Recurrence vs de novo metastatic seem to be better than disease volume to decide the therapy for mHSPCa: dr Fizazi discusses trials

[Maxone73]

...a nice video, with some interesting overview also about drugs repurposing

urotoday.com/video-lectures...

[MoonRocket]

Good Video. My takeaway is do not just assume clinical trials drive treatment. The every day clinical setting, ie MO treatment, is equally important as these professionals apply the treatments approved via clinical trials. Often, the real office clinical setting differs from the clinical trial setting and a good MO starts to adjust treatments based on their patients profiles.

[Balylone]

Karim Fizzazi wrote me 4 years ago Radiotherapy was unnecessary because I had more than 5 metastases. I did radiotherapy anyway because “God does not play dices” famous Einstein sentence about Quantum Theory. Life is too complex for a number to segment it. I am glad to hear we did the right thing.

There is another aspect in this low and high volume classification. Actual ending clinical trials have classified burdens with X scanner and not PetScan. Obviously you see more metastases with PetScan. So I believe your volume classification must be taken from X Scanner because trials are based on Scanners (this is usually explained at the beginning of the trial results)

[HikerWife]

So, if I'm understanding this correctly, the new thinking is that having radiation to prostate would have been helpful for my husband's de novo, high-volume mHSPC? He did triplet therapy and is currently continuing ADT and abiraterone. He is not yet castrate resistant (dx October 2022).

[Maxone73 in reply to HikerWife]

Seems so for side effects but if I understood correctly there’s no OS benefit

[HikerWife in reply to Maxone73]

Thanks. Fortunately he's not having cancer-related SE yet...still, something to run by our MO. Appreciate the clarification!

[treedown]

Thank you. I enjoyed the video.