Podcasts about abiraterone

The AUA Expert Exchange Podcast: Discussions in Managing GU Cancer: Treatment Intensification for Advanced Prostate Cancer CME Available: https://auau.auanet.org/node/39486 At the conclusion of these activities, participants will be able to: 1. Identify the latest developments in hormone therapy for advanced prostate cancer, including the use of novel treatments and combinations. 2. Discuss the concept of doublet and triplet therapy in advanced prostate cancer and its rationale in enhancing treatment efficacy. 3. Consider the challenges and future directions in implementing doublet and triplet therapy in clinical practice, including cost, accessibility, and patient selection. This series is supported by independent educational grants from: Astellas and Pfizer, Inc. AstraZeneca Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC Lantheus Medical Imaging Merck & Co., Inc. REFERENCES: Freedland SJ, et al. Enzalutamide and Quality of Life in Biochemically Recurrent Prostate Cancer. NEJM Evidence. 2023. Smith MR, et al. Darolutamide and Survival in Metastatic, Hormone-Sensitive Prostate Cancer. N Engl J Med 2022. Fizazi K, et al. Abiraterone plus prednisone added to androgen deprivation therapy and docetaxel in de novo metastatic castration-sensitive prostate cancer (PEACE-1): a multicentre, open-label, randomised, phase 3 study with a 2 × 2 factorial design. Lancet. 2022. Clarke NW, et al. Abiraterone and Olaparib for Metastatic Castration-Resistant Prostate Cancer. NEJM Evidence. 2022 Chi KN, et al. Niraparib and Abiraterone Acetate for Metastatic Castration-Resistant Prostate Cancer. J Clin Oncol. 2023. Agarwal N, et al. Talazoparib plus enzalutamide in men with first-line metastatic castration-resistant prostate cancer (TALAPRO-2): a randomised, placebo-controlled, phase 3 trial. Lancet. 2023.

Drs Sandhya Srinivas and Tanya B. Dorff discuss metastatic hormone-sensitive prostate cancer, which patients are the best candidates for doublets vs triplets, and how we pick these patients. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/988737). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Prostate Cancer https://emedicine.medscape.com/article/1967731-overview Metastatic Hormone-Sensitive Prostate Cancer: Toward an Era of Adaptive and Personalized Treatment https://pubmed.ncbi.nlm.nih.gov/37220335/ Triplet or Doublet Therapy in Metastatic Hormone-Sensitive Prostate Cancer: Updated Network Meta-Analysis Stratified by Disease Volume https://pubmed.ncbi.nlm.nih.gov/37055323/ PSMA PET in Imaging Prostate Cancer https://pubmed.ncbi.nlm.nih.gov/35155262/ Risks and Cancer Associations of Metachronous and Synchronous Multiple Primary Cancers: a 25-Year Retrospective Study https://pubmed.ncbi.nlm.nih.gov/34556087/ The Promise of Metastasis-Directed Therapy for Oligometastatic Prostate Cancer: Going Beneath the Surface With Molecular Imaging https://pubmed.ncbi.nlm.nih.gov/35058322/ Gleason Score https://www.ncbi.nlm.nih.gov/books/NBK553178/ Luteinizing Hormone-Releasing Hormone (LHRH) Receptor Agonists Vs Antagonists: a Matter of the Receptors? https://pubmed.ncbi.nlm.nih.gov/23418666/ The Role of CYP17A1 in Prostate Cancer Development: Structure, Function, Mechanism of Action, Genetic Variations and Its Inhibition https://pubmed.ncbi.nlm.nih.gov/29372682/ Chemohormonal Therapy in Metastatic Hormone-Sensitive Prostate Cancer: Long-Term Survival Analysis of the Randomized Phase III E3805 CHAARTED Trial https://pubmed.ncbi.nlm.nih.gov/29384722/ Abiraterone for Prostate Cancer Not Previously Treated With Hormone Therapy https://pubmed.ncbi.nlm.nih.gov/28578639/ Abiraterone Plus Prednisone in Metastatic, Castration-Sensitive Prostate Cancer https://pubmed.ncbi.nlm.nih.gov/28578607/ Health-Related Quality of Life in Metastatic, Hormone-Sensitive Prostate Cancer: ENZAMET (ANZUP 1304), an International, Randomized Phase III Trial Led by ANZUP https://pubmed.ncbi.nlm.nih.gov/34928708/ Darolutamide and Survival in Metastatic, Hormone-Sensitive Prostate Cancer https://pubmed.ncbi.nlm.nih.gov/35179323/ Abiraterone Plus Prednisone Added to Androgen Deprivation Therapy and Docetaxel in De Novo Metastatic Castration-Sensitive Prostate Cancer (PEACE-1): a Multicentre, Open-Label, Randomised, Phase 3 Study With a 2 × 2 Factorial Design https://pubmed.ncbi.nlm.nih.gov/35405085/

Susan Slovin describes her JCO investigator initiated R2 study which show the addition of cabazitaxel to abiraterone may be of benefit in CRPC

