissection (RPLND) in seminoma stage IIA-IIC ≤3 cm tumors. These early results of primary RPLND of seminomas IIA-IIB ≤ 3 cm are promising and can be performed at experienced centers. Longer follow-up is required to ensure this as a safe treatment option, but currently risk of late morbidity and mortality is minimal.
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| Discussant: Germinating Data for Germ Cell Tumors
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| Ben Tran, MD |
| Ben Tran discusses germinating data from germ cell tumors. Dr. Tran notes that testicular cancer is the most common cancer in young men, with long life expectancies secondary to the high cure rate because of cisplatin-based chemotherapy combinations. Importantly, a disease-free condition is not the equivalent of a life free of physical and psychosocial health problems. |
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| Molecular Drivers of Organotropism and Cisplatin Resistance in Germ Cell Tumors
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| Aditya Bagrodia, MD, FACS
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| Aditya Bagrodia discusses molecular drivers of organotropism and cisplatin resistance in germ cell tumors. Dr. Bagrodia started by highlighting that brain, bone, and liver metastases are associated with poor germ cell tumor outcomes. There are no molecular alterations associated with site of metastasis: KIT mutations are more prevalent in primary tumors and TP53 mutations more prevalent in metastases.
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Poster Session: Genitourinary Cancer--Prostate
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| Efficacy and Safety of Darolutamide in Chinese Patients with mHSPC: A Subpopulation Analysis of the Phase 3 ARASENS Study
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| Shanshan Wang, Ph.D.
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| In the ARASENS subpopulation of Chinese patients with mHSPC, darolutamide + ADT + docetaxel showed favorable efficacy and safety vs placebo + ADT + docetaxel. Overall survival and clinically relevant secondary endpoints favored darolutamide vs placebo, and the incidences of treatment-emergent adverse events were similar in the two treatment groups. These results are consistent with the findings reported for the overall population in ARASENS.
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| ADT and Risk of Dementia in Patients with Prostate Cancer: Clinical Outcomes from Real-World Data
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| Dina Elantably, MD
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| Dina Elantably discusses clinical outcomes from real-world data assessing ADT and risk of dementia in patients with prostate cancer. For decades, ADT has been the cornerstone for the treatment advanced prostate cancer. However, based on several studies in the past few years, there has been growing concerns regarding increased risk of depression and dementia with ADT.
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| The Role of Volume of Disease for Treatment Selection in Patients with mCSPC: A Living Meta-Analysis
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| Syed Arsalan Ahmed Naqvi, MBBS
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| Syed Arsalan Ahmed Naqvi discusses a meta-analysis of the role of volume of disease for treatment selection in patients with mCSPC. These results indicate that triplet therapy may be preferred in mCSPC patients with high volume disease. On the other hand, androgen pathway inhibitor doublet therapy may be preferred in mCSPC patients with low volume disease.
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| Pre-Surgical 68Ga-PSMA-11 PET for Biochemical Recurrence Risk Assessment: A Surrogate of Pelvic Lymph Node Dissection? Follow-up Analysis of a Multicenter Prospective Phase 3 Imaging Trial
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| Loic Djaileb, MD, Ph.D.
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| Given the detection rate of PSMA-PET for lymph node metastasis, there is increased interest as to whether there is utility in performing a lymph node dissection if imaging is negative, or perhaps performing an extended more thorough dissection if imaging is positive. As such, the objective of this study was to compare the prognostic value of presurgical PSMA-PET and pelvic lymph nodes invasion for biochemical recurrence free-survival in patients with intermediate-risk to high-risk prostate cancer treated with radical prostatectomy and pelvic lymph node dissection.
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