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PEER-TO-PEER CLINICAL CONVERSATIONS |
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Multidisciplinary Approach in the Treatment of Metastatic Prostate Cancer
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Robert Dreicer, MD, MS, MACP, FASCO
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| Alicia Morgans and Robert Dreicer discuss advancements in treating metastatic prostate cancer, highlighting the complexity of the disease and the importance of a multidisciplinary approach. They emphasize the underutilization of intensification strategies and the challenges in ensuring optimal patient care, noting the need for ongoing education for clinicians and patients to improve treatment outcomes.
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Understanding the Underutilization of Germline Genetic Testing in Prostate Cancer
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Sarah Nielsen Young, MS, LCGC, and David Wise, MD, PhD
Neal Shore, Sarah Nielsen, and David Wise discuss broadening access to germline testing for prostate cancer patients. Reflecting on their collective efforts, including the PROCLAIM Trial and an editorial on Universal Genetic Germline Testing for Hereditary Cancer Syndromes, they emphasize democratizing genetic testing and universal accessibility.
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Multidisciplinary Transitions in Care for Patients Receiving Lutetium-177
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Benjamin Lowentritt, MD, and Robert Brookland
Phillip Koo hosts Benjamin Lowentritt, Urologist, and Robert Brookland, Radiation Oncologist, to discuss the multidisciplinary approach to patient care with PLUVICTO® (lutetium Lu 177 vipivotide tetraxetan). Dr. Lowentritt outlines the seamless transition from identifying suitable candidates for PLUVICTO to referring them to Dr. Brookland for further consultation and treatment.
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Workflow Considerations from the Front Desk to Nursing Including the Supportive Care Idea: "Presentation"
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Linda Gardner, RN, MSN, and Amanda Morley, RN, BSN
Linda Gardner and Amanda Morley detail the critical steps and challenges in setting up a Radioligand Therapy (RLT) program, covering aspects from licensing and space planning to staff training and patient care logistics. They highlight the importance of adaptability, thorough planning, and the efficient use of resources, demonstrating how UCLA and UCSF navigate operational demands to provide patient-centered care in RLT.
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| Understanding the Incidence, Duration, and Severity of Symptoms Through Daily Symptom Monitoring Among Frail and Non-Frail Older Patients Receiving Metastatic Prostate Cancer Treatments - Beyond the Abstract
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| Ferozah Nasiri, Kian Godhwani, Milothy Parthipan, MScPT, & Shabbir M. H. Alibhai, MD, MS
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| This study explored treatment toxicities in older adults with metastatic prostate cancer, focusing on frail and non-frail patients. It found that frail individuals experienced higher incidences and longer durations of symptoms like fatigue, insomnia, and poor well-being compared to non-frail individuals. The study highlights the need for further research to better understand and manage these toxicities, as current data often underrepresent older adults, especially those who are frail.
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| How to Manage Patients with Low-Volume on Conventional and High-Volume on Next-Generation Imaging |
| Dana Rathkopf, MD |
| Dana Rathkopf discussed the complexities of managing patients with mHSPC with low-volume disease on conventional imaging and high-volume disease on next-generation imaging like PSMA PET. Dr. Rathkopf highlighted the advantages and limitations of PSMA PET, noting its increased accuracy but the potential for indeterminate findings that may not clearly dictate treatment decisions. |
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| Responsible and Equitable Biomarker Stewardship: How Do We Ensure Access to All Patients
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| Timothy Rebbeck, PhD
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| Timothy Rebbeck emphasizes the need for responsible and equitable biomarker stewardship to ensure all patients have access to personalized cancer care. He highlights two main approaches: a population-based approach and a precision approach that includes stratified and adaptive methods.
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| Patient Selection for Radioligand Therapy: How to Do It in Clinical Practice and How to Decide on the Number of Cycles
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| Thomas Hope, MD
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| Thomas Hope discusses patient selection and the determination of the number of cycles for PSMA radioligand therapy in prostate cancer treatment. He outlines that patients should have PSMA-positive lesions with uptake greater than the liver, as seen in PET imaging, and emphasizes that SUVmean should not be a sole criterion for selection. Dr. Hope recommended using post-treatment SPECT imaging to assess treatment response and manage ongoing therapy, suggesting that FDG PET may only be necessary in challenging cases.
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| How to Identify Aggressive Variant Prostate Cancer?
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| Himisha Beltran, MD
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| Himisha Beltran discussed the identification of aggressive variant prostate cancer (AVPC), characterized by clinical features like exclusive visceral metastases and genetic alterations in RB1, TP53, and PTEN. These aggressive subtypes may require therapy intensification and alternative treatments, with ongoing research focusing on better diagnostic tools and biomarker standardization to guide clinical decisions.
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| How to Personalize Treatment in mHSPC? More than Just Counting Metastases
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| Karim Fizazi, MD, PhD
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| Karim Fizazi emphasizes the importance of personalizing treatment in metastatic hormone-sensitive prostate cancer beyond just counting bone metastases. He highlights the benefits of triplet therapy for high-volume disease and different approaches for low-volume cases, including the potential use of prostate radiotherapy and APIs. He also discussed the role of biomarkers and the impact of an 8-month PSA response in guiding treatment strategies.
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