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Genomic Classifier Decipher® Guides Treatment Intensification in Post-Prostatectomy Patients
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Phuoc Tran, MD, PhD
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| Phuoc Tran joins Angela Jia to discuss findings from the RTOG 0534 SPPORT trial examining Decipher® genomic classifier scores as predictors of treatment response in post-prostatectomy salvage radiotherapy.
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Highlights from the 2025 American Society of Clinical Oncology Genitourinary Cancers Symposium
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| Gene Signature Predictor of Dose-response to Prostate Radiation: Validation of PORTOS in Phase III Trials
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| Shuang Zhao, MD
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| Dr. Shuang Zhao presented a validation of the prostate cancer radiation therapy gene expression score (PORTOS) in phase III trials assessing a gene signature predictor of dose-response to prostate radiation.
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| Radical Prostatectomy Versus Radiotherapy in High-Risk Prostate Cancer: Emulated Randomized Comparison with Individual Patient Data from Two Phase III Randomized Trials |
| Soumyajit Roy, MD, MSc |
| Soumyajit Roy presented an emulated randomized comparison of radical prostatectomy versus radiotherapy in high-risk prostate cancer, using individual patient data from two Phase III trials. The study found that radiation therapy with long-term ADT resulted in a lower cumulative incidence of distant metastasis compared to radical prostatectomy. However, about 80% of prostate cancer patients treated with surgery will require additional treatments or experience recurrence, highlighting the importance of adjuvant and salvage therapies. |
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| Prospective Monitoring of Prostate Specific Membrane Antigen (PSMA) –Positive Recurrent Prostate Cancer: Preliminary Data from 6 Months PSMA Follow-Up.
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| Ravi A. Madan, MD
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| Dr. Ravi Madan presented the preliminary results of a 6-months PSMA follow-up study prospectively monitoring patients with prostate-specific membrane antigen (PSMA)-positive recurrence prostate cancer.
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| Final Overall Survival with Talazoparib + Enzalutamide as First-Line Treatment in Unselected Patients with mCRPC in the Phase 3 TALAPRO-2 Trial
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| Neeraj Agarwal, FASCO, MD
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| The final overall survival results from the TALAPRO-2 trial confirm that talazoparib + enzalutamide significantly improves survival in unselected patients with mCRPC compared to enzalutamide alone. The combination also extended radiographic progression-free survival by 13.6 months, with no new safety concerns. These findings support talazoparib + enzalutamide as a standard first-line treatment for mCRPC.
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| Which Patients with mHSPC Benefit More from Androgen Receptor Pathway Inhibitors? STOPCAP Meta-Analyses of Individual Participant Data |
| David Fisher, MSc |
| David Fischer presented results of the STOPCAP meta-analysis of individual participant data from seven major trials which confirmed that androgen receptor pathway inhibitors significantly improve overall survival and progression-free survival in mHSPC, with a substantial absolute benefit at five years. While benefits were consistent across most clinical subgroups, age was a key factor—older patients had a reduced benefit from abiraterone, whereas "amide" inhibitors showed consistent efficacy across all ages. |
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| Discussant: Personalizing Prostate Cancer Care for mHSPC to mCRPC
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| Tanya B. Dorff, MD
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| In this discussion session Dr. Tanya Dorff discussed two abstracts: “Final overall survival with talazoparib + enzalutamide as first-line treatment in unselected patients with (mCRPC) in the phase 3 TALAPRO-2 trial” by Dr. Neeraj Agarwal, and “Which patients with mHSPC benefit more from androgen receptor pathway inhibitors? STOPCAP meta-analyses of individual participant data” by David Fisher.
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| Prognostic Value of Quantitative PSMA-PET Parameters During Chemotherapy in Prostate Cancer |
| Stephan Beintner-Skawran, MD |
| A retrospective study presented by Stephan Beintner-Skawran evaluated the prognostic value of quantitative PSMA-PET parameters in prostate cancer patients undergoing taxane-based chemotherapy. Baseline PSMA tumor volume and changes in PSA levels were the strongest predictors of overall survival, with baseline PSMA volume showing the highest prognostic value. While PSMA-PET/CT parameters provided useful prognostic insights, changes in PSA levels outperformed them in predicting treatment outcomes. |
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| Evaluation of the Impact on Overall Survival Curves of Patients with Metastatic Castration-Sensitive Prostate Cancer Staged with PSMA-PET and Classified According to Current Prognostic Criteria by Volume and Risk
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| Isadora Martins de Sousa, MD
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| Isadora Martins de Sousa presented a study assessing the prognostic value of conventional imaging-defined volume and risk criteria when applied to PSMA PET findings in mCSPC. PSMA PET detected 67% more distant metastases than conventional imaging, with a 79% discordance in bone lesion detection. The study found that volume-based criteria remained prognostic for overall survival, while risk-based criteria did not, reinforcing the superior diagnostic accuracy of PSMA PET in staging mCSPC
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| PET Imaging for Metastatic Castration Sensitive Prostate Cancer (mCSPC) for Patients with PSA Response After Systemic Therapy: A Multicentric Ambispective Analysis
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| Mathilde Beaufils, MD
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| A multicentric analysis evaluated PET imaging in mCSPC patients who achieved a PSA response after systemic therapy. Among 60 patients treated with ADT ± ARPI ± docetaxel, 81% had a complete PET response, with non-responders more likely to have high-volume and synchronous metastatic disease. While PET CR was associated with improved radiologic progression-free survival, overall survival did not differ, suggesting PSMA PET may help refine treatment deintensification or intensification strategies in this setting.
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| Clinical Outcomes of Prompt vs Deferred 177Lu-PSMA-617 Initiation for mCRPC Based on Prior Androgen Receptor Pathway Inhibitor and Taxane Chemotherapy Exposure |
| Oliver Sartor, MD |
| A real-world study using the PRECISION data platform evaluated clinical outcomes of prompt vs. deferred initiation of 177Lu-PSMA-617 in mCRPC patients with prior androgen receptor pathway inhibitor and taxane chemotherapy exposure. Prompt initiation led to superior PSA response rates and longer overall survival compared to deferred initiation. These findings suggest that earlier use of 177Lu-PSMA-617 may improve outcomes, though further research is needed to refine treatment sequencing strategies. |
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| Darolutamide + ADT in Patients with mHSPC by Disease Volume: Subgroup Analysis of the Phase 3 ARANOTE Trial |
| Fred Saad, MD, FRCS |
| The Phase 3 ARANOTE trial subgroup analysis showed that darolutamide + ADT significantly improved radiological progression-free survival versus placebo + ADT in both high-volume and low-volume mHSPC patients. Darolutamide also delayed time to mCRPC and PSA progression across both subgroups. Notably, low-volume patients had a greater relative benefit, with PSA <0.2 ng/mL achieved in 82.6% vs. 25.4%. |
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| CLARIFY: PET Using 64Cu-SAR-bisPSMA in Patients with High-Risk Prostate Cancer Prior to Radical Prostatectomy—A Phase 3 Diagnostic Performance Study |
| Michael A. Gorin, MD |
| The Phase 3 CLARIFY trial aims to evaluate the diagnostic performance of 64Cu-SAR-bisPSMA PET for detecting pelvic lymph node metastases in high-risk prostate cancer patients before radical prostatectomy. Compared to current PSMA PET agents, 64Cu-SAR-bisPSMA offers higher tumor uptake, prolonged retention, and a longer half-life, potentially improving sensitivity for regional metastases. The study will enroll 383 patients and assess sensitivity, specificity, and predictive values by comparing PET findings to surgical pathology results. |
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