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- Rashid Sayyid and Zachary Klaassen discuss the resurgence of radium-223 in treating metastatic castration-resistant prostate cancer (mCRPC), focusing on the PEACE-3 trial results. The conversation begins with an overview of radium-223's mechanism as a targeted alpha emitter and its historical efficacy in the ALSYMPCA trial, before exploring its underutilization despite FDA approval. The discussion...
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- Phillip Koo and Zachary Klaassen discuss the UpFrontPSMA study, a Phase 2 trial published in Lancet Oncology. The study evaluates lutetium-177 PSMA-617 followed by docetaxel versus docetaxel alone in patients with de novo high-volume metastatic hormone-sensitive prostate cancer. They highlight the trial design, which uses PSMA and FDG PET for patient selection, and discuss key results. The primary...
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- Rashid Sayyid and Zach Klaassen discuss the ARANOTE trial, a phase III study evaluating darolutamide plus ADT in metastatic hormone-sensitive prostate cancer. They highlight the trial's design, which randomized 669 patients to darolutamide plus ADT or placebo plus ADT. The study meets its primary endpoint, showing significant improvement in radiographic progression-free survival for the darolutami...
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- Rashid Sayyid and Zach Klaassen discuss a meta-analysis published in JAMA Oncology examining cardiovascular events associated with androgen receptor signaling inhibitors (ARSIs) in advanced prostate cancer. The study analyzes 24 randomized controlled trials across various prostate cancer stages, involving 22,166 patients. Results show a significant increase in both all-grade and grade 3+ cardiovas...
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- Rashid Sayyid and Zach Klaassen review the 2024 NCCN prostate cancer guideline updates focusing on treatment-related bone loss in patients on androgen deprivation therapy (ADT). They emphasize the importance of addressing bone health due to increased fracture risk associated with ADT. The speakers outline a comprehensive approach to bone health management, including risk assessment using the FRAX...
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- Rashid Sayyid and Zach Klaassen review the NCCN prostate cancer guideline updates regarding the prevention of symptomatic skeletal-related events in bone metastatic CRPC patients. They discuss the efficacy and safety profiles of denosumab and zoledronic acid, highlighting key clinical trials that have shaped current recommendations. The speakers emphasize the importance of considering dosing frequ...
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- Rashid Sayyid and Zach Klaassen discuss the PI-CAI Challenge, an international study comparing artificial intelligence (AI) to radiologists in prostate cancer detection using MRI. The study develops and validates an AI system using a large dataset of prostate MRIs, comparing its performance to both study radiologists and real-world radiology readings. The AI system demonstrates superiority to stud...
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- Rashid Sayyid and Zach Klaassen discuss the 2024 updates to the NCCN Prostate Cancer Guidelines. They focus on non-hormonal systemic therapy, highlighting significant changes, particularly the emergence of PARP inhibitors like olaparib and rucaparib. The discussion covers their monotherapy and combination therapies, emphasizing the stronger endorsement for PARP inhibitors in patients with BRCA mut...
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- Rashid Sayyid and Zach Klaassen explore the findings of the ProScreen trial, a rigorous examination into sequential prostate cancer screening using PSA, a kallikrein panel, and MRI. Highlighting the study's aim to refine screening methods by enhancing detection rates of high-grade cancers while reducing unnecessary diagnoses of low-grade conditions, they delve into the process and preliminary resu...
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- Rashid Sayyid and Zach Klaassen dissect the EV-302 trial, presenting enfortumab vedotin and pembrolizumab as a first-line treatment for advanced urothelial cancer. This trial, marked by its publication in The New England Journal of Medicine, challenges the four-decade reign of platinum-based chemotherapy, revealing its limitations, particularly a median overall survival of merely 15-16 months. Dr....
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