Steven E. Finkelstein, MD, FACRO, presented “Update on New Approaches Combining Brachytherapy with Immunotherapy” during the 31st International Prostate Cancer Update in July 2021 in Snowbird, Utah.
How to cite: Finkelstein, Steven E. “Update on New Approaches Combining Brachytherapy with Immunotherapy.” July 2021. Accessed Dec 2024. https://dev.grandroundsinurology.com/update-on-new-approaches-combining-brachytherapy-with-immunotherapy/
Update on New Approaches Combining Brachytherapy with Immunotherapy – Summary
Steven E. Finkelstein, MD, FACRO, a radiation oncologist with Florida Cancer Affiliates in Panama City, Florida, discusses the process of combining brachytherapy with immunotherapy, highlighting the need for better applicators. He begins the presentation by describing radical prostatectomy, external beam radiation (EBRT), cryotherapy, and brachytherapy, and then reviews data on each of their relapse-free survival results. A trial found that when comparing EBRT with surgery against EBRT with brachytherapy, treatment with EBRT in combination with brachytherapy has a higher rate of PSA progression-free survival, and including ADT increases the rate even more. Dr. Finkelstein then considers the “cogwheels of cancer practice,” i.e., the idea that the combination of guidelines, management, bias, patient preference, marketing, reimbursement, payer, and task force systems sometimes takes more precedence in treatment choice than data. He goes on to describe brachytherapy in detail, noting that it uses precisely-delivered radiation sources to treat cancer within patients through small applicators that are unable to apply additional therapeutic agents. He cites this shortcoming as support for a need for applicators for additional therapeutic approaches. Dr. Finkelstein continues with a detailed overview of radiation-driven immunotherapy. He discusses a study showing that radiation can induce unique cellular expression of MHC Class I adhesion molecules, costimulatory molecules, heat shock proteins, inflammatory mediators, immunomodulatory cytokines, and death receptors. He concludes with a discussion of “Immuno-Site,” an applicator designed to provide simple, effective, and isolated localized radiation therapy, including brachytherapy and immunotherapy simultaneously.
About The 31st Annual International Prostate Cancer Update:
The International Prostate Cancer Update (IPCU), founded in 1990, is a multi-day CME conference focused on prostate cancer treatment updates with expert, international faculty. It is led by expert physicians and is designed for urologists, medical oncologists, radiation oncologists, and other healthcare professionals involved in the diagnosis and treatment of prostate cancer. Dr. Finkelstein delivered this educational activity during the 31st iteration of the meeting in July 2021 in Snowbird, Utah.
ABOUT THE AUTHOR
Steven E. Finkelstein, MD, FACRO, is a radiation oncologist with Florida Cancer Affiliates in Panama City, Florida. He has served as a Co-Chair on the NRG Immunotherapy Committee, Co-Chair of the 2018-2019 ACRO Scientific Program Committee, and Chair of the SWOG Radiation STG Committee. He currently serves on the Board of Chancellors for ACRO. Dr. Finkelstein has also served as National Director of Translational Research Consortium (TRC), the cutting-edge therapy arm of 21st Century Oncology in Scottsdale, Arizona. Inspired by his grandmother, a cancer patient, he became a dedicated cancer surgeon who found that radiation therapy could sometimes do for his patients what surgery could not. Dr. Finkelstein received his medical degree from the University of Michigan Medical School. He served a residency in General Surgery at Washington University in Saint Louis, Missouri, and was Chief Resident in Radiation Oncology at the Moffitt Cancer Center in Tampa, Florida. Dr. Finkelstein also served fellowships in Biologic Immunotherapy, Clinical Cancer, and Surgical Oncology at the Surgery Branch of the National Cancer Institute in Bethesda, Maryland. He is a member of the American College of Radiation Oncology, the American Medical Association, the American Society of Clinical Oncology, the American Society for Therapeutic Radiology and Oncology, the Radiological Society of North America, and the Radiation Therapy Oncology Group.
