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Introducing UroToday's Newest Editor in Chief |
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| A Letter from Neeraj Agarwal, MD, FASCO, mHSPC Center of Excellence Editor-in-Chief
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| Advancing Metastatic Hormone-Sensitive Prostate Cancer Care: Bridging Research and Practice
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| In this editorial, Dr. Neeraj Agarwal highlights the advancements in treating mHSPC, emphasizing the importance of moving beyond androgen deprivation therapy (ADT) alone. He discusses the benefits of adding androgen receptor pathway inhibitors (ARPIs) and triplet regimens involving docetaxel, ADT, and ARPIs, which significantly improve patient outcomes.
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PEER-TO-PEER CLINICAL CONVERSATIONS
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IMPLEMENT Study: Addressing the Underutilization of Treatment Intensification in Metastatic Castration-Sensitive Prostate Cancer
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Stacy Loeb, MD, MSc, PhD (Hon)
Zach Klaassen and Stacy Loeb discuss the IMPLEMENT Study, which investigates the underutilization of treatment intensification in metastatic hormone-sensitive prostate cancer.
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| Systematic Review Sheds Light on Treatment Intensification in Metastatic Prostate Cancer |
Peter Goebell, MD, PhD
Zach Klaassen and Peter Goebell discuss a systematic review focused on treatment intensification for metastatic hormone-sensitive prostate cancer. Dr. Goebell's study aims to assess if scientific evidence, as outlined in guidelines, translates into real-world practice changes. |
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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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| The Current State of Treatment Implementation for Metastatic Hormone-Sensitive Prostate Cancer in North America
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| Zachary Klaassen, MD MSc, and Rashid Sayyid, MD, MSc
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| The treatment landscape for mHSPC in North America has evolved significantly over the past decade with the introduction of combination therapies that improve overall survival compared to ADT alone. Despite these advances and the availability of doublet and triplet therapy options, there remains a significant underutilization of treatment intensification strategies in real-world practice. Barriers to adoption include concerns about tolerability, the perceived need for broader clinical evidence, and financial considerations, highlighting the need for further medical education and tailored treatment approaches based on disease volume and timing of metastasis.
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| Underutilization of ADT Intensification for the Treatment of Men with mHSPC: A Systematic Review of Real-World Database Studies |
| Peter J. Goebell, MD, Ph.D. |
| Peter Goebell presents a systematic review of real-world studies showing that androgen deprivation therapy (ADT) intensification is underutilized in men with metastatic hormone-sensitive prostate cancer (mHSPC), despite its clinical benefits. Data from 29 studies, encompassing over 344,000 men, indicated that while the use of ADT with androgen receptor pathway inhibitors has increased since 2015, a significant proportion of patients still receive ADT monotherapy, particularly in the US. |
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| Darolutamide Real-World Doublet and Triplet Utilization in Metastatic Hormone-Sensitive Prostate Cancer (mHSPC): US Community Urology Setting
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| Benjamin Lowentritt, MD, FACS
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| Benjamin Lowentritt presents the findings on the real-world use of darolutamide in doublet and triplet therapy for mHSPC within US community urology practices. The study, which included 319 men, found that 60% received darolutamide doublet therapy (with ADT) and 40% received triplet therapy. Patients in both groups often had high Gleason scores and elevated PSA levels, indicating advanced disease.
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| mHSPC: Optimizing Combination Therapy
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| Paul Sieber, MD
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| Paul Sieber discusses optimizing combination therapy for metastatic hormone-sensitive prostate cancer (mHSPC). He emphasized that doublet therapy with androgen deprivation therapy (ADT) and an androgen receptor pathway inhibitor (ARPI) is recommended for all mHSPC patients. Triplet therapy, which adds docetaxel, should be considered for high-volume, fit patients.
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| Clinical and Patient Factors Associated with Treatment Intensification for mHSPC |
| Sreevalsa Appukkuttan, MPH, MBBS |
| Sreevalsa Appukkuttan presents findings on factors influencing treatment intensification for metastatic hormone-sensitive prostate cancer (mHSPC) in the US. The study found that 57% of patients received intensified therapy within 90 days of starting androgen deprivation therapy (ADT), with younger age, bone metastasis, residing in the Northeast or West regions, and lower comorbidity scores being associated with increased likelihood of intensification. |
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