Drs Sandhya Srinivas and Heather Cheng discuss PARP inhibitors, clinical trials, and germline vs somatic testing for patients with prostate cancer, as well as the optimal time for this testing. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/988734). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Germline Testing in Prostate Cancer: When and Who to Test https://pubmed.ncbi.nlm.nih.gov/34669358/ Germline and Somatic Mutations in Prostate Cancer for the Clinician https://pubmed.ncbi.nlm.nih.gov/31085765/ Genetic and Genomic Testing for Prostate Cancer: Beyond DNA Repair https://pubmed.ncbi.nlm.nih.gov/37207301/ Genome-Wide Association Study of Prostate Cancer-Specific Survival https://pubmed.ncbi.nlm.nih.gov/26307654/ Inherited DNA-Repair Gene Mutations in Men With Metastatic Prostate Cancer https://pubmed.ncbi.nlm.nih.gov/27433846/ NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Prostate Cancer https://www.nccn.org/professionals/physician_gls/pdf/prostate.pdf PARP Inhibitors in Metastatic Prostate Cancer https://pubmed.ncbi.nlm.nih.gov/37168382/ Rucaparib in Men With Metastatic Castration-Resistant Prostate Cancer Harboring a BRCA1 or BRCA2 Gene Alteration https://pubmed.ncbi.nlm.nih.gov/32795228/ Olaparib for Metastatic Castration-Resistant Prostate Cancer https://pubmed.ncbi.nlm.nih.gov/32343890/ Abiraterone and Olaparib for Metastatic Castration-Resistant Prostate Cancer https://evidence.nejm.org/doi/full/10.1056/EVIDoa2200043 Rucaparib or Physician's Choice in Metastatic Prostate Cancer https://pubmed.ncbi.nlm.nih.gov/36795891/ FDA Approves Olaparib With Abiraterone and Prednisone (or Prednisolone) for BRCA-Mutated Metastatic Castration-Resistant Prostate Cancer https://www.fda.gov/drugs/drug-approvals-and-databases/fda-approves-olaparib-abiraterone-and-prednisone-or-prednisolone-brca-mutated-metastatic-castration Niraparib and Abiraterone Acetate for Metastatic Castration-Resistant Prostate Cancer https://pubmed.ncbi.nlm.nih.gov/36952634/ Talazoparib Plus Enzalutamide in Men With First-line Metastatic Castration-Resistant Prostate Cancer (TALAPRO-2): A Randomised, Placebo-Controlled, Phase 3 Trial https://pubmed.ncbi.nlm.nih.gov/37285865/

A combination product is now available of niraparib + abiraterone for use in mCRPC. Another BCMA-CD3 agent is approved for r/r multiple myeloma and melphalan hepatic arterial infusion for metastatic uveal melanoma is approved.

Drs Sandhya Srinivas and Shilpa Gupta discuss castration-resistant prostate cancer and the sequence, method of therapy, and specific patient populations in which these drugs will be most effective. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/988733). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Prostate Cancer. https://www.nccn.org/professionals/physician_gls/pdf/prostate.pdf Patient-Reported Outcomes Following Enzalutamide or Placebo in Men With Non-Metastatic, Castration-Resistant Prostate Cancer (PROSPER): A Multicentre, Randomised, Double-Blind, Phase 3 Trial https://pubmed.ncbi.nlm.nih.gov/30770294/ Apalutamide and Overall Survival in Prostate Cancer https://pubmed.ncbi.nlm.nih.gov/32907777/ Darolutamide in Nonmetastatic, Castration-Resistant Prostate Cancer https://pubmed.ncbi.nlm.nih.gov/30763142/ Long-term Safety and Tolerability of Darolutamide and Duration of Treatment in Patients With Nonmetastatic Castration-Resistant Prostate Cancer (nmCRPC) From the ARAMIS Rollover Study. https://ascopubs.org/doi/abs/10.1200/JCO.2023.41.6_suppl.147 Chemohormonal Therapy in Metastatic Hormone-Sensitive Prostate Cancer: Long-Term Survival Analysis of the Randomized Phase III E3805 CHAARTED Trial https://pubmed.ncbi.nlm.nih.gov/29384722/ An International Prospective Open-label, Randomized, Phase III Study Comparing 177Lu-PSMA-617 in Combination With SoC, Versus SoC Alone, in Adult Male Patients With mHSPC (PSMAddition) https://clinicaltrials.gov/ct2/show/NCT04720157 Cabazitaxel versus Abiraterone or Enzalutamide in Metastatic Prostate Cancer https://pubmed.ncbi.nlm.nih.gov/31566937/ Lutetium Lu 177 Vipivotide Tetraxetan: First Approval https://pubmed.ncbi.nlm.nih.gov/35553387/

Listen to a soundcast of the May 31, 2023, FDA approval of Lynparza (olaparib), with abiraterone and prednisone, for BRCA-mutated metastatic castration-resistant prostate cancer.”

Dr Armstrong discusses the FDA approval of olaparib plus abiraterone in patients with BRCA-mutated mCRPC, key efficacy and safety data from the PROpel trial, and where the field of prostate cancer research may be headed in the future.

