Prostate Cancer

Panelists discuss how PSMA PET imaging plays a crucial role in the initial staging of prostate cancer, offering superior accuracy over conventional methods. Medical professionals consider factors such as diagnostic performance, tracer availability, and patient-specific characteristics when selecting appropriate PSMA PET agents. The integration of PSMA PET findings into clinical practice has led to more precise treatment planning, potentially improving patient outcomes. Pivotal trials have demonstrated the efficacy of various PSMA PET tracers in detecting prostate cancer metastases.

Focused, high-dose radiotherapy doses may prolong survival and the interval to subsequent therapy for patients with advanced prostate cancer.

Data show increasing use of proton therapy overall but widening gaps in populations who have access to this treatment, Curtiland Deville Jr, MD, says.

Panelists discuss how high-quality imaging is crucial for accurately staging prostate cancer, guiding treatment decisions, and optimizing patient outcomes. Superior resolution and sensitivity of PSMA PET tracers enhance lesion detection, influencing surgical, radiation, and systemic therapy choices. Differences in tracer properties impact specificity, affecting treatment planning. Advanced imaging reduces uncertainty, improving risk stratification and therapeutic precision.

Panelists discuss how medical professionals select PSMA PET tracers based on factors such as diagnostic accuracy, tracer availability, patient-specific considerations, and logistical aspects such as half-life and production facilities. Fluorine-18 (^18F)–labeled tracers, such as ^18F-PSMA-1007, offer logistical advantages due to their longer half-life and higher image resolution, facilitating broader clinical application.

Panelists discuss how PSMA PET imaging utilizes various tracers, each with distinct properties influencing image quality and diagnostic accuracy. Fluciclovine F18 (Axumin) is primarily used for detecting recurrent prostate cancer, offering moderate sensitivity but lower specificity compared with PSMA-targeted agents. Gallium Ga 68 gozetotide (Illuccix) provides high sensitivity and specificity for prostate cancer lesions; however, its shorter half-life and limited availability may restrict widespread use. Piflufolastat F18 (Pylarify) combines the benefits of F18’s longer half-life with high image resolution, enhancing detection accuracy. Similarly, flotufolastat F18 (Posluma) leverages F18’s favorable imaging characteristics, offering high-quality images and reliable lesion detection.

Panelists discuss how prospective randomized data, notably from Hofman et al (Lancet, 2020), demonstrate that PSMA PET-CT exhibits superior diagnostic accuracy compared with conventional imaging in detecting pelvic nodal and distant metastases in patients with high-risk prostate cancer. Conventional imaging techniques, such as CT and bone scans, often have lower sensitivity and specificity, potentially missing smaller or early metastatic lesions. In contrast, PSMA PET-CT offers enhanced sensitivity and specificity, leading to more precise staging and management decisions.

A cohort study found that pre-radical prostatectomy levels greater than 20 ng/mL were associated with increased all-cause mortality risk and prostate cancer-specific mortality risk.

The adverse effect profile was similar among patients with prostate cancer using NeuroSAFE-assisted RARP vs standard RARP.

The new drug application for TLX007-CDx has been approved by the FDA for patients with prostate cancer.

Prior data support the ability of PATHOMIQ_PRAD to predict patients at a high risk of biochemical recurrence and metastasis.

Results from the phase 1/2a SeCuRE trial support the FDA decision for patients with metastatic castration-resistant prostate cancer.

“Even after doing 10,000 of these operations, we are tweaking [the hood technique]…to make things better,” according to Ash Tewari, MD, MBBS, MCh, FRCS.

Data show improvements in overall survival and time to subsequent therapy initiation with darolutamide plus ADT/docetaxel.

Olaparib plus abiraterone improved radiographic PFS and overall survival in mCRPC patients with germline or somatic BRCA mutations vs placebo plus abiraterone.

The hood technique, developed by Ash Tewari, MD, aids in facilitating earlier returns of continence with reduced residual cancer rates.

Patients who did not receive fish oil experienced a Ki-67 index increase of 24% vs the 15% Ki-67 index decrease for patients with a low omega-6, high omega-3 diet who received fish oil.

The ARANOTE phase 3 trial showed darolutamide plus ADT improved outcomes in mHSPC regardless of disease volume.

Phase 3 ARASENS trial results highlight the role of G-CSF in optimizing docetaxel delivery within the darolutamide-based regimen for mHSPC.

More adverse factors occurred in those with intermediate-risk prostate cancer undergoing neoadjuvant androgen deprivation therapy than those who did not.

The TALAPRO-2 trial revealed promising survival data for patients with metastatic CRPC treated with talazoparib and enzalutamide.

The imaging agent led to changes in intended treatment plans for 48% of patients with prostate cancer and biochemical recurrence after definitive therapy.

Standardizing surgical outcomes and better training oncologic surgeons may be accomplished through the use of AI.

The poly-ICLC trial seeks to develop a delivery mechanism to prostate cancer through different biomarkers.

Ablative technology may generate an immune response that can be enhanced via injected immunotherapy in patients with solid tumors.

Data show an early trend towards improved overall survival with capivasertib plus abiraterone and androgen deprivation therapy in CAPItello-281.

The VIOLETTE trial, which used OBT-fusion technology for patients with focal ablation of the prostate by microwave needles, released interim results.

Darolutamide with androgen deprivation therapy has shown promising efficacy and safety results for patients with hormone-sensitive prostate cancer.

Pembrolizumab with platinum-based chemotherapy yielded encouraging progression-free and overall survival outcomes in this patient population.

Stereotactic body radiotherapy showed noninferior biochemical or clinical failure compared with standard radiotherapy in select patients with prostate cancer.