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PEER-TO-PEER CLINICAL CONVERSATIONS |
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COBRA Trial Shows Promise for 64Cu-SAR-bisPSMA PET in Biochemical Recurrence
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Phillip Koo, MD
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| Phillip Koo and Neal Shore discuss the COBRA trial, which investigates the use of 64Cu-SAR-bisPSMA PET imaging in prostate cancer patients with biochemical recurrence (BCR). Dr. Shore, the lead principal investigator, introduces Clarity, an Australian company developing Copper-64-based radiopharmaceuticals.
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Personalizing Salvage Radiation and Hormone Therapy for Biochemical Recurrence
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Daniel Spratt, MD
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| Alicia Morgans speaks with Dan Spratt about his presentation on the management of biochemical recurrence in prostate cancer post-radical prostatectomy. Dr. Spratt explains the considerations for using hormone therapy alongside salvage radiation, emphasizing the variability in treatment needs based on PSA levels.
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| EMBARK Trial: Age-Stratified Analysis of Enzalutamide in High-Risk Biochemically Recurrent Prostate Cancer |
| Neal Shore, MD, FACS |
| Zach Klaassen interviews Neal Shore about the EMBARK trial's post hoc analysis by age. The study examines the efficacy of enzalutamide alone or combined with leuprolide for high-risk biochemical recurrence in prostate cancer patients. |
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| State of the Art Lecture: The Role of Adjuvant and Salvage Radiation Therapy for Prostate Cancer
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| Thomas Ahlering, MD
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| Thomas Ahlering critically assesses the historical role of adjuvant and salvage radiation therapy in prostate cancer, questioning the design and oversight of key randomized trials. He argued that these studies did not appropriately compare treatment options and concluded that postoperative radiation therapy has yet to show significant improvement in metastasis-free or prostate cancer-specific survival.
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| Prostate Cancer Case Studies: Localized, Salvage Radiotherapy/BCR, mHSPC, and mCRPC
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| Tanya Dorff, MD, Amar U. Kishan, MD, Arash R. Kalebasty, MD, and Jun Gong, MD
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| At the 2024 Southern California GU Cancer Research Forum, several prostate cancer trials were discussed, focusing on localized, salvage radiotherapy/BCR, mHSPC, and mCRPC stages. Trials include NePtune and INTREPId investigating ADT-based combinations in localized prostate cancer, while trials like NADIR and HEATWAVE focus on novel hormone therapies and radiotherapy.
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| COBRA: Assessment of Safety and Efficacy of 64Cu-SAR-bisPSMA in Patients with Biochemical Recurrence of Prostate Cancer Following Definitive Therapy
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| Luke Nordquist, MD
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| The COBRA trial, presented by Dr. Luke Nordquist, assessed the safety and efficacy of 64Cu-SAR-bisPSMA in detecting lesions in prostate cancer patients with biochemical recurrence after definitive therapy. The study found that 64Cu-SAR-bisPSMA identified lesions in up to 80% of patients, with a significant increase in detection on next-day imaging compared to same-day imaging.
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| The Role of PSA Doubling Time in the Stratification of Patients with a Negative PSMA PET After Biochemical Recurrence of Prostate Cancer: Implications for Tailored Salvage Treatment Strategies
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| Daniele Robesti, MD
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| Daniele Robesti presents findings on the role of PSA doubling time (PSADT) in stratifying patients with a negative PSMA PET scan after biochemical recurrence (BCR) of prostate cancer following radical prostatectomy. The study aimed to determine whether certain clinical factors, such as PSADT and ISUP grade, could predict early clinical progression (new metastasis within 12 months) despite a negative PSMA PET scan.
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| 18F-rhPSMA-7 and 18F-Flotufolastat PET-Guided Salvage Radiotherapy in Recurrent Prostate Cancer
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| Isabel Rauscher, MD
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| Isabel Rauscher presents a study comparing 18F-rhPSMA-7 and 18F-flotufolastat PET-guided salvage radiotherapy to conventional salvage radiotherapy in prostate cancer patients with biochemical recurrence after radical prostatectomy. The PET-guided approach showed improved, though not statistically significant, biochemical failure-free survival compared to conventional radiotherapy, with the PET-guided group achieving longer disease control at 12, 24, and 36 months.
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| Setting the Stage: Biochemical Recurrence After Local Treatment for Prostate Cancer
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| Derya Tilki, MD
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| Derya Tilki discusses the challenges and management of biochemical recurrence (BCR) after local prostate cancer treatment. She reviewed definitions of BCR, highlighted the natural history and risk factors, and emphasized the importance of PSA doubling time and ISUP grade in predicting outcomes. Dr. Tilki also discussed evidence from clinical trials, including the DIPPER trial and the ARTISTIC meta-analysis, which showed that early salvage radiotherapy is as effective as adjuvant radiotherapy, particularly when delivered at low PSA levels, improving patient outcomes.
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