Prostate Cancer Highlights from ESMO23

[marnieg46]

For those interested in the outcomes of recent prostate cancer trials or those just curious about the current thinking on 'where to next' the latest GU Cast podcast from Declan Murphy is well worth watching.

The presentation is ‘peppered’ with conversation from the various speakers interviewed that contain gems and insights into not just the outcomes of the trials but often their own opinions on what went well and what might be worth pursuing further.

In this episode the topic of PSMA theranostics with Louise Emmett (ENZA-P) and Oliver Sartor (PSMAfore) is explored. Also discussed is the androgen receptor pathway inhibitors (ARPIs) in biochemical recurrence with Steve Freedland (EMBARK), Morgan Roupret and Boris Hadaschik. Christian Gratze discusses the latest negative immunotherapy trials in prostate cancer.

youtu.be/iXE63tBsqjE(Not working as expected?)

[cujoe]

Exceptionally informative podcast interview by one of the best med podcasters around, Declan Murphy. Not only are the Aussies out in front of the US in PSMA theranostics, they also shine in the free dissemination of invaluable information to the patient community. Much good info on the emerging value of PSMA treatment from these two trials.

The results seems to clearly indicate the value of treating earlier and of using "adaptive dosing" in formulating/monitoring the treatment plan. A major plus is that, so far, short and longer-term side effects seem more than acceptable to patients receiving PSMA therapies.

Good news all around. However, getting PSMA out to PCa patients earlier and providing the sort of genetic testing and scans to monitor will be the giant hurdles to access outside of clinical trials.

Super Tar to Ms. M and to her OZonian compatriots.

Ciao - Cujoe

[marnieg46 in reply to cujoe]

Thank you cujoe...yes I thought it was one of Declan's best to date. I was hoping one of the more acute, informed posters on FPC would elaborate a bit on the adaptive dosing and the discussion between the three urologists. I didn't feel equipped myself to add to this section. Do appreciate you summing it up so succinctly in your usual style.

I think there's little doubt that eventually lutetium will be like Abi and Enza...the earlier the better offering the opportunity for men to leave off treatments earlier with better outcomes all round. It's already being trialled/offered for some patients at Peter Mac pre-prostatectomy. Until something better comes along it seems to be a game changer for some men.

I've posted the same as here on APC as I think some readers there might appreciate the content. Be interesting to see if it's deleted and I receive a warning about posting from 'commercial organisations' as happened previously when I posted one from Declan! Hardly think a public cancer hospital qualifies as commercial. So let's see shall we?

[d3is4me in reply to cujoe]

Cujoe your reply is absolutely correct

[Ramp7 in reply to cujoe]

Adaptive dosing makes so much sense. When discussing this with my regular MO, there is not enough time for Doctors to actually monitor the finer points of this approach. Unless the patient actually becomes involved.

[d3is4me]

Hi Marnie

Another great Declan podcast love Louise Emmett's section.

I only wish we did not have to wait for trials etc. and could have treatment early. on our demand.

When I saw your post on APC I also thought would it be deleted.

Ross

[marnieg46 in reply to d3is4me]

Yes Ross, very impressive I thought. Louise is going to be our hope for getting lutetium funded by Medicare I think. Trust all goes well for you.

[NPfisherman]

Marnie,

Great post... good information... It was exciting listening to Louise talk about pushing towards the use of Lutetium earlier in treatment and the need for Phase III trials in regards to deciding that issue, as well as the use of adaptive dosing. When you hear MOs talk excitedly about reducing cognitive issues by using less medicine, or taking vacations, then it makes me believe that we are on the right track on this forum.

Patients are individuals, and one size does not fit all. The talk with Oliver and Louise focusing on resistant clones, and eliminating them was good stuff as well.

I believe that we will eventually see Lutetium as a first line therapy replacing chemo. It is tolerated better, less SEs, and only about 5% of patients wanted to change after starting treatment versus chemo at 15%. The fact that EMBARK showed that MO's can choose between an ARPI or ARPI plus ADT, and that ADT alone was not a choice... ( I hope the AUA gets on their members about ADT alone...)

Selection of patients based on genotype for immunotherapy was discussed by Steve Freeland and as he said, we need to find drugs that provide synergy with immunotherapy to allow better tumor penetration of those drugs.

The Science is Coming, my friends... Count on it !!!

Don Pescado