Dr. Katherine Virgo discusses the latest evidence-based guideline recommendation updates regarding initial management of metastatic prostate cancer based on the new clinical trial results comparing triplet therapies (the addition of darolutamide, abiraterone, or enzalutamide to docetaxel plus androgen deprivation therapy) to standard of care. Dr. Virgo also discusses cost of treatment options and ongoing research questions in this field. Read the full guideline, “‘Initial Management of Noncastrate Advanced, Recurrent, or Metastatic Prostate Cancer: ASCO Guideline Update” at www.asco.org/genitourinary-cancer-guidelines. TRANSCRIPT This guideline, clinical tools, and resources are available at www.asco.org/genitourinary-cancer-guidelines. Read the full text of the guideline and review authors' disclosures of potential conflicts of interest disclosures in the Journal of Clinical Oncology, https://ascopubs.org/doi/10.1200/JCO.23.00155.  Brittany Harvey: Hello and welcome to the ASCO Guidelines podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges, and advances in oncology. You can find all the shows, including this one, at asco.org/podcasts.   My name is Brittany Harvey, and today I am interviewing Dr. Katherine Virgo from Emory University, lead author on the ‘Initial Management of Noncastrate Advanced, Recurrent, or Metastatic Prostate Cancer: ASCO Guideline Update'.   Thank you for being here, Dr. Virgo.  Dr. Katherine Virgo: Thank you.  Brittany Harvey: Before we discuss this guideline, I'd just like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO Conflict of Interest Policy is followed for each guideline. The disclosures of potential conflicts of interest for the guideline panel, including Dr. Virgo, are available online with the publication of the guideline update in the Journal of Clinical Oncology, which is linked in the show notes.    So then, getting into the content of this update first, Dr. Virgo, what prompted this update to the initial management of noncastrate advanced, recurrent or metastatic prostate cancer guideline?  Dr. Katherine Virgo: The update is primarily driven by new clinical trial results comparing triplet therapies to standard of care. Triplet therapy here refers to the addition of darolutamide, abiraterone, or enzalutamide to docetaxel plus androgen deprivation therapy for patients with de novo metastatic noncastrate prostate cancer.  Brittany Harvey: Great. And then, based on this, what are the new and updated recommendations from the guideline panel?   Dr. Katherine Virgo: The first updated recommendation adds darolutamide to the list of treatment options as follows: docetaxel, abiraterone, enzalutamide, apalutamide or darolutamide, each when administered with androgen deprivation therapy, represent five separate standards of care for noncastrate metastatic prostate cancer, with the exception of the triplet therapies of docetaxel plus abiraterone plus ADT and docetaxel plus darolutamide plus ADT. The use of any of these agents in any other particular combination or in any particular series cannot yet be recommended.   The second updated recommendation states: for patients with metastatic noncastrate prostate cancer with high volume disease as defined per CHAARTED, who are candidates for treatment with chemotherapy but are unwilling or unable to receive triplet therapy, for example, due to insurance constraints, docetaxel plus ADT should be offered. We add some practical information here. Patients should be made aware that doublet therapy, docetaxel plus ADT, has inferior overall survival compared to triplet therapy, such as abiraterone and prednisone plus docetaxel plus ADT.   Then, I have a few recommendations here with respect to triplet therapy, and these are new. For patients with de novo metastatic noncastrate prostate cancer with high volume disease as defined per CHAARTED who are being offered ADT plus docetaxel chemotherapy, triplet therapy, abiraterone and prednisone plus ADT and docetaxel should be offered per the PEACE-1 trial. Abiraterone and prednisone plus ADT and docetaxel demonstrated significant overall survival and radiographic progression-free survival benefits compared to ADT and docetaxel alone for patients with high volume disease.   Again, we add some practical information. Overall survival data for patients with low volume de novo metastatic noncastrate prostate cancer from the PEACE-1 trial are still too immature to justify recommending abiraterone-based triplet therapy, in other words, abiraterone and prednisone plus ADT and docetaxel, for patients with low volume de novo metastatic noncastrate disease.   A second new recommendation, as opposed to a revised recommendation with respect to triplet therapy, is: for patients with de novo metastatic noncastrate prostate cancer who are being offered ADT plus docetaxel chemotherapy, triplet therapy, darolutamide plus ADT and docetaxel should be offered per the ARASENS trial. Compared to placebo plus ADT and docetaxel, darolutamide plus ADT and docetaxel demonstrated significant overall survival benefits, in addition to significantly longer times to castration-resistant prostate cancer, pain progression, first skeletal event, and initiation of subsequent systemic antineoplastic therapy.   The practical information offered here is that discussion with patients should include the cost of darolutamide treatment compared with other options, such as abiraterone. There was no change to the 2021 recommendation for enzalutamide other than to report long term results from the ENZAMET and ARCHES trials that was not available in 2021. We added similar practical information here with respect to discussing costs of enzalutamide treatment. Discussion with patients should include the cost of enzalutamide treatment compared with other options, such as abiraterone.  Brittany Harvey: Excellent. I appreciate you reviewing those new and updated recommendations from the expert panel along with that practical information.   So then, Dr. Virgo, what should clinicians know as they implement these updated recommendations? And also, in your view, how will these guideline recommendations affect patients with noncastrate metastatic prostate cancer?   Dr. Katherine Virgo: That's a good question. Clearly, cost is a factor for patients, and we felt it was important to emphasize this in the guideline update. In the data supplement to the guideline update, we included a table listing all the agents discussed in the update, as well as the associated pivotal trials, main outcomes, the control group, the cost per cycle of treatment, and the cost for the full treatment course. This should be particularly helpful to clinicians as they discuss treatment options with patients. We also thought it would be helpful to have a visual guide to treatment options that reflects the clinician's decision-making process more directly. So figure one is the result of a group effort to achieve that aim.  Brittany Harvey: Excellent. And there have been a lot of changes in this field that prompted this update, but what are the outstanding questions regarding triplet therapy in the treatment of patients with metastatic noncastrate prostate cancer?   Dr. Katherine Virgo: Well, the burning question is whether docetaxel is really still necessary in the treatment of patients with metastatic noncastrate prostate cancer. No phase III clinical trials have yet compared, for example, androgen deprivation therapy plus darolutamide or androgen deprivation therapy plus abiraterone versus androgen deprivation therapy plus docetaxel. Also improved overall survival for patients undergoing triplet therapy is largely confined at present to those with high volume disease. So for patients with low-volume disease, clinical trials as yet show no significant benefit of triplet therapy.  Brittany Harvey: Great. Well, then I guess we'll look forward to future trials to determine if that's still appropriate and look for future updates of this guideline.   So I want to thank you so much for your time developing and updating this guideline. And thank you for joining me today, Dr. Virgo.  Dr. Katherine Virgo: Thank you. I appreciate it.   Brittany Harvey:  And thank you to all of our listeners for tuning in to the ASCO Guidelines Podcast. To read the full guideline, go to www.asco.org/genitourinary-cancer-guidelines. You can also find many of our guidelines and interactive resources in the newly redesigned ASCO Guidelines app, available for free in the Apple App Store or the Google Play Store. If you have enjoyed what you've heard today, please rate and review the podcast and be sure to subscribe, so you never miss an episode.   The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions.   Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.     

