ASCO 2017

ASCO 2017

ASCO 2017: Does Prostate Cancer Presentation and Biologic Characteristics Differ in Older Patients?

Chicago, IL (UroToday.com) Dr. Alberto Briganti gave an interesting discussion on the presentation and biologic characteristics of prostate cancer (PC) in older patients. The presentation objectives were to assess candidates for early diagnosis and local treatment, assess determinants of pathological and long term outcomes, and evaluate outcomes of men treated with curative intent.

ASCO 2017: How Randomized Trials of STAMPEDE Have Influenced Treatment Decisions in the United Kingdom

Chicago, IL (UroToday.com) Dr. Nicholas James elegantly presented some thoughts and conclusions from the ongoing STAMPEDE trial. This trial examines addition of further treatments to standard of care in prostate cancer (PC). It recruits men from 4 groups starting long term androgen deprivation therapy (ADT):

ASCO 2017: Physical and Cognitive Effects of Systemic Therapy in Older Men with Prostate Cancer

Chicago, IL (UroToday.com) Dr. Alicia Morgans from Vanderbilt University concluded the “Disparities in Screening and Treatment of Prostate Cancer for the Older Patient” session at the 2017 ASCO meeting with an excellent talk regarding the physical and cognitive effects of systemic therapy in older men with prostate cancer.

ASCO 2017: Key Interdisciplinary and Integrated Treatment Planning Necessary to Effectively Treat Older Adults With Prostate Cancer

Chicago, IL (UroToday.com) Dr. William Dale from the City of Hope in Los Angeles provided an important and interesting discussion from a geriatrician’s perspective regarding key aspects of interdisciplinary and integrated treatment planning for effectively treating older patients with prostate cancer at the ASCO 2017 “Disparities in Screening and Treatment of Prostate Cancer for the Older Patient” session.

ASCO 2017: How Advances in Molecular Imaging Have Changed Our Understanding of State and Stage of the Disease

Chicago, IL (UroToday.com) Dr. Juergen Gschwend, from Munich, Germany, provided an excellent summary of the advances in molecular imaging, specifically PSMA PET scan, in prostate cancer (PCa) management. As Germany has been a leader in this technology, his experience with the technology provided an important context for the discussion.

ASCO 2017: Neoadjuvant randomized trial of degarelix (Deg) ± cyclophosphamide/GVAX (Cy/GVAX) in men with high-risk prostate cancer (PCa) undergoing radical prostatectomy (RP)

Chicago, IL (UroToday.com) There has been a paradigm shift over the last several years regarding treating high risk patients up front with multimodal therapy with the hope of long-term survival durability. Along this line of thinking, Dr. Emmanuel Antonarakis and colleagues presented results of their neoadjuvant randomized trial of degarelix with or without cyclophosphamide/GVAX (Cy/GVAX) in men with high-risk prostate cancer undergoing radical prostatectomy at the prostate cancer poster session at the 2017 ASCO annual meeting.

ASCO 2017: Targeting the AR: Biomarkers and Novel Therapeutic Approaches

Chicago, IL (UroToday.com) Dr. Terence Friedlander focused on targeting the androgen receptor (AR), with an emphasis on biomarkers and novel therapeutic approaches. In the setting of metastatic prostate cancer (PCa), androgen deprivation therapy (ADT) remains the standard of care.

ASCO 2017: Have Decisions by the National Institute for Health and Care Excellence Affected Outcomes of British Patients With Metastatic Castration-Resistant Prostate Cancer?

Chicago, IL (UroToday.com) John Graham gave an excellent talk regarding the role of NICE (National Institute for Health and Care Excellence) in the drug therapeutic approval process in the setting of metastatic castration-resistant prostate cancer (mCRPC). His summary of the role of NICE as it relates to the National Health Service (NHS) in England and the UK provides a nice contrast to the drug approval process here in the United States.

ASCO 2017: Intensification of Therapy for Locally Advanced and Oligometastatic Disease (Discussing Abstract 5018, 5019, 5020)

Chicago, IL (UroToday.com) Dr. Ganesh Palapattu provided the discussion for three abstracts presented at the prostate cancer poster session at the 2017 ASCO 2017 meeting. These abstracts included Abstract 5018 (Extended versus limited pelvic lymphadenectomy during radical prostatectomy for intermediate- and high-risk prostate cancer: Early outcomes from a randomized controlled phase III study)¹, Abstract 5019 (Adjuvant androgen deprivation (AD) +/- mitoxantrone + prednisone (MP) in patients with high-risk prostate cancer (PC) post radical prostatectomy (RP): Phase III intergroup trial S9921)², and Abstract 5020 (Stereotactic ablative radiation therapy for the treatment of oligometastatic prostate cancer).³

ASCO 2017: ARASENS phase 3 trial of ODM-201 in men with metastatic hormone-sensitive prostate cancer

Chicago, IL (UroToday.com) Dr. Matthew Smith and colleagues presented the design for their trial, the ARASENS phase III trial assessing ODM-201 (darolutamide) in men with metastatic hormone-sensitive prostate cancer at the prostate cancer poster session at ASCO 2017. Even with first line therapy (ADT +/- docetaxel or abiraterone, based on the LATITUDE and STAMPEDE studies presented this week), most patients with metastatic hormone-sensitive prostate cancer (mHSPC) progress to castration-resistant prostate cancer (CRPC).

ASCO 2017: PROfound: A randomized Phase III trial evaluating olaparib in patients with metastatic castration-resistant prostate cancer and a deleterious homologous recombination DNA repair aberration

Chicago, IL (UroToday.com) The genetic landscape for men with metastatic castration resistant prostate cancer (mCRPC) is rapidly evolving. At the 2017 ASCO prostate cancer poster session, Dr. Johann De Bono and colleagues presented their phase III trial design for PROfound, an evaluation of olaparib in patients with mCRPC and a deleterious homologous recombination DNA repair aberration. There are available agents that may be offered with limited therapeutic benefit for these patients, however no molecularly stratified treatment has been approved for this heterogeneous disease.

