25 ASCO GU 2021 PCa Videos

[pjoshea13]

For those with time on their hands, informative videos from ASCO GU 2021:

urotoday.com/video-lectures...

-Patrick

[cigafred]

That page is where I found the posting I did on Sartor, BAT, and base line mutations. Also the top right post is with Dan Shevrin, my oncologist, and the first in the third row is Pedro Barata, whom I saw at Tulane. The page has transcriptions, so not as much of a time sink.

[pjoshea13 in reply to cigafred]

At first I was tempted to post each separately, with comments - if I had any. That would have been a time sink. But I will mention the part of the interview with Praful Ravi that covered the ACIS trial.

Briefly, is Apalutamide plus Abiraterone better than Abi alone in mCRPC?

The good news: "there was a seven-month improvement in radiographic progression-free survival with adding apalutamide to abiraterone. So it improved from 16 months to around 24 months."

The bad news: "there was no difference in overall survival between the two arms, both arms had overall survival around 33 to 35 months."

Treatments that delay progression do not necessarily improve survival. I would expect treatment-emergent adaptations to differ between the arms. I'm very suspicious of studies where radiographic progression-free survival is hyped as a meaningful end-point.

It is tempting to look at the "seven-month improvement" (50%) & think that the combo is obviously better. But after the added morbidity of the additional drug - not to mention the "financial toxicity" - to end up with no survival benefit!

-Patrick

[Fiddler2004]

Excellent resource. thank you1

[MateoBeach]

What a feast of new relevant research! Awesome to dig in.

[timotur]

Thank you, the one I found interesting was Dr Efstathiou‘s video on CTC’s...

Now, if you look at the table of the results here, you'll see that interestingly, tumors that had been treated first with docetaxel and then with an enhanced androgen-signal inhibitor, actually had a higher percentage of circulating tumor cells detectable. 62% of the tumors had detectable CTCs.

Whereas if you have tumors that had first been targeted with abiraterone and enzalutamide then with docetaxel, only 30% of these tumors had CTCs.

What does that say about early docetaxel?

[Shooter1]

What does that say about early docetaxel? It says we are still playing a guessing game with these meds and our lives... I had early docetaxel and added enzalutamide in the middle of 9 cycles. Made me a complete invalid and left me with neuropathy, but after over 4 years, I am still here. Would I do the same treatment again...probably not. The order of things is still up to debate, but when I made my decisions, the newer data was not available. Best of luck to all and remember Life is Good.