Dan George and Silke Gillessen disagree amicably. 

Novavax vaccine booster update; over-the-counter hearing aids; priority review for a castration-resistant prostate cancer combination treatment; a first gene therapy approved for beta-thalassemia; FDA urges repeat at home COVID-19 testing to reduce risk of missing infection.

In this podcast, Dr. Alicia Morgans discusses recent data presented at the 2022 ASCO GU Cancers Symposium, including trials evaluating the use of first-line PARP inhibitors in combination with abiraterone for mCRPC, continuation of enzalutamide after progression, and imaging modalities as predictive and prognostic biomarkers. This activity is available for CE/CME credit. Claim your credit at pce.is/ascogu.Contributors: Dr Morgans has disclosed that she has received funds for research support from Atellas, AstraZeneca, Bayer, Myovant, and Pfizer, and consulting fees from AAA, Astellas, AstraZeneca, Bayer, Blue Earth, Clovis, Dendreon, Janssen, Lantheus, Merck, Myovant, Novartis, Pfizer, Sanofi, and Telix.Ms Martone has no relevant conflicts of interest to report. 

Fred Saad describes the results of this trial. 

Kim Chi describes the results of this randomised phase 3 study. 

In this second of two podcasts, Rana R. McKay, MD, and Arjun Balar, MD, and moderator Terran W. Sims, MSN, ACNP-C, CNN-BC, COCN, discuss the optimal treatment selection and management of adverse events for patients with metastatic and nonmetastatic castration-resistant or castration-sensitive prostate cancers, including the use of taxanes, androgen receptor agonists, and other therapies.This activity is available for CE/CME credit. Claim your credit at pce.is/GIGU.Contributor:Arjun Balar, MDRana R. McKay, MDTerran W. Sims, MSN, ACNP-C, CNN-BC, COCNDr Balar: consulting fees: Bristol-Myers Squibb, Incyte, Istari Oncology, Janssen, Pfizer; consulting fees/research support: Immunomedics, Seagen; consulting fees/contracted research/fees for non-CME/CE services: AstraZeneca/Medimmune, Genentech; Merck; consulting fees/contracted research: Immunomedics/Gilead, Nektar, Seagen; consulting/ownership interest: EpiVax Oncology, GT Biopharma.Dr McKay: consulting fees: AstraZeneca, Bristol-Myers Squibb, Calithera, Caris, Dendreon, Exelixis, Janssen, Merck, Myovant, Novarits, Sanofi, Sorrento Therapeutics; Vividion Therapeutics; consulting fees/contracted research: Bayer, Pfizer, Tempus.Ms Sims: consulting fees: Coloplast.

In this first of two podcasts, Dr. Rana R. McKay discusses the optimal treatment selection and management of adverse events for patients with metastatic and nonmetastatic castration-sensitive prostate cancer (CRPC), including the use of taxanes, androgen receptor agonists, and other therapies.This activity is available for CE/CME credit. Claim your credit at pce.is/GIGU.Contributors:Arjun Balar, MDRana R. McKay, MDTerran W. Sims, MSN, ACNP-C, CNN-BC, COCNDr Balar: consulting fees: Bristol-Myers Squibb, Incyte, Istari Oncology, Janssen, Pfizer; consulting fees/research support: Immunomedics, Seagen; consulting fees/contracted research/fees for non-CME/CE services: AstraZeneca/Medimmune, Genentech; Merck; consulting fees/contracted research: Immunomedics/Gilead, Nektar, Seagen; consulting/ownership interest: EpiVax Oncology, GT Biopharma.Dr McKay: consulting fees: AstraZeneca, Bristol-Myers Squibb, Calithera, Caris, Dendreon, Exelixis, Janssen, Merck, Myovant, Novarits, Sanofi, Sorrento Therapeutics; Vividion Therapeutics; consulting fees/contracted research: Bayer, Pfizer, Tempus.Ms Sims: consulting fees: Coloplast. 

In this episode, Daniel W. Lin, MD; Alicia K. Morgans, MD, MPH; and David F. Penson, MD, answer audience questions from a live CCO webinar focused on current best practices and emerging strategies in androgen deprivation therapy, with questions including:How to select between GnRH agonists and antagonists for initial androgen deprivation therapy?How should androgen receptor inhibitors be incorporated into treatment paradigms for nonmetastatic castration-resistant prostate cancer and metastatic hormone-sensitive prostate cancer?How should patients with prostate cancer and bone density issues be managed?How should nonmetastatic and metastatic prostate cancer be classified in light of novel imaging modalities, and how does this affect treatment?Presenters:Daniel W. Lin, MDProfessor and Chief of Urologic OncologyDepartment of UrologyUniversity of WashingtonSeattle, WashingtonAlicia K. Morgans, MD, MPHGenitourinary Medical OncologistDana-Farber Cancer InstituteBoston, MassachusettsDavid F. Penson, MDProfessor and ChairDepartment of UrologyVanderbilt University School of MedicineNashville, Tennessee Content based on an online CME program supported by educational grants from Astellas, Bayer HealthCare Pharmaceuticals Inc., Myovant Sciences Ltd, and Pfizer, Inc.  Link to full program:https://bit.ly/3iFCis5    

Gert Attard describes this practice-changing plenary data.

