GENITOURINARY CANCERS

Case Based Peer Perspectives: Metastatic Castration-Resistant Prostate Cancer

Updated NCCN guidelines in prostate cancer recommend integration of tumor genetic testing into clinical practice for patients with advanced prostate cancer. For patients with regional or metastatic disease, the guidelines recommend testing for homologous recombination gene mutations and for microsatellite instability or mismatch repair deficiency, according to Emmanuel S. Antonarakis, MBBCh.

Metastatic Hormone-Sensitive Prostate Cancer Progression to CRPC

The combination of avelumab (Bavencio) and axitinib (Inlyta) has been approved by the FDA for the frontline treatment of patients with advanced renal cell carcinoma, based on findings from the phase III JAVELIN Renal 101 trial.

Elizabeth Kessler, MD, explained to a group of physicians in a recent&nbsp;<em>Targeted Oncology&nbsp;</em>live case-based peer perspectives presentation the treatment considerations and decisions she makes when seeing a patient with prostate cancer in the clinic.

In a preliminary analysis of a phase II trial, the radiolabeled small molecule, ¹⁷⁷LuPSMA-617, demonstrated a biochemical progression-free survival of 4 months in a cohort of 64 men with metastatic castrate-resistant prostate cancer.

A phase III clinical trial evaluating&nbsp;cabozantinib (Cabometyx) in combination with nivolumab (Opdivo) and ipilimumab (Yervoy) in patients with previously untreated advanced renal cell carcinoma has been initiated, according to Exelixis, the developer of cabozantinib.

A look back at all the&nbsp;FDA news&nbsp;that happened in the month of&nbsp;April 2019, including several new approvals, a priority review, breakthrough designation, and more.

Apalutamide has been submitted for FDA approval for the treatment of patients with metastatic castration-sensitive prostate cancer.

A new drug application seeking the approval of darolutamide as a treatment for patients with nonmetastatic castration-resistant prostate cancer has been granted a priority review designation by the FDA.

The results of several studies presented at the 2019 Genitourinary Cancers Symposium confirmed that the combination of PD-1/PD-L1 checkpoint inhibitors with tyrosine kinase inhibitors of the VEGF pathway was superior to VEGF inhibitors alone in patients with clear cell renal cell carcinoma, which accounts for about 70% of patients with kidney cancer.

Since the approval of sipuleucel-T for the treatment of minimally symptomatic metastatic castration-resistant prostate cancer in 2010, barriers to administration and the approval of competing drugs has tampered wide adoption of its use.

Before a community oncology practice considers getting involved in clinical trials research, there are many factorsto consider. Perhaps foremost is the fact that cancer clinical trials provide the evidence base for new advances in oncology.&nbsp;

Artificial intelligence has made inroads in many industries&mdash;banking, finance, security&mdash;but its adoption in healthcare has been lagging and real-world clinical implementation has yet to become a reality. Nonetheless, proponents say it is only a matