Consensus recommendations from the US Prostate Cancer Conference 2024 for BCR and advanced prostate cancer

[Graham49]

It’s quite a long read but I don’t think much is unexpected. Please reply with anything you disagree with.

Implementing evidence-based strategies for men with biochemically recurrent and advanced prostate cancer: Consensus recommendations from the US Prostate Cancer Conference 2024

Alan H. Bryce MD, Neeraj Agarwal MD, Himisha Beltran MD, Maha H. Hussain MD, Oliver Sartor MD, Neal Shore MD, Emmanuel S. Antonarakis MD, Andrew J. Armstrong MD, MSc … See all authors

First published: 01 December 2024

doi.org/10.1002/cncr.35612

[NanoMRI]

Disagree? Ya! As I share, at 0.13, this is post RP (and salvage RT to bed), six cancerous pelvic lymph nodes confirmed by salvage ePLND, including para-aortic. All were missed by Ga68 PSMA PET whilst being identified by Ferrotran nanoparticle MRI.

The 'consensus recommendations ' include this statement "The expanding treatment landscape for BCR is confounded by the use of PSMA PET/CT".

What confusion? Clearly cancer is present and active before the established PSA values for 'recurrence'; biochemical and clinical. Yet, the charade carries on, just as with screening 'guidelines'. Kick the cancer (recognition) down the road strategies.

All the best to all of us navigating diagnosis and treatment strategies!

[Graham49 in reply to NanoMRI]

Thanks for post. I had never heard of Ferrotran nanoparticle MRI. I asked Perplexity AI about it, see below.

Ferrotran nanoparticles have shown the ability to target specific types of tumors, particularly:

• Prostate Cancer: Ferrotran (ferumoxtran-10) is in advanced clinical trials for detecting lymph node metastases in prostate cancer patients, offering high sensitivity for identifying affected nodes.

• Glioblastoma: Studies suggest that iron oxide nanoparticles, similar to Ferrotran, can target glioblastoma cells by binding to overexpressed EGFR (epidermal growth factor receptor).

• Nasopharyngeal Carcinoma: These nanoparticles have also been explored for imaging and targeting nasopharyngeal carcinoma using EGFR-specific conjugation.

Their tumor-specific targeting is often enhanced by functionalizing the nanoparticles to bind receptors overexpressed in malignant cells.

[Leonardo556]

Thank you, Consensus recommendations from the US Prostate Cancer Conference 2024 are very interesting and helpful.

[Concerned-wife]

thank you very much. It is interesting that 3.1 recommends somatic testing for all metastasic patients. my husband consults with one of the doctors on the committee, but it has never been recommended to him. He is researching this before his oncology appointment next week. We appreciate you sharing!

The discussion about intermittent was interesting, too.

[Mgtd in reply to Concerned-wife]

Please keep in mind that this is a consensus agreement and your doctor although listed as a member of this committee may not agree with it.

Or he has not seen your husband since this report and will do so.

Or the details in his case do not warrant doing this test.

But certainly worth mentioning. Please let us know the results of the discussion.

[Mgtd]

Thank you for posting. As the conductor of my train may announce soon that BCR next stop.

[Teufelshunde]

Good info, but also points out the major issue between those of us with disease, and those that study the disease and do the gold standard recommendations. Here is the quote:

Thus the advent of PSMA PET/CT has introduced a data gap that will take years to prospectively address, and a significant part of the USPCC proceedings focused on the application of PSMA PET/CT in current practice.

[PELHA]

Will definitely read. Our MO is Dr Bryce.

[kainasar]

Surprised, we dont see discussion of sequencing and approaches to challenging resistence to Arpi's and docataxel. The limits of PSMA testing also inc neurendocrine lesions, and a percentage of false positives. Does the ferrotran detect NE?

[j-o-h-n]

I happen to of lost/misplaced my Consensus CONFLICT OF INTEREST STATEMENT. I think I must of accidentally mixed it in with my load of divorce decree information.

Good Luck, Good Health and Good Humor.

j-o-h-n

[jfoesq]

I am not sure of if I was 4b or not but was DX more than 12 yrs ago with 4-5 bone Mets and another was removed from my lymph nodes during prostate removal surgery (along with more than 30 others that were benign. My pSA was in the mid-40s and my Gleason score was 9. I started with Lupron and had Abiraterone added after a few yrs. Other than 3 “vacations” during my first 5 yrs, I have always been in ADT and still am, although it does appear to be getting less effective as I just had my 2nd tumor “whack-a-moled” in the last 3 yrs. I will get a PSA test in a month to see if the radiation was effective on this bone met as it was k. The previous one I had radiated about 3 yrs ago. If it is not as effective, the I will have to change or add to my ADT treatment.