In this episode, Chris Parker, MD, and Bertrand Tombal, MD, PhD, discuss the clinical implications of the latest data on radiopharmaceuticals in the treatment of patients with metastatic castration-resistant prostate cancer (CRPC). Topics include:Data from the PEACE-3 trial on the effect of bone-protective agents on fracture risk with enzalutamide plus radium-223Efficacy and toxicity of PSMA lutetium plus standard of care in the VISION trialOngoing trials evaluating radionuclides in combination with other agents in metastatic CRPCPresenters:Chris Parker, MDProfessor of Prostate OncologyInstitute of Cancer ResearchClinical OncologistDepartment of Uro-oncologyRoyal Marsden HospitalSutton, Surrey, United KingdomBertrand Tombal, MD, PhDProfessor of UrologyInstitut de Recherche Clinique (IRC)Cliniques universitaires Saint-LucChairmanDepartment of SurgeryCliniques universitaires Saint-LucBrussels, BelgiumLink to full program, including downloadable slides: https://bit.ly/36IEnNE

In this episode,  Wassim Abida, MD, PhD; Joaquin Mateo, MD, PhD; and Charles J. Ryan, MD, answer questions from an audience of healthcare professionals on topics related to prostate cancer and PARP inhibition including:  Germline and somatic mutation testingPARP inhibition in earlier stage diseasePARP inhibitors plus AR-targeted therapy after progression on AR-targeted therapyPARP inhibition in taxane-sensitive patientsPresenters:Wassim Abida, MD, PhDAssistant MemberAssistant Attending PhysicianGenitourinary Oncology ServiceDepartment of MedicineMemorial Sloan Kettering Cancer CenterNew York, New YorkJoaquin Mateo, MD, PhDGroup LeaderProstate Cancer Translational ResearchVall d'Hebron Institute of OncologyAttending PhysicianMedical OncologyVall d'Hebron University HospitalBarcelona, SpainCharles J. Ryan, MDProfessor of MedicineB.J. Kennedy Chair in Clinical Medical OncologyDirector, Division of Hematology, Oncology and TransplantationDepartment of MedicineUniversity of MinnesotaOncologistDivision of Hematology, Oncology and TransplantationUniversity of Minnesota Health Clinics and Surgery CenterMinneapolis, MinnesotaLink to full program, including downloadable slidesets, expert commentaries, and on-demand webcast:https://bit.ly/3h1T5oR

In this episode, Karim Fizazi, MD, PhD, and Joaquin Mateo, MD, PhD, consider the potential implications of ongoing and planned clinical trials using PARP inhibitors in combination with other therapies to treat men with prostate cancer including:PARP inhibitors combined with androgen receptorsPhase III trials of PARP inhibitors with androgen receptor–directed therapyPARP inhibitors combined with immunotherapyPARP inhibitors and DNA damaging agentsPresenters:Karim Fizazi, MD, PhDFull ProfessorCancer MedicineInstitut Gustave RousseyVillejuif, FranceJoaquin Mateo, MD, PhDAttending PhysicianMedical OncologyVall d’Hebron University Hospital,Barcelona, SpainContent is part of an online program supported by an educational grant from Pfizer Inc.Link to full program, including associated downloadable Podcast Pearls slidesets, expert analysis, and expert commentary:https://bit.ly/3spLzqa

The treatment landscape for men with advanced prostate cancer keeps on shifting and expanding. As new therapy options continue to emerge, it is important to understand which treatment options are currently available and how they work in fighting the disease. To highlight a few of the new options, we have Dr. Natasha Kyprianou, an award-winning prostate cancer investigator, joining us on the podcast today to help you get up to speed. Stay tuned for more! Dr. Natasha Kyprianou completed her fellowship in molecular oncology at Johns Hopkins University and in molecular biology at the Imperial Cancer Research Fund in London, UK. She is a professor in the Department of Urology in Oncological Sciences at Mount Sinai Medical Center in New York City and a member of the National Cancer Institute-designated Tisch Cancer Institute. She has also been active nationally and internationally in several leadership positions, including being a board member of the International Prostate Health Council, member of the American Urologic Association Education Council, and honorary board member of the EAU Council, and has served as President of the Society for Basic Urologic Research. It is also worth noting that she was also the Chair of the Department of Defence Congressional Directed Program for Prostate Cancer Research, and was the first female to be elected to this position. Her research focuses on the molecular mechanisms underlying prostate cancer progression to metastasis and apoptosis-driven molecular therapeutics that are targeting urologic tumors. During her career, she has received numerous awards, including being the first female to be awarded by the American Urologic Association for her contribution to urology research. Be sure to listen in to find out what Dr. Kyprianou has to say about the new treatment options that are currently available for advanced prostate cancer. Disclaimer: The Prostate Health Podcast is for informational purposes only. Nothing in this podcast should be construed as medical advice. By listening to the podcast, no physician-patient relationship has been formed. For more information and counseling, you must contact your personal physician or urologist with questions about your unique situation. Show highlights: Dr. Kyprianou explains what motivated her to follow the path she has taken to get to where she is today. More than thirty-thousand men will die of prostate cancer in 2021. The survival rates for prostate cancer drop dramatically once cancer has metastasized to distant sites. Dr. Kyprianou explains what it means for a man to undergo Androgen Deprivation Therapy (ADT). Dr. Kyprianou discusses the novel agents developed in recent years for the treatment of advanced prostate cancer. Dr. Kyprianou talks about the role of the androgen receptor in driving advanced prostate cancer. Dr. Kyprianou explains how the new novel medication, Enzalutamide, also known as Xtandi, works in helping men with advanced prostate cancer. Dr. Kyprianou explains from a research perspective how a treatment like Enzalutamide gets discovered and then ultimately brought to the point where it becomes available to the consumer. Dr. Kyprianou talks about some of the more commonly reported side-effects of Enzalutamide. How the novel agent, Abiraterone, or Azteca, works in helping men with advanced prostate cancer. Dr. Kyprianou explains why men need to keep getting their ADT injections with the new therapy once their prostate cancer has become resistant to the standard hormonal therapy. Dr. Kyprianou discusses what the next ten years hold for the advancement of treatment options for men with advanced prostate cancer. Links and resources: Follow Dr. Pohlman on Twitter and Instagram - @gpohlmanmd  Get your free What To Expect Guide (or find the link here, on our podcast website)   Join our Facebook group  Follow Dr. Pohlman on Twitter and Instagram  Go to the Prostate Health Academy to sign up for the wait-list for our bonus video content.  You can access Dr. Pohlman's free mini webinar, where he discusses his top three tips to promote men's prostate health, longevity, and quality of life here.

