Summary
Professor Karim Fazazi from the Center Oscar Lambre in Lille, France, shares insights on the recent ASCO plenary presentation of the Proteus trial, which examines the efficacy of perioperative apalutamide combined with androgen deprivation therapy (ADT) in patients with high-risk localized prostate cancer undergoing radical prostatectomy. The trial, involving around 2,000 men, shows a positive outcome in terms of metastasis-free survival, particularly when assessed using modern imaging techniques like PSMA PET. However, Fazazi notes that the trial did not demonstrate significant improvement in metastasis-free survival when evaluated with conventional imaging, raising questions about the trial's overall impact on clinical practice.
Fazazi discusses the importance of patient preferences in treatment decisions, particularly the choice between surgery and radiation therapy for high-risk localized disease. He emphasizes that while many patients opt for surgery due to psychological factors, the standard of care remains ADT combined with radiation. The conversation also touches on the challenges of conducting randomized trials in prostate cancer, especially when comparing surgical and radiation approaches. Fazazi highlights the evolving landscape of prostate cancer treatment, including the role of biomarkers and advanced imaging techniques like PSMA PET in guiding therapy decisions, particularly for patients with localized disease.
In the context of castration-resistant prostate cancer, Fazazi explains the significance of androgen receptor mutations and the potential of new therapies targeting these mutations. He elaborates on the development of agents like OPV Zostad, which aims to inhibit steroid hormone production in patients with these mutations. The discussion also covers the comparative efficacy and safety profiles of emerging treatments, including radioligands like actinium PSMA and lutetium PSMA, as well as the role of chemotherapy in hormone-sensitive metastatic disease. Fazazi concludes by emphasizing the need for personalized treatment strategies based on individual patient characteristics and the latest clinical evidence.
Show Notes
Featuring an interview with Prof Karim Fizazi, including the following topics: Perspectives on the PROTEUS Phase III trial evaluating the addition of apalutamide to standard therapy for high-risk localized prostate cancer (0:00) Mechanism of action of opevesostat and potential role in castration-resistant prostate cancer with androgen receptor mutations (15:37) Perspectives on alpha- and beta-emitting radiopharmaceuticals in the treatment of prostate cancer (22:47) Novel antibody-drug conjugates and proteolysis-targeting chimeras (30:43) Treatment approaches for metastatic hormone-sensitive prostate cancer — de novo symptomatic presentation versus PSMA-only metastatic recurrence after local therapy (34:51) Role of intermittent therapy in the treatment of prostate cancer (38:48) Treatment intensification approaches in prostate cancer (41:38) Case: A man in his late 60s with de novo PSMA PET-positive metastatic castration-sensitive prostate cancer (45:25) CME information and select publications
More from Research To Practice | Oncology Videos
Featuring a slide presentation and related discussion from Prof Karim Fizazi, including the following topics: PROTEUS Phase III trial evaluating the addition of apalutamide to standard therapy in high-risk localized prostate cancer (0:00) Time to testosterone recovery during treatment suspension in the Phase III EMBARK trial of enzalutamide and leuprolide in nonmetastatic prostate cancer (5:05) Radiographic progression-free survival subgroup analysis in the PSMAddition Phase III trial of 177Lu-PSMA-617 in metastatic hormone-sensitive prostate cancer (6:58) TALAPRO-3: Efficacy of talazoparib and enzalutamide in metastatic hormone-sensitive prostate cancer harboring homologous recombination repair gene alterations (8:16) Phase I/II PETRANHA study of novel PARP inhibitor saruparib in metastatic hormone-sensitive prostate cancer (10:52) Phase II A-DREAM trial of androgen deprivation therapy interruption in