mHSPC VL

RADIOSA Trial: SBRT vs SBRT+ADT for Oligorecurrent Prostate Cancer - Giulia Marvaso

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Giulia Marvaso discusses the RADIOSA trial, a phase II randomized study comparing SBRT alone versus SBRT with short-course hormonal therapy for oligorecurrent prostate cancer. The trial includes 102 patients with up to three metastatic lesions, randomized into two arms. Results show improved biochemical and clinical progression-free survival in the combination arm. Dr. Marvaso highlights that pati...

IMPLEMENT Study: Addressing the Underutilization of Treatment Intensification in Metastatic Castration-Sensitive Prostate Cancer - Stacy Loeb

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Zach Klaassen and Stacy Loeb discuss the IMPLEMENT Study, which investigates the underutilization of treatment intensification in metastatic hormone-sensitive prostate cancer. Despite guidelines recommending this approach, it is used in less than a third of cases. Phase one of the study identified barriers like limited knowledge of clinical trials and concerns about using up treatment options earl...

NCCN 2024 Prostate Cancer Guidelines Update: Relugolix Gains Prominence in Treating Metastatic Castration-Sensitive Prostate Cancer - Rashid Sayyid & Zachary Klaassen

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Rashid Sayyid and Zach Klaassen explore the significant updates to the 2024 NCCN guidelines for prostate cancer, focusing on the integration of relugolix for metastatic castration-sensitive prostate cancer (M1-CSPC). Dr. Sayyid highlights the HERO trial, which established relugolix as an effective oral GnRH antagonist with rapid and sustained testosterone suppression, outperforming leuprolide in b...

Enzalutamide Plus 5-Alpha Reductase Inhibitors for Castrate-Sensitive Prostate Cancer: A Phase 2 Trial - Deepak Kilari

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Deepak Kilari discusses a Phase II trial exploring the combination of enzalutamide with five alpha-reductase inhibitors (ARIs) for castrate-sensitive prostate cancer. Driven by observations from geriatric oncology, the study seeks alternatives to androgen deprivation therapy (ADT) for older, frail men who struggle with its side effects. The trial examines whether enzalutamide combined with dutaste...

Prognostic Power of Multi-Modal Artificial Intelligence Biomarker in CHAARTED Trial Subset - Mark Markowski

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Zach Klaassen speaks with Mark Markowski about the advancements in AI, particularly the ArteraAI Prostate Test, and its implications for prostate cancer treatment. Dr. Markowski explains how ArteraAI has evolved from predicting treatment responses in localized prostate cancer to potentially guiding treatment decisions in metastatic hormone-sensitive prostate cancer. The CHAARTED study, a pivotal t...

OASIS Project Highlights the Survival Benefits of Rapid PSA Decline with Apalutamide in Prostate Cancer - Benjamin Maughan

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Zach Klaassen and Benjamin Maughan discuss new insights into the real-world application of apalutamide in treating metastatic hormone-sensitive prostate cancer (mHSPC). Dr. Maughan highlights the significance of achieving deep PSA responses as a key prognostic marker for patient outcomes. The OASIS project, utilizing data from diverse medical settings across the U.S., demonstrates that patients wh...

Escalation Strategies for Suboptimal PSA Decline in mHSPC - Mary-Ellen Taplin

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Alicia Morgans speaks with Mary-Ellen Taplin about strategies for managing metastatic hormone-sensitive prostate cancer (mHSPC) patients who do not achieve optimal PSA declines. Dr. Taplin emphasizes that an unfavorable PSA decline is not synonymous with progression and highlights the prognostic value of achieving a PSA nadir below 0.2. She discusses data from various trials, such as SWOG 9346, CH...

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...

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)...

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...