Non-Metastatic Castration-Resistant Prostate Cancer (nmCRPC)

Prostate cancer is the most frequently diagnosed form of cancer in the United States. Additionally, it is the second leading cause of death in men. There were approximately 240,000 diagnoses and 28,000 deaths in the United States in 2012. Non-metastatic castration-resistant prostate cancer (nmCRPC) is a heterogenous disease state. Above all, the aim of treatment is to delay metastasis as the metastasized form has no known cure and a survival rate of less than two years. However, multiple new treatments and studies outline new options, importantly giving more men better prognoses and quality of life. Many of these studies exist because of our associated doctors and they discuss their findings in more detail below.

Multimodal Approach to Advanced Prostate Cancer

Martin E. Gleave, MD, FRCSC, FACS, discusses his views on improving advanced prostate cancer treatment approaches. Specifically, he emphasizes methods that integrate various treatment options beyond surgical castration and androgen deprivation therapy (ADT).

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M0 Space and The SPARTAN Trial

Eric J. Small, MD, defines nonmetastatic castration-resistant prostate cancer, or M0 disease. He then discusses the design, implementation, and results of the SPARTAN trial, which he also presented at the 2018 Genitourinary Cancers Symposium. The study tested the efficacy of apalutamide in men with M0 disease.

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Integrating the AUA Guidelines into Your Practice

Michael S. Cookson, MD, MMHC, describes how urologists can use American Urological Association (AUA) guidelines to better manage metastatic castration resistant prostate cancer (mCRPC) patients. He stresses the importance of urologists serving as the primary caregiver, the multidisciplinary care model, and organized sequencing of treatments and therapeutics.

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AR-V7 in Castration Resistant Prostate Cancer

Dr. Emmanuel Antonarakis provides an update on treating chemo-naive metastatic hormone sensitive prostate cancer and then discusses the impact of AR-V7 in Castration Resistant Prostate Cancer.

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An Update on the PROSPER Trial: Focusing on Nonmetastatic CRPC

Dr. Maha H.A. Hussain, MBChB, provides an overview of the PROSPER trial, which tested the efficacy and safety of enzalutamide in the setting of nonmetastatic CRPC. She details the trial’s design, materials, and data.

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The Role of Genetic Testing for Inherited Prostate Cancer Risk

Dr. Veda N. Giri, MD, commenced the Philadelphia Prostate Cancer Consensus 2017 by explaining the purpose and need for creating updated, centralized guidelines regarding genetic testing for inherited prostate cancer. Dr. Giri urged the conference members to focus on addressing the criteria for referring a patient, how genetic counseling is relevant to men at risk for prostate cancer, which genes to test, and how this informs the management of patients.

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The Role of Genetic Testing for Inherited Prostate Cancer Risk

Dr. Veda N. Giri, MD, commenced the Philadelphia Prostate Cancer Consensus 2017 by explaining the purpose and need for creating updated, centralized guidelines regarding genetic testing for inherited prostate cancer. Dr. Giri urged the conference members to focus on addressing the criteria for referring a patient, how genetic counseling is relevant to men at risk for prostate cancer, which genes to test, and how this informs the management of patients.

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Timing and Optimization of Radium 223 in CRPC

Dr. Phillip J. Koo, MD, discusses the appropriate timing of radium 223 treatments in castration resistant prostate cancer patients, the best approaches to therapeutic layering, and the importance of recognizing bone metastasis when making these therapeutic decisions.

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The IDMC’s Recommendation to Unblind a Phase III Trial of Radium-223 in Combination with Abiraterone Acetate for Prostate Cancer

Breaking News about the ERA 223 Trial, a phase III trial of radium-223 in combination with abiraterone acetate and prednisone/prednisolone for patients with metastatic castration-resistant prostate cancer unblinded: In early December 2017, the ERA 223 trial released safety concerns of the combination arm of abiraterone acetate and radium-223 of prostate cancer patients. The information released suggests that patients receiving radium-223 with abiraterone acetate had more incidences of bone fractures and deaths.

Debate: Comparative Effectiveness of Surgery versus Radiation

Dr. Laurence Klotz and Dr. Mack Roach, III presented a debate on “Comparative Effectiveness of Surgery and Radiation: Surgery Is Better” versus “Radiotherapy Yields Better Oncologic Outcomes than Radical Prostatectomy for Clinically Localized Prostate Cancer” at the 6th Symposium on the Treatment of Prostate Cancer (STOP-6), which was held in Lisbon, Portugal between October 14th and 16th 2016.