APCCC 2024 VL

Comparing PSMA Ligands for Prostate Cancer Imaging - Michael Hofman

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Alicia Morgans discusses advances in prostate cancer imaging and theranostics with Michael Hofman. Dr. Hofman emphasizes the growing variety of PSMA ligands for PET-CT imaging and treatment, comparing their subtle differences and implications for clinical practice. He notes that while ligands like Gallium PSMA-11 and DCFPyL are similar and FDA-approved, others like PSMA-1007, although widely used...

Hypofractionation in Prostate Cancer Radiotherapy: Balancing Efficacy and Safety - Neha Vapiwala

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Alicia Morgans speaks with Neha Vapiwala about advancements in radiotherapy for high-risk and locally advanced prostate cancer. Dr. Vapiwala highlights the importance of dose escalation in improving survival and explains the benefits of moderate and ultra-hypofractionation, including the use of stereotactic body radiotherapy (SBRT). She emphasizes that while SBRT can safely deliver higher doses of...

Escalation Strategies for Suboptimal PSA Decline in mHSPC - Mary-Ellen Taplin

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Alicia Morgans speaks with Mary-Ellen Taplin about strategies for managing metastatic hormone-sensitive prostate cancer (mHSPC) patients who do not achieve optimal PSA declines. Dr. Taplin emphasizes that an unfavorable PSA decline is not synonymous with progression and highlights the prognostic value of achieving a PSA nadir below 0.2. She discusses data from various trials, such as SWOG 9346, CH...

Testosterone Recovery After ADT: Timing, Predictive Factors, and Clinical Implications - Pierre Blanchard

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Alicia Morgans interviews Pierre Blanchard about testosterone recovery after prostate cancer treatment. Dr. Blanchard explains that testosterone recovery can take 6 to 24 months with LHRH agonists and 1 to 6 months with antagonists. Factors affecting recovery include patient age, baseline testosterone, ADT duration, and comorbidities. He emphasizes the importance of realistic expectations and ackn...

Radiating the Primary Tumor in Metastatic Hormone-Sensitive Prostate Cancer - Sandy Srinivas

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Alicia Morgans interviews Sandy Srinivas about her presentation on treating the primary tumor in synchronous high-volume metastatic hormone-sensitive prostate cancer. Dr. Srinivas reviews key trials such as HORRAD and STAMPEDE, which indicate that radiating the primary tumor may benefit low-volume patients but not those with high-volume disease. She highlights the PEACE-1 trial, which found no sur...

EMBARK Trial: Enzalutamide Monotherapy and Combination Therapy for High-Risk Biochemical Recurrence - Neal Shore

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Alicia Morgans speaks with Neal Shore about managing biochemical recurrence (BCR) in high-risk patients, particularly following radiotherapy (RT) and radical prostatectomy (RP). Discussing findings from the EMBARK trial, Dr. Shore emphasizes that combining enzalutamide with LHRH, or using enzalutamide alone, significantly improves metastasis-free survival compared to leuprolide monotherapy. He foc...

Personalizing Salvage Radiation and Hormone Therapy for Biochemical Recurrence - Daniel Spratt

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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. He highlights findings from several randomized trials, showing that higher PSA levels...

Prognostic and Predictive Factors in Metastatic Hormone-Sensitive Prostate Cancer - Matthew Smith

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Alicia Morgans speaks with Matthew Smith about prognostic and predictive factors in treating metastatic hormone-sensitive prostate cancer (mHSPC). Dr. Smith explains the importance of clinical, imaging, and molecular factors in patient selection for treatment intensification. He highlights that factors like disease volume, manner of presentation, and specific genomic alterations (e.g., PTEN, P53)...

Optimizing Lutetium-PSMA Dosing in High-Volume Disease and Special Situations - Louise Emmett

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Alicia Morgans speaks with Louise Emmett about the use of radiopharmaceuticals in prostate cancer, particularly for frail patients. Professor Emmett focuses on dosing radioligand therapy in special situations and managing toxicity, particularly marrow and kidney toxicity. She highlights the need for individualized dosing strategies, noting that current protocols might not adequately treat high-vol...

Sequencing Therapies in mCRPC After Progression on Combination Treatment - Ian Davis

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Alicia Morgans interviews Ian Davis to discuss the challenges of sequencing treatments for patients with metastatic hormone-sensitive prostate cancer (mHSPC) that have progressed to metastatic castrate-resistant disease (mCRPC). Dr. Davis emphasizes that there is no ideal sequence of treatments but identifies several less-than-ideal approaches. He highlights the importance of achieving maximum ben...