patients with metastatic hormone-sensitive prostate cancer responding to androgen receptor pathway inhibitor (13:23) Overall survival by duration of enzalutamide treatment received in the Phase III ARCHES trial (15:21) Efficacy of capivasertib and abiraterone in the Phase III CAPItello-281 trial for patients with PTEN-deficient metastatic hormone-sensitive prostate cancer (16:24) Phase I AcTION study of 225Ac-PSMA-617 in patients with metastatic castration-resistant prostate cancer (mCRPC) with or without prior 177Lu-PSMA radioligand therapy (18:16) Phase III PSMAfore trial of 177Lu-PSMA-617 in progressive mCRPC; ongoing Phase III trials of radioligands in mCRPC (19:54) Ongoing Phase III OMAHA-004 trial of CYP11 inhibitor opevesostat versus next-generation hormonal agent switch in patients with mCRPC and 1 prior next-generation hormonal agent (23:14) CME information and select publications
Featuring perspectives from Prof Susana Banerjee, including the following topics: Case: A woman in her mid 50s with multiregimen-recurrent low-grade serous ovarian cancer and a KRAS G12V mutation who receives avutometinib/defactinib with response, asymptomatic creatine phosphokinase elevation and mild facial rash — Dr Stover (0:00) Case: A woman in her early 30s with recurrent metastatic low-grade serous ovarian cancer, originally offered hospice due to poor condition, who receives avutometinib/defactinib with an excellent response — Dr Hussein (7:58) Case: A woman in her late 30s with multiregimen-recurrent folate receptor alpha-positive low-grade serous ovarian cancer (HER2 IHC 2+) who receives mirvetuximab soravtansine — Dr Cobb (18:21) CME information and select publications
Featuring perspectives from Prof Susana Banerjee, including the following topics: Overview of the biology and treatment of low-grade serous ovarian cancer (0:00) Mechanism of action of avutometinib/defactinib (10:16) RAMP 201 Trial: Avutometinib/defactinib in recurrent low-grade serous ovarian cancer (14:32) Ongoing clinical trials in low-grade serous ovarian cancer (27:57) CME information and select publications
Featuring perspectives from Dr Spencer Bachow, Dr Bhavana (Tina) Bhatnagar, Dr Jennifer Crombie, Dr Manali Kamdar and Ms Alexandra Lynch, co-moderated by Dr Bachow and Dr Bhatnagar, including the following topics: Introduction and Overview of Bispecific Antibodies in the Clinic (0:00) Current and Future Role of Bispecific Antibodies in Non-Hodgkin Lymphoma — Dr Kamdar (15:58) Case: A man in his early 60s with diffuse large B-cell lymphoma (DLBCL) receives glofitamab (42:40) Case: A woman in her early 80s with follicular lymphoma (FL) receives mosunetuzumab (51:50) Mitigation and Management of Cytokine Release Syndrome (CRS) and Other Toxicities Associated with Bispecific Antibodies — Dr Crombie (1:00:39) Case: A woman in her early 80s with DLBCL receives glofitamab (1:18:50) Case: A woman in her early 70s with FL receives epcoritamab (1:26:38) Outpatient CRS Management in B-Cell Lymphomas — Ms Lynch (1:29:28) Case: A woman in her late 40s with FL receives epcoritamab (1:38:33) Case: A man in his early 70s with mantle cell lymphoma receives mosunetuzumab (1:46:26) CME information and select publications
Featuring a slide presentation from Dr Julia Rotow, including the following topics: Rationale and potential clinical role of PD-1/PD-L1 x vascular endothelial growth factor (VEGF) bispecific antibodies in the treatment of non-small cell lung cancer (NSCLC) (0:00) Key findings from the Phase III HARMONi-6 study; ongoing Phase III HARMONi-3 study (5:12) Key findings from the Phase III HARMONi-2 study; ongoing Phase III HARMONi-7 study (9:59) Clinician insights about the potential role of ivonescimab in the front-line setting (12:02) Impetus for investigating ivonescimab in the relapsed/refractory (R/R) EGFR-mutant setting (14:01) Key findings from the Phase III HARMONi-A and HARMONi studies (16:07) Clinician insights about the potential role of ivonescimab in the treatment of R/R EGFR-mutant NSCLC; other novel PD-1/PD-L1 x VEGF bispecific antibodies under investigation (20:30) CME information and select publications