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Highlights from the 2021 American Society of Clinical Oncology Annual Meeting
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| Social Determinants, Not Biology: Time to Reappraise Genetics-Based Theories of Racial/Ethnic Cancer Outcome Disparities |
| Prostate Cancer: Rejecting the Biologic Basis for Outcome Disparities |
| Robert Timothy Dess, MD |
| We know from SEER data that black men are 1.7x more likely to be diagnosed with prostate cancer and are 2.1x more likely to die from their prostate cancer. This is not new data, as these trends were evident in the 1950s and 1970s as well but appear to be worsening in severity. This has led to the perception that race is an independent prognostic factor associated with worse prostate cancer outcomes. This is reflected in guidelines from the AUA/ASTRO/SUO that advise counseling patients on their individualized risk of disease recurrence based on clinical factors and patient race. |
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| A Blueprint for Addressing Cancer Disparities |
| Nestor Esnaola, MD |
| In this presentation, Nestor Esnaola unpacked some of the underlying mechanisms and shared ongoing research that aims to help address this problem. He utilized data from non-small cell lung cancer (NSCLC), but similar findings are also seen within prostate cancer. |
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| Oligometastases in Prostate Cancer: How to Rationally Incorporate Metastasis-Directed Therapy into your Practice |
| Radiation Oncologist’s Perspective
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| Phuoc T. Tran, MD, Ph.D.
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| Phuoc Tran presents a cased-based discussion and the radiation oncologist's perspective on incorporating metastasis-directed therapy into clinical practice. He presents three cases with question and answer discussion on how he chooses his treatment decisions.
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| International Perspective
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| Nicholas D. James, Ph.D., MBBS, FRCP |
| Nicholas James presented the international perspective on how to incorporate metastasis-directed therapy into clinical practice at this year's American Society of Clinical Oncology Annual Meeting. He presents three cases detailing treatment decisions and taking questions regarding those patients.
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| Community Perspective |
| Robert Given, MD, FACS |
| Robert Given presents the international perspective on how to incorporate metastasis-directed therapy into clinical practice at this year's American Society of Clinical Oncology Annual Meeting. He presents three cases detailing treatment decisions and taking questions regarding those patients. |
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| Application of Genomic Testing Treatment for Patients with Prostate Cancer |
| Genomic Medicine in Prostate Trials and Treatments |
| Veda N. Giri, MD |
| Veda Giri presented on genetic testing in prostate cancer. Current genomic tests for prostate cancer are summarized in the table provided below and cross-referenced with their clinical use. Multiple other genomic tests are under clinical development at the present time. She discusses what we have learned from past clinical trials as well as those currently under development. |
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| Medical Oncologist Perspective: The Promise and Limitations of Precision Health in Metastatic Disease |
| Franklin Huang, MD, Ph.D. |
| Franklin Huang focused his presentation on the role of genomic testing in metastatic prostate cancer and how it influences therapeutic decision-making for medical oncologists. He specifically focused on genomic testing for microsatellite instability, tumor mutational burden, and DNA damage repair deficiency and the role of immunotherapy and PARP inhibitors for these alterations. |
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| Oral Abstract Session - Kidney and Bladder |
| Analysis of Two Poor Prognosis Subgroups in ACIS Evaluating Apalutamide + Abiraterone Acetate + Prednisone Versus Placebo + Abiraterone Acetate + Prednisone in mCRPC |
| Fred Saad, MD, FRCS, |
| Fred Saad presented the results of these two key subgroups of the ACIS trial. In this analysis of two difficult to treat mCRPC subgroups (≥ 75 years of age and visceral disease) in the ACIS study, addition of apalutamide + abiraterone acetate + prednisone favored rPFS and OS compared to placebo + abiraterone acetate + prednisone. |
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| Biomarker Analysis of Phase IB Trial of Radium-223 and Niraparib in Patients with mCRPC (NiraRad) |
| Eddy Shih-Hsin Yang, MD |
| Eddy Yang presented results of an exploratory biomarker analysis in the NiraRad phase Ib clinical trial. Nanostring exploratory analysis on whole blood suggests potential response biomarkers that warrant further investigation. PAX5, which controls MYC and immune pathways, is higher at screening and downregulated in patients with longer treatment duration. |
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| Copy Number Profiles of Primary Tumors for Risk Stratification of Advanced Prostate Cancer: A Biomarker Study Embedded in the Multicenter STAMPEDE Trial |
| Emily Grist |
| Grist and colleagues presented the results of a study assessing copy number profiles of primary tumors for risk stratification of advanced prostate cancer in the STAMPEDE trial. Evaluation of the burden of copy aberrations in archival, poor quality formalin fixed paraffin embedded diagnostic tissue from men randomized in the STAMPEDE trial is feasible using low coverage whole genome sequencing. Increased copy number alteration in advanced prostate cancer is significantly and non-linearly associated with increased hazard of death. |
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| Association of ATM Mutations in Metastatic Prostate Cancer with Differential Genomic Alteration Profiles from Homologous Recombination Deficient and Proficient Tumors |
| Charles Ryan, MD |
| Charles Ryan presented the results of a study exploring co-occurring genomic alterations that may drive outcomes of metastatic prostate cancer patients with tumors harboring ATM mutations and provide clues for understanding therapy resistance and potential targets. Future directions include multi-omic approaches to further characterize ATM and BRCA2 loss in prostate cancer, and novel therapeutic strategies that account for mechanistic differences between patients with ATM-mutated and other HRD mutations may improve outcomes in this population. |
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| To view our full coverage of the 2021 ASCO Annual Meeting, visit the Conference Coverage section on UroToday.com
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