ASCO 2017: A phase III trial comparing atezolizumab with enzalutamide vs enzalutamide alone in patients with metastatic castration-resistant prostate cancer

Chicago, IL (UroToday.com) Selecting the appropriate sequence and combination of therapy for metastatic castration-resistant prostate cancer (mCRPC) is challenging. At the ASCO 2017 prostate cancer poster session, Dr. Thomas Powles and colleagues presented their study design for a phase III trial comparing atezolizumab with enzalutamide versus enzalutamide alone in patients with mCRPC (IMbassador250 Trial).

ASCO 2017: Androgen deprivation therapy in the treatment of prostate cancer and dementia risk: A systematic review and meta-analysis

Chicago, IL (UroToday.com) Since the introduction of the concept of castration as a treatment for advanced or metastatic prostate cancer (PCa) by Huggins & Hodges in 1941, castration and subsequently androgen deprivation therapy (ADT) have remained the standard first-line therapy for metastatic PCa.

ASCO 2017: Clinical activity and safety of ASN001, a selective CYP17 lyase inhibitor, administered without prednisone in men with metastatic castration-resistant prostate cancer (mCRPC): A phase 1/2 clinical trial

Chicago, IL (UroToday.com) Abiraterone acetate, a CYP17A inhibitor, is now a well-established treatment option for metastatic castration-resistant prostate cancer (mCRPC), regardless of prior docetaxel chemotherapy treatment, based on the results of the COU-AA-301 and COU-AA-302. studies.^1,2 However, abiraterone administration was approved along with the administration of prednisone 5 mg twice daily, due to the risk of mineralocorticoid excess from suppression of the glucocorticoid synthesis.

ASCO 2017: Prostate cancer in 696 hypogonadal men with and without long-term testosterone therapy: Results from a controlled registry study

Chicago, IL (UroToday.com) The endocrinology relationship between testosterone and prostate cancer (PCa) is well-established, however whether men with hypogonadism have increased prostate cancer incidence or severity is controversial. Dr. Ahmad Haider and colleagues from Germany presented their results of assessing prostate cancer outcomes among men on long-term testosterone therapy (TTh) at the 2017 ASCO annual meeting’s prostate cancer poster session.

ASCO 2017: Phase 1b/2 keynote-365 trial: Pembrolizumab (pembro) combination therapy in metastatic castration-resistant prostate cancer

Chicaco, IL (UroToday.com) Dr. Evan Yu and colleagues presented their trial design for KEYNOTE-365, a phase Ib/II trial assessing pembrolizumab combination therapy for metastatic castration-resistant prostate cancer (mCRPC) at the prostate cancer sessions at the 2017 ASCO annual meeting. We know that approved treatments for mCRPC (eg, enzalutamide and docetaxel) may increase programmed death ligand 1 (PD-L1) expression and facilitate neoantigen release. Furthermore, olaparib, a PARP inhibitor, has shown activity in mCRPC with DNA-repair defects. The objective of this study is to evaluate the safety and efficacy of pembrolizumab with olaparib (cohort A), docetaxel + prednisone (cohort B), or enzalutamide (cohort C) in mCRPC patients.

ASCO 2017: A phase II trial of abiraterone acetate (AA) without prednisone in castration resistant prostate cancer (CRPC)

Chicago, IL (UroToday.com) Abiraterone acetate, a CYP17A inhibitor, is now a well-established treatment option for metastatic castration-resistant prostate cancer (mCRPC), regardless of prior docetaxel chemotherapy treatment, based on the results of the COU-AA-301 and COU-AA-302 studies.^1,2 Enzalutamide, a novel androgen axis inhibitor, was introduced as a treatment for mCRPC around the same time, and has been a competitor in the same disease space.

ASCO 2017: Avelumab in metastatic castration-resistant prostate cancer (mCRPC)

Chicago, IL (UroToday.com) Avelumab, an anti-PD-L1 antibody, is one of the novel immune checkpoint inhibitors generating so much interest in the field of cancer therapy. With growing evidence for its efficacy in multiple solid malignancies, including its recent approval for the treatment of metastatic bladder cancer, there is an effort to assess these agents in the setting of castration-resistant prostate cancer.

ASCO 2017: Assessment of quality of life, cognitive function and depression in a randomized phase II study of abiraterone acetate (ABI) plus prednisone (P) vs enzalutamide (ENZA) for metastatic castrate-resistant prostate cancer (mCRPC)

Chicago, IL (UroToday.com) As enzalutamide (Enza) and abiraterone (Abi) have become mainstays of therapy for patients with metastatic castration-resistant prostate cancer (mCRPC), a difficult clinical question has always been how to sequence these medications. In this randomized phase II clinical study, the goal is to evaluate the clinical efficacy and side effects of sequencing these two medications.

ASCO 2017: Survival impact of initial local therapy selection for men under 60 with high risk prostate cancer

Chicago, IL (UroToday.com) The impact of initial local therapy selection on survival for high-risk prostate cancer (PCa) patients remains uncertain, particularly in younger men who in general have an appropriate life-expectancy at the time of prostate cancer diagnosis. Dr. Adeel Kaiser and colleagues presented their results of a study assessing the impact of initial local therapy selection for men under 60 with high-risk prostate cancer at the prostate cancer poster sessions at the 2017 ASCO annual meeting. To minimize the competing risk of death, the authors chose a younger cohort to assess the impact of initial local therapy on survival.