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PEER-TO-PEER CLINICAL CONVERSATIONS |
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Risk Assessment in Localized Prostate Cancer - Insights from Real-World Data and the SEER Registry
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Jim Hu, MD, MPH
Ashley Ross and Jim Hu discuss the use of genomic classifiers, specifically the Decipher Genomic Classifier, in the management of localized prostate cancer. They review its performance in larger datasets and its association with prostate cancer outcomes.
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DEAR: Comparative Real-World Evidence on Darolutamide, Enzalutamide, and Apalutamide for Patients with nmCRPC in the United States
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Neal Shore, MD, FACS
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| Alicia Morgans engages with Neal Shore about the DEAR study, an analysis of real-world outcomes for non-metastatic castration-resistant prostate cancer (nmCRPC) patients treated with darolutamide, apalutamide, and enzalutamide.
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| A US Real-World Study of Treatment Patterns and Outcomes in Localized or Locally Advanced Prostate Cancer Patients - Beyond the Abstract |
| Stephen J. Freedland, MD |
| Men with localized or locally advanced prostate cancer (LPC/LAPC) are at risk of progression after radiotherapy (RT) or radical prostatectomy (RP). Using real-world data, this study evaluated patient characteristics, treatment patterns, and outcomes in LPC/LAPC. |
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Real World Evidence Evaluating the Underutilization of Treatments for mCRPC in Clinical Practice
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Mark Fleming, MD
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| Mark Fleming highlights the under-utilization of treatments for metastatic castration-resistant prostate cancer, emphasizing the need for multidisciplinary management involving urologists, medical oncologists, radiation oncologists, and genetic counselors to optimize patient outcomes.
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| Real-World Analyses of Mortality Risk After ADT Initiation in Black vs White Patients with Prostate Cancer
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| Judd Moul, MD
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| Judd Moul presents a study comparing mortality risk after androgen deprivation therapy initiation between Black and White prostate cancer patients. The study found that White patients had a significantly higher mortality risk compared to Black patients, with adjusted hazard ratios showing a 24% increased risk for White patients. Potential explanations for this disparity include differences in cardiovascular health and the protective effects of higher BMI in Black patients, underscoring the need for further research to confirm these findings and explore underlying causes.
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| Rapid and Deep Prostate-Specific Antigen Response to Apalutamide plus ADT and Survival in mCSPC in Real World Practice in the US (OASIS Project) |
| Benjamin Maughan, MD, PharmD, |
| Benjamin Maughan presented findings from the OASIS Project, a study assessing the real-world impact of apalutamide plus androgen deprivation therapy (ADT) on prostate-specific antigen (PSA) responses and survival in metastatic castration-sensitive prostate cancer (mCSPC). The study, utilizing data from ConcertAI, found that rapid and deep PSA reductions (including achieving undetectable PSA levels) were strongly associated with improved overall survival. |
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| Darolutamide Real-World Doublet and Triplet Utilization in Metastatic Hormone Sensitive Prostate Cancer (mHSPC): US Community Urology Setting |
| Benjamin Lowentritt, MD, FACS |
| Benjamin Lowentritt presented a study on the use of darolutamide in combination with androgen deprivation therapy (ADT) and/or docetaxel for metastatic hormone-sensitive prostate cancer (mHSPC) in a US community urology setting. The study found that 60% of patients received darolutamide plus ADT (doublet therapy) and 40% received triplet therapy with docetaxel. |
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| Real-World Comparative Effectiveness and Cardiovascular Safety of Enzalutamide Versus Abiraterone Amongst Older Men Diagnosed with Metastatic Castration-Resistant Prostate Cancer
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| Charles Gaber, Ph.D., MPH
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| Charles Gaber presented a real-world comparative analysis of enzalutamide versus abiraterone acetate for older men with mCRPC. The study found that while overall survival rates were similar for both treatments, abiraterone was associated with a 26% higher rate of major adverse cardiovascular events (MACE) compared to enzalutamide. Notably, the increased MACE risk with abiraterone was more pronounced in frail patients, emphasizing the need to consider frailty when selecting treatment options for older men with mCRPC.
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| Efficacy and Toxicity of 177Lu-PSMA-617 for Metastatic Castration-Resistant Prostate Cancer in a Real-World Setting: Results from the U.S. Expanded Access Program and Comparison with Phase 3 VISION Data |
| Vishnu Murthy |
| At the SNMMI 2024 meeting, Vishnu Murthy presented data from the U.S. expanded access program for 177Lu-PSMA-617, comparing it to the phase 3 VISION trial. Both programs showed similar overall survival (15.1 months vs. 15.3 months) and PSA response rates (42% vs. 46%). However, the expanded access program reported higher rates of hematologic adverse events, particularly lymphopenia and neutropenia. |
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| Real-World Analysis of Metastatic Hormone-Sensitive Prostate Cancer: Are Randomized Clinical Trials More Trustworthy? Insights from PIONEER, the European Network of Excellence for Big Data in Prostate Cancer
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| Juan Gómez Rivas, MD, PhD,
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| Juan Gómez Rivas presents the results from the PIONEER study, which analyzed real-world data of over 94,000 European patients with metastatic hormone-sensitive prostate cancer (mHSPC). The study highlighted that a significant portion of mHSPC patients are older than those typically included in clinical trials, and many are not receiving early treatment intensification despite evidence supporting its benefits. The findings underscore the importance of understanding real-world practice patterns to improve guideline implementation and patient outcomes.
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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) |
| Rossella Nicoletti, MD |
| Rossella Nicoletti presents interim findings 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 study identified factors associated with higher mortality, such as age over 90, non-adenocarcinoma cancer types, and visceral metastasis, while younger age and adenocarcinoma types were linked to better survival odds. |
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