Advanced Prostate Cancer VL

Radiating the Primary Tumor in Metastatic Hormone-Sensitive Prostate Cancer - Sandy Srinivas

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Alicia Morgans interviews Sandy Srinivas about her presentation on treating the primary tumor in synchronous high-volume metastatic hormone-sensitive prostate cancer. Dr. Srinivas reviews key trials such as HORRAD and STAMPEDE, which indicate that radiating the primary tumor may benefit low-volume patients but not those with high-volume disease. She highlights the PEACE-1 trial, which found no sur...

EMBARK Trial: Enzalutamide Monotherapy and Combination Therapy for High-Risk Biochemical Recurrence - Neal Shore

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Alicia Morgans speaks with Neal Shore about managing biochemical recurrence (BCR) in high-risk patients, particularly following radiotherapy (RT) and radical prostatectomy (RP). Discussing findings from the EMBARK trial, Dr. Shore emphasizes that combining enzalutamide with LHRH, or using enzalutamide alone, significantly improves metastasis-free survival compared to leuprolide monotherapy. He foc...

Personalizing Salvage Radiation and Hormone Therapy for Biochemical Recurrence - Daniel Spratt

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Alicia Morgans speaks with Dan Spratt about his presentation on the management of biochemical recurrence in prostate cancer post-radical prostatectomy. Dr. Spratt explains the considerations for using hormone therapy alongside salvage radiation, emphasizing the variability in treatment needs based on PSA levels. He highlights findings from several randomized trials, showing that higher PSA levels...

COBRA Trial Shows Promise for 64Cu-SAR-bisPSMA PET in Biochemical Recurrence - Neal Shore

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Phillip Koo and Neal Shore discuss the COBRA trial, which investigates the use of 64Cu-SAR-bisPSMA PET imaging in prostate cancer patients with biochemical recurrence (BCR). Dr. Shore, the lead principal investigator, introduces Clarity, an Australian company developing Copper-64-based radiopharmaceuticals. He explains the advantages of Copper-64, such as its long half-life and bivalent structure,...

Prognostic and Predictive Factors in Metastatic Hormone-Sensitive Prostate Cancer - Matthew Smith

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Alicia Morgans speaks with Matthew Smith about prognostic and predictive factors in treating metastatic hormone-sensitive prostate cancer (mHSPC). Dr. Smith explains the importance of clinical, imaging, and molecular factors in patient selection for treatment intensification. He highlights that factors like disease volume, manner of presentation, and specific genomic alterations (e.g., PTEN, P53)...

Optimizing Lutetium-PSMA Dosing in High-Volume Disease and Special Situations - Louise Emmett

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Alicia Morgans speaks with Louise Emmett about the use of radiopharmaceuticals in prostate cancer, particularly for frail patients. Professor Emmett focuses on dosing radioligand therapy in special situations and managing toxicity, particularly marrow and kidney toxicity. She highlights the need for individualized dosing strategies, noting that current protocols might not adequately treat high-vol...

Sequencing Therapies in mCRPC After Progression on Combination Treatment - Ian Davis

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Alicia Morgans interviews Ian Davis to discuss the challenges of sequencing treatments for patients with metastatic hormone-sensitive prostate cancer (mHSPC) that have progressed to metastatic castrate-resistant disease (mCRPC). Dr. Davis emphasizes that there is no ideal sequence of treatments but identifies several less-than-ideal approaches. He highlights the importance of achieving maximum ben...

Managing Frail Patients with Metastatic Hormone-Sensitive Prostate Cancer - Maria De Santis

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Maria De Santis discusses managing frail patients with metastatic hormone-sensitive prostate cancer. Dr. De Santis explains the importance of defining frailty, which involves five key factors: unintended weight loss, weakness, low physical activity, difficulty lifting objects, and mobility issues. She highlights the necessity of evaluating frailty using tools like the G8 screening and emphasizes t...

Redefining Low-Volume Metastatic Prostate Cancer in the Era of PSMA PET Imaging - Oliver Sartor

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Oliver Sartor discusses his approach to treating low-volume metastatic prostate. Dr. Sartor emphasizes the importance of molecular imaging, particularly PSMA PET, to define low-volume and oligometastatic disease accurately. He advocates for a "total therapy" approach, combining androgen deprivation, novel hormones, and targeted radiation, including SBRT for metastatic sites and pelvic radiation. D...

The EvoPAR-Prostate 01 Trial: Novel PARP Inhibitor Saruparib in mHSPC - Neeraj Agarwal

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Zach Klaassen discusses the EvoPAR-Prostate 01 trial with Neeraj Agarwal. The trial examines a new PARP inhibitor combined with ARPI in metastatic hormone-sensitive prostate cancer, both in biomarker-positive and -negative populations. Dr. Agarwal explains the rationale based on preclinical data and previous trials like PROpel and TALAPRO-2, showing efficacy in HRR mutation-positive patients and p...