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PEER-TO-PEER CLINICAL CONVERSATIONS |
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| Advancing mHSPC Treatment Options: ARANOTE Trial Analysis |
Fred Saad, MD, FRCS, and Neal Shore, MD, FACS
Fred Saad and Neal Shore discuss the ARANOTE trial with Zach Klaassen, exploring the use of darolutamide plus ADT in metastatic hormone-sensitive prostate cancer. They highlight the trial's diverse patient population and impressive results, including a 46% reduction in radiographic progression-free survival risk. |
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| Best Practices for Successfully Implementing Triplet Therapy in mHSPC |
| Christopher Pieczonka, MD |
| Christopher Pieczonka discusses the management of metastatic hormone-sensitive prostate cancer with a focus on triple therapy. Dr. Pieczonka emphasizes that ADT is no longer the standard of care as monotherapy for metastatic prostate cancer, citing the ARASENS study's results, which demonstrate the overall survival benefit of adding docetaxel and Nubeqa to ADT. |
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Coordinating Complex Care in High-Volume mHSPC Through Multidisciplinary Communication
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R. Jonathan Henderson, MD, and Sunil Kakadia, MD, MPH, FACP
Alicia Morgans convenes a discussion on managing high-volume metastatic hormone-sensitive prostate cancer, bridging the practices of urology and medical oncology with Jonathan Henderson and Sunil Kakadia, a medical oncologist from Genesis Oncology.
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Impact of Time to Metastatic Disease Onset and Extent of Disease Volume Across Metastatic Hormone-Sensitive and Castration-Resistant Prostate Cancer - Beyond the Abstract
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| Mike Wenzel, Benedikt Hoeh, Philipp Kopf et al. |
| This study explored the impact of time to metastatic disease onset and disease volume on overall survival (OS) in metastatic hormone-sensitive prostate cancer (mHSPC). Utilizing data from the Frankfurt Metastatic Cancer database, researchers analyzed 504 mHSPC patients, categorizing them into four groups: De Novo Low Volume (DNLV), De Novo High Volume (DNHV), Metachronous Low Volume (SecLV), and Metachronous High Volume (SecHV). |
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| A Systematic Review and Meta-Analysis of the Impact of Local Therapies on Local Event Suppression in Metastatic Hormone-Sensitive Prostate Cancer - Beyond the Abstract
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| Ichiro Tsuboi, MD
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| A systematic review and meta-analysis assessed the impact of local therapies, specifically radical prostatectomy and radiotherapy, on suppressing local events in mHSPC. The analysis of 3,565 patients revealed that RP significantly reduced the incidence of local events, while RT showed no significant effect on overall local events, although both therapies decreased the need for surgical interventions. Despite the benefits of local treatments, the definitive effectiveness of these approaches in reducing local events in mHSPC remains insufficiently explored.
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| Synchronous Low-Volume mHSPC – In Which Patients Do You Recommend Combination Systemic Therapy Plus Local Treatment of the Primary and in Which Patients is ADT Alone Plus Radiotherapy Enough?
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| Robert Jones, MD, PhD
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| Robert Jones discussed the management of synchronous low-volume metastatic hormone-sensitive prostate cancer (mHSPC). He highlighted that while combination systemic therapy with local treatment may be beneficial for certain patients, studies, including PEACE-1 and a recent network meta-analysis, indicate that adding radiotherapy to androgen deprivation therapy (ADT) and androgen receptor signaling inhibitors (ARPI) does not significantly improve overall survival.
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| Comparison of Outcomes with Docetaxel or ARPI Combination Therapy for mHSPC by Volume of Disease |
| Martin W. Schoen, MD, MPH |
| Martin Schoen presented a study comparing outcomes for metastatic hormone-sensitive prostate cancer (mHSPC) patients treated with docetaxel versus androgen receptor pathway inhibitors (ARPI). The study found no significant differences in overall survival between the two therapies for both high-volume and low-volume disease; however, ARPI was associated with longer progression-free survival compared to docetaxel. |
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| Clinical Prognostic Factors Within the High-Volume Subgroup of Metastatic Hormone-Sensitive Prostate Cancer in ENZAMET (ANZUP 1304)
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| Anis A. Hamid, MBBS
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| Anis Hamid presented findings from a post-hoc analysis of the ENZAMET trial, highlighting that high alkaline phosphatase (ALP) levels and Gleason scores are significant prognostic factors for poorer overall survival in patients with high-volume metastatic hormone-sensitive prostate cancer (mHSPC). In low-volume disease, having four or more bone metastases was associated with improved survival, suggesting the need for further stratification to identify high-risk patients for therapy intensification.
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| Development of a Prediction Model of Survival Amongst Patients with Metastatic Hormone-Sensitive Prostate Cancer Using Big Data: Interim Results from the European Network of Excellence for Big Data in Prostate Cancer (PIONEER)
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| Rossella Nicoletti, MD
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| Rossella Nicoletti presented interim results from the PIONEER study, which aimed to develop a survival prediction model for patients with metastatic hormone-sensitive prostate cancer (mHSPC) using real-world data. The model identified key factors influencing mortality, such as age over 90, non-adenocarcinoma variants, and visceral metastases, but was only able to predict survival with 75% accuracy for the first year post-diagnosis due to the heterogeneity of mHSPC patients.
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