One of the most common question men with prostate cancer ask us at Cancer ABCs is if they can stop their hormone therapy (ADT) when they go on a second generation hormone treatment like abiraterone (Zytiga).A recent analysis of the SPARE Trial points us in the direction that it might be possible to halt ADT when you are taking Zytiga. SPARE was a small trial which needs to be replicated by a larger trial before we can gain confidence in this conclusion. SPARE did not evaluate what, if any change. stopping ADT when you are on Zytiga might have on survival, economic costs and the quality of life. Support the show (https://www.cancerabcs.org/new-page-2/)

The Oncology Journal Club - Delivering Oncology News DifferentlyThe Oncology Podcast, brought to you by www.oncologynews.com.au, is proud to present the next episode of The Oncology Journal Club.This week's episode is hosted by Professor Eva Segelov from Monash University. Eva is joined by Dr Craig Underhill from Albury-Wodonga and Professor Hans Prenen from Belgium.This week Professor Eva Segelov  gets us started with a presentation on assessing the value of abiraterone and enzalutamide in advanced prostate cancer.Hans interviews Professor Fotios Loupakis exploring "what's important in BRAF mutated colon cancer" and has the Quick Bites this week.And Craig presents a couple of fascinating papers on breast cancer - the first on the monarcHER phase 2 trial on hormone receptor-positive, HER2-positive advanced breast cancer. The second is on the FAST-Forward trial on hypofractionated breast radiotherapy.We hope you enjoy another entertaining episode of The Oncology Journal Club. As ever, the links to all the papers discussed today are available below.As ever, the links to all the papers discussed today are available in the notes on our website.About The Oncology Journal ClubWe have taken an old concept and updated it with a new format. In each episode a team of expert contributors will review topical journal papers and studies presented at key meetings to help keep you informed of the latest developments on the go.For the latest oncology news visit www.oncologynews.com.au and for regular oncology updates for healthcare professionals, please subscribe to The Oncology Newsletter.The Oncology Podcast - An Australian Oncology Perspective

This week, we discuss two studies in genitourinary cancers presented at the ESMO Congress 2019. The CARD trial investigated treatment with cabazitaxel vs an androgen signaling–targeted inhibitor among patients with metastatic castration-resistant prostate cancer who had disease progression on docetaxel and the alternative androgen signaling–targeted inhibitor. The IMvigor130 trial focused on the efficacy and safety of atezolizumab as monotherapy or combined with platinum-based chemotherapy vs placebo plus platinum-based chemotherapy in previously untreated locally advanced or metastatic urothelial carcinoma.Coverage of stories discussed this week on ascopost.com:ESMO 2019: Cabazitaxel vs Abiraterone or Enzalutamide in Previously Treated Metastatic Castration-Resistant Prostate CancerESMO 2019: IMvigor130: Addition of Atezolizumab to Platinum-Based Chemotherapy in Advanced Urothelial Carcinoma

