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Highlights from the 2023 American Society of Clinical Oncology Annual Meeting
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Prioritizing and Sequencing Therapy for Advanced Prostate Cancer
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| When More Is More: Treatment Intensification for Hormone-Sensitive Prostate Cancer |
| Neeraj Agarwal, MD |
| Neeraj Agarwal discusses the current treatment landscape of metastatic hormone-sensitive prostate cancer (mHSPC), debating in favor of early treatment intensification for mHSPC patients and arguing that ‘more is more’ in this scenario. |
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| When Less Is More: Decreasing Exposure to Systemic Therapy for Hormone-Sensitive Prostate Cancer |
| Anis Hamid, MBBS |
| Anis Hamid discusses the current treatment landscape of metastatic hormone-sensitive prostate cancer (mHSPC), debating against routine, early treatment intensification for mHSPC patients and arguing that ‘less is more’ in this scenario. |
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| Timing of PARP Inhibition for Prostate Cancer with Defects in Homologous Recombination Repair
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| Julie N. Graff, MD
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| Julie Graff discusses the timing of Poly (adenosine diphosphate-ribose) polymerase inhibitors (PARP) inhibitors use for prostate cancer patients with defects in homologous recombination repair (HRR) genes. Every patient with metastatic disease should have genetic testing for germline and somatic mutations. Metastatic castration-resistant prostate cancer patients with HRR mutations should be considered for PARP inhibitor monotherapy following progression on enzalutamide/abiraterone.
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Management of Prostate Cancer in Older Adults
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| Management of Prostate Cancer in Older Adults: Assessment and Decision Tools for Balancing Survival and Quality of Life |
| Elizabeth R. Kessler, MD |
| Elizabeth Kessler discusses the assessment and decision tools for balancing survival and quality of life. Dr. Kessler started her presentation by posing the question: Do we want to live longer or live better? She also notes that there are several goals of concordant care: Care that aligns with patient values and priorities. Care the accounts for physical and emotional health of the patient, and care that is decided upon together. |
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| Helping Our Elders Survive and Thrive with Prostate Cancer: Known and Novel Intervention Strategies |
| Ravi Bharat Parikh, MD, MPP, FACP
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| Ravi Parikh discusses known and novel intervention strategies for helping our elders survive and thrive with prostate cancer. Frailty is prevalent among prostate cancer survivors, particularly among individuals who are peri-surgery and/or on ADT. Prehabilitation and treatment modification based on frailty assessment can improve peri-surgical outcomes. |
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| Applying Risk/Benefit Considerations for Elder Patients to Current Treatment Advances in Prostate Cancer |
| Alicia K. Morgans, MD, MPH |
| Alicia Morgans discusses applying risk/benefit considerations for elder patients to current treatment advances in prostate cancer. Dr. Morgans started by emphasizing that when evaluating the patient we need to take a five step approach. To highlight this approach, Dr. Morgans discussed a case presentation of metastatic hormone sensitive prostate cancer. This patient was a 74 year old male who presents from his urologist with a diagnosis of de novo metastatic hormone sensitive prostate cancer. |
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Poster Session: Genitourinary Cancer--Prostate
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| AI-Enabled Analysis of H&E-Stained Prostate Cancer Tissue Images: Assessing Risk for Metastasis Prior to Apalutamide (APA) Treatment of Patients with Non-Metastatic Castration-Resistant Prostate Cancer (nmCRPC)
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| Pooya Mobadersany, Ph.D.
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| Pooya Mobadersany presents the results of an AI-enabled analysis of hematoxylin and eosin (H&E)-stained prostate cancer tissue images to assess the risk of subsequent metastasis in patients with non-metastatic castrate-resistant prostate cancer (nmCRPC) subsequently receiving apalutamide. These results suggest that H&E-based AI could be a tool to risk-stratify patients with nmCRPC.
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| Prevalence of Mismatch Repair Deficiency in a Large Prospective Prostate Cancer Cohort |
| Ciara S. McNevin, MBBCh, MSc
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| Ciara McNevin presented the results of an analysis of a large, prospective prostate cancer cohort examining the prevalence of mismatch repair deficiency mutations. In this nationwide study, MMR deficiency was rare in primary, surgically treated patients. There appears to be a discordance between results from this population-based analysis and those reported previously from hospital-based registries, with a significantly lower proportion of dMMR tumors in this study.
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| Sequential Metastasis-Directed Therapy for Oligometastatic Prostate Cancer Assessed by PET-Based Imaging |
| Nonna Shakhnazaryan, BS
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| Nonna Shakhnazaryan presents the results of a single institution analysis evaluating sequential metastasis-directed therapy (MDT) for oligometastatic prostate cancer patients, detected via PET-based imaging. The objective of this study was to evaluate the feasibility and clinical outcomes of serial PET-directed SBRT for patients with evidence of oligo-progressive prostate cancer following initial SBRT treatment.
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