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PEER-TO-PEER CLINICAL CONVERSATIONS |
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Novel Epigenomic Liquid Biopsy Detects PSMA Expression in Prostate Cancer
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Jacob Berchuck, MD
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| Oliver Sartor hosts Jake Berchuck to discuss a novel epigenomic liquid biopsy platform for determining PSMA expression in prostate cancer. Dr. Berchuck explains how the assay analyzes cell-free DNA to infer tumor PSMA expression, showing strong correlation with PSMA PET scan results.
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PEACE-3 Trial Results Show Promise for Radium-223 and Enzalutamide in Asymptomatic mCRPC
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Fred Saad, MD, FRCS
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| In this conversation, Fred Saad discusses the PEACE-3 trial results. The study compares enzalutamide plus radium-223 versus enzalutamide alone in metastatic castration-resistant prostate cancer patients with bone metastases. Dr. Saad discusses the trial's design, highlighting significant improvements in radiographic progression-free survival and overall survival with the combination therapy.
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hK2-Targeted Radioligand Shows Promise in Treating Advanced Prostate Cancer: Phase I Findings
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Michael Morris, MD
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| Michael Morris shares insights into his presentation on a novel hK2-targeting antibody radioconjugate, JNJ-6420, which uses an actinium radioisotope. Dr. Morris explains that hK2, akin to PSA, binds to prostate cancer cell membranes, making it an ideal target for this radioligand therapy.
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| Patient Selection for Radioligand Therapy: Case Study Discussion |
Amir Iravani, MD, and Evan Yu, MD
Phillip Koo hosts a discussion on patient selection for radioligand therapy (RLT) in prostate cancer, featuring Amir Iravani and Evan Yu. The conversation delves into complex clinical decisions involving advanced prostate cancer management. |
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SEARCHABLE DATA BASE OF CURRENTLY ENROLLING CLINICAL TRIALS |
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Radium-223, Prolonging Survival in Combination with Enzalutamide at an Earlier Disease State
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Evan Yu, MD
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| The PEACE-3 trial presented at ESMO 2024 shows that combining radium-223 with enzalutamide significantly improves survival for patients with asymptomatic or mildly symptomatic bone metastatic castration-resistant prostate cancer, with median radiographic progression-free survival increasing to 19.4 months. This combination also demonstrated an overall survival benefit, but highlights the need for bone protective agents to prevent fractures.
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| Efficacy of SPLASH and UpFrontPSMA Trials |
| Irene Burger, Prof Dr. Med |
| Professor Irene Burger discusses findings from the SPLASH and UpFrontPSMA trials, highlighting that both demonstrated significant radiographic progression-free survival benefits for Lu-PSMA treatments in prostate cancer. SPLASH and PSMAfore trials in mCRPC patients showed Lu-PSMA benefits with notable quality of life improvements, though no overall survival benefit was observed, and a high treatment crossover rate affected results. In mHSPC, the UpFrontPSMA trial indicated that adding 177Lu-PSMA-617 to ADT and docetaxel provides progression-free survival benefits comparable to abiraterone-based regimens, potentially offering a safer alternative for patients with specific comorbidities. |
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| Hematologic Impact of [177Lu]Lu-PSMA-617 Versus ARPI Change in Patients with Metastatic Castration-Resistant Prostate Cancer in PSMAfore |
| Kim N. Chi, MD |
| Kim Chi presented findings from the PSMAfore trial on hematologic adverse effects of 177Lu-PSMA-617 versus ARPI change in patients with metastatic castration-resistant prostate cancer (mCRPC). Hematologic treatment-emergent adverse events (TEAEs) were more common in the 177Lu-PSMA-617 group than in the ARPI group (37.9% vs. 23.3%), with anemia, thrombocytopenia, and neutropenia being the most frequent. |
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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
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| Vishnu Murthy
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| Vishnu Murthy presented findings on 177Lu-PSMA-617’s efficacy and toxicity for mCRPC patients in a real-world expanded access program, comparing them with VISION phase 3 trial data. While overall survival and PSA response rates were similar to VISION, patients in the real-world program had a more advanced disease stage and worse ECOG performance. Adverse events, particularly lymphopenia, neutropenia, thrombocytopenia, and leukopenia, were significantly more common in this cohort, though severe toxicity-related treatment discontinuation rates remained low and comparable to VISION.
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| Radium-223 and Enzalutamide in Asymptomatic or Mildly Symptomatic Patients with Bone Metastatic Castration-Resistant Prostate Cancer: First Results of EORTC-GUCG 1333/PEACE-3 |
| Silke Gillessen Sommer, MD |
| Silke Gillessen Sommer presents the first results of the PEACE-3 trial, a phase III study examining the combination of radium-223 (223Ra) and enzalutamide in asymptomatic or mildly symptomatic mCRPC patients with bone metastases. The study found that adding 223Ra to enzalutamide significantly improved rPFS with a median of 19.4 months versus 16.4 months for enzalutamide alone. At 24 months, 45% of patients on the combination therapy were progression-free, compared to 36% on enzalutamide monotherapy. |
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