Welcome to the ASCO Daily News Podcast. I'm Dr. Richard Schilsky, senior vice president and chief medical officer of ASCO. I am pleased to be joined by Dr. Christopher Sweeney, a medical oncologist and professor of medicine at Harvard Medical School and Dana Farber Cancer Institute. He presented abstract LBA2 entitled overall survival results of a phase three randomized trial of standard of care therapy with or without enzalutamide for metastatic hormone sensitive prostate cancer, the ENZAMET trial, an ANZUP led international cooperative group trial. Dr. Sweeney, welcome to the podcast. Thank you for having me. So testosterone suppression and androgen receptor blockade, of course, have been the cornerstone of treatment for men with advanced prostate cancer for many, many years. This large trial of men with metastatic hormone sensitive prostate cancer demonstrated an overall survival advantage by substituting enzalutamide for older androgen receptor blockers. Tell us more about how the patients did on this treatment. Well, the first big line item to report is that men who got the drug enzalutamide, which, as you point out, is the more potent version of the way to block the androgen receptor than our old drugs, lived longer. In terms of relative risk, men had a 33% chance of being alive longer than men who got the older drugs. In terms of absolute numbers, 80% of men who got the early drug were alive at three years versus 72%. What's buried in all those numbers, though, is that there are different patient populations. Patients who have a higher burden disease, have a faster progression, and, unfortunately, a shorter survival than men who have a lower burden of disease. With our previous iteration of this type of a trial in men starting hormones, we showed that docetaxel benefited patients who had high volume disease very clearly. And we could also see enzalutamide works just as well with docetaxel in that patient group. On the other hand, men who had a low burden of disease, we didn't really see a benefit with chemotherapy docetaxel. But we did see a big benefit here in this study with using the hormone enzalutamide. So that now comes to the question, well, what about men who are treated with docetaxel? Did enzalutamide help them? And we actually had a group of patients in this study who we can pull out and analyze separately. And we can see that the enzalutamide delayed the time to progression when it was added to the docetaxel. But at this early analysis, we don't see any meaningful impact in survival. And that could well be because men who get the hormones and the docetaxel and then have the drugs, like enzalutamide, do just as well as getting all three drugs upfront, testosterone suppression, docetaxel, and the enzalutamide, do just as well as getting docetaxel, testosterone suppression, followed by enzalutamide. So it's a little bit of a parsing out of who the patients were and what treatments they get to work out how they actually fared. Tell us a little bit more about enzalutamide. This is a drug that's already FDA approved. It's already in use for later lines of therapy. How does it differ from the earlier group of androgen receptor blockers? Do you attribute all of the benefits seen in the enzalutamide group to the drug itself, or were there differences in patient populations perhaps from groups studied with the earlier generation of androgen receptor blockers? It seems like a pretty substantial improvement just by swapping out a newer version of an old drug. Yes, that's a very interesting observation. So the first notion is that the drug was tailored and designed by chemistry to be a much more potent version of the old drugs. So they're able to see the crystal structure of the androgen receptor and then do chemistry to say, how can we block that and shut that receptor down more efficiently? What is unique about the trial design, because we ran this as an academic study, is that we incorporated in a control arm, every patient had to have one of the older less potent drugs as a control to really show that the more potent drug did actually have all the benefits and conferred the benefits over the older drug. So it wasn't versus a non-active placebo. So it's very clear as a direct more potent versus less potent drug, we had a survival benefit. The other thing to note is that we had clues that this may work is because patients who have testosterone suppression and when their cancer progressed, they had an up regulation of the androgen receptor. So the cells say, help me, help me. I need more testosterone or testosterone like hormones to live. And it up regulates that receptor to survive. And it becomes a target that we can use. Whereas the older drugs would be able to bind to it. But sometimes, they actually became agonists. They turned the receptor on rather than turning it off. Where this drug has complete antagonistic turning the receptor off properties. So it's really quite a clear more potent drug versus less potent drug leading to the survival benefit across both patients with a poor risk, higher volume disease and a lower risk, lower volume disease. It's really interesting how understanding the structure of the androgen receptor and the chemistry of the drug really seems to have led to a very substantial improvement in patient outcomes. So this is a drug, as I mentioned earlier, that's already FDA approved, although in another line of therapy, but could potentially be substituted into routine clinical care immediately. Do you think the study results justify making that switch? It's a very important question. So another way to phrase what you just said there, Rich, is we're seeing advances in advanced stage disease. And my mantra is let's go forward by moving backwards into the earliest stage disease where the patients are starting the hormone not when they're progressing on the testosterone suppression. So when they're starting the hormones, we actually see a survival benefit when we give it upfront. That is a new indication. And so it will be up to the developer of the drug, which is both co-developed by a company called Pfizer and [INAUDIBLE], to present that to the FDA and see if it will get a label extension from the castration setting, resistance setting to the hormone sensitive setting. So that's a work in progress. Now the important item is to recognize that to be able to access the drug, there's going to have to think through the side effect profile. And there are some side effects with regard to it can cause a little bit more fatigue, a little bit more impairing concentration because of the way it works. And some patients can feel a little bit more frail. So some patients have these side effects, and there have to be dose modifications. So the risk and benefit profile has to be adjudicated. But by patients living longer and having their cancer controlled for longer, most patients do get a benefit. But the flip side is we also have to work out other alternatives. Docetaxel is an alternative for patients with high volume disease. Abiraterone is another drug that's approved in this setting, which is another different type of a hormone. And when we write for these drugs, we have to adjudicate how much the patient is going to have to pay. Some patients, they have a copay of $5. Other patients, a copay of about $2,500, because these drugs are very expensive. And if patients have no insurance, the cost is close to $9,000. So I think it is a very good option that will emerge. I suspect it will get approved. But when patients are counseled by their physicians on the options, they have to review the side effects, the benefits, as well as the financial access issues. Yeah, very important points to bring up. So it always comes down to risks, benefits, and costs, and how that translates into access. So just to wrap up, obviously, prostate cancer is a very common disease. As our population continues to age, I think we can foresee that it may become even more common in the population. What's on the horizon for prostate cancer research and treatment? This is a disease where there's been a considerable amount of progress has been made in recent years. But perhaps, there's going to be a growing medical need as the population continues to age. So where do you see the future in prostate cancer research? So the first thrust of work that I'm actively involved in and have engaged with collaborations around the globe to do more trials is to go even further back into the disease setting and augment the adjuvant therapy around the time of prostate radiation or prostate surgery to decrease the risk of relapse. So we have less patients who actually develop metastatic disease and die of the disease. So a lot of us are now getting very proactive in that setting. The other setting is profiling the tumors to work out which patients would be better treated with our current chemotherapy, be it the hormones, be it the combination, as well as develop new drugs that target new targets that are identified. So early identification and more aggressive proactive treatment to prevent relapses. And if patients do relapse, interrogate the tumors more to get more informative data on how best to treat the patient with which new drugs that emerge. So just along those lines actually, your comment prompted a thought. One of the other abstracts presented in the plenary session was about a PARP inhibitor for maintenance therapy in patients with pancreatic cancer, certainly a difficult disease to treat. There's been some preliminary evidence that PARP inhibitors may have activity in prostate cancer as well. Do you think that's going to be an emerging molecular target in prostate cancer? I definitely think it will be. And to some degree, it already is a player. What we need to do is being conducted are the proper rigorous trials to work out, which is the genomic profile that of the DNA damage repaired defects in the genes like the BRCA2 gene you're referring to, that actually do portend a potential response. So we see that the DNA damage genes, response genes that may portend a response to a PARP inhibitor are about 20%. But maybe half of those are truly the genes that really are the responders, that define the responders. And the question now is, of those particular genes that are refined, how many of those actually respond and how long? So we're seeing, I would say, responses of about 50% in that subgroup. So it is very much the notion of precision medicine, because it's the precise group of patients, which inherently is a small subset, but a subset that we can identify and potentially give a meaningful treatment with a reasonable side effect profile. So that data should emerge over the next 12 to 24 months, I think, based on the status of the trials. Great. Thanks so much for giving us that little glimpse into the future. So again, today, my guest has been Dr. Christopher Sweeney from Harvard Medical School and Dana Farber Cancer Institute. Chris, thanks so much for being on the podcast today.   It was my honor. And to our listeners, thank you for tuning into the ASCO Daily News Podcast. If you're enjoying the content, we encourage you to rate us and review us on Apple Podcasts

Welcome to Prostate Cancer & You, a series of podcasts sponsored by the Massachusetts Prostate Cancer Coalition. Today’s podcast features an interview with Glenn Bubley, MD, director of the Division of Genitourinary Medical Oncology at the Beth Israel Medical Center  and associate professor of medicine at Harvard Medical School. He is the 2009 recipient of the Jack Colbert Memorial Award. On this podcast he discusses the good news about new treatments for metastatic and non-metastatic prostate cancer. Important clinical trials have been performed that have shown that earlier treatment of metastatic disease with combinations of existing agents have provided a major improvement in overall and cancer specific survival. This includes combinations of hormonal agents like Lupron with Abiraterone or Lupron with the chemotherapeutic agent Docetaxel. At the May 10 Prostate Cancer Symposium his session is “Newer Therapeutic Strategies for Advanced Prostate Cancer.” Go here for more information and to register.

Dr. Daniel Goldstein considers new data by Clarke & colleagues on a combination of the PARP inhibitor olaparib with abiraterone for molecularly unselected metastatic prostate cancer, along with providing a context of results from similar prior research.

Chris Sweeney discusses which is best? Abiraterone vs docetaxal with ADT for hormone naïve metastatic prostate cancer

Dr Joaquin Mateo speaks to ecancertv at ASCO GU 2015 following results from the Phase II trial using abiraterone and cabazitaxel combination in metastatic castration-resistant prostate cancer where it's found to be well tolerated and demonstrated antitumor activity in the post-docetaxel, post-abiraterone setting.

Dr Banerjee speaks with ecancertv at ESMO 2016 about the primary results from the CORAL trial. She outlines the background of anti-androgen therapy which has led to abiraterone, a CIP17 upstream inhibitor of androgen and oestrogen, and considers other avenues of research that may help patients with advanced ovarian cancer. Dr Banerjee explains that, while 26% of patients in the trial had a clinical benefit and 14% a prolonged benefit, only 1 patient of the cohort of 42 was fully responsive, leading to cessation of the study. With these results in mind, she believes that further understanding of highly responsive patient subtypes will help in advancing ovarian cancer care for all patients.

Dr Alibhai speaks with ecancertv at SIOG 2016 about the experience of men receiving abiraterone or docetaxel for the treatment of metastatic castrate resistant prostate cancer. He discusses how the efficacy was similar to prior published studies, and how toxicities were slightly greater.

Prof Fizazi presents data to the press at ASCO 2017 from the LATITUDE trial of abiraterone added to prednisone and hormonal therapy to treat metastatic prostate cancer. The results of this phase III trial show a significant delay in disease progression, from 14.8 months to 33 months, and a 38% reduced risk of death compared to control.

Prof James presents, at a press session at ASCO 2017, results from the STAMPEDE trial of abiraterone added to standard care in treating advanced prostate cancer. By completely stopping testosterone production, which can persist in the body even after androgen deprivation therapy, he describes a boost to survival at 3 years, and an overall 37% reduction of death compared to standard therapy alone.

At ESMO 2014 in Madrid, Spain, Prof McVie (ecancer) interviews Prof Ryan (University of California, San Francisco, USA) on the emerging frontiers of metastatic castration-resistant prostate cancer. Prof Ryan describes the final results of the COU-302 study, his phase III clinical trial on the effectiveness of abiraterone acetate plus prednisone on overall survival in metastatic castration-resistant prostate cancer. "This demonstrates the therapy definitively improves survival, but it also demonstrates the power of completing a trial," Prof Ryan says.

At an expert to expert discussion at the ASCO GU congress 2014, Dr Chris Parker from The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom is joined by Dr Kurt Miller from the Benjamin Franklin Medical Center, Berlin, Germany to examine the use of enzalutamide and abiraterone acetate in men with mCRPC and asks what the future may look like for prostate cancer patients. The discussion includes: - Clinical strategies to overcome androgen resistance - What treatment options are available for patients with CRPC - Determining the correct sequence for the use of newly available drugs for the management of CRPC and issues with cross resistance - Identification of patient sub-groups that can optimally benefit from new treatment approaches using predictive markers - Future predictions on treatment based on the results of the PREVAIL trial - Where Ra-223 fits into the treatment landscape This programme has been supported by an unrestricted educational grant from Janssen Pharmaceutica (A Johnson & Johnson Company).

Dr Karim Fizazi of Institut Gustave Roussy in Paris, France at the ASCO GU congress 2014 explores the results of phase III trials looking at whether or not Gleason scores predict efficacy of abiraterone acetate therapy in patients with mCRPC. The discussion includes the potential future of treatment options in CRPC, clinical strategies overcoming androgen resistance, treatment options available to patients with CRPC, correct sequencing for the use of newly available drug for CRPC management and identification of patient sub-groups that may optimally benefit from novel treatment approaches. This programme has been supported by an unrestricted educational grant from Janssen Pharmaceutica (A Johnson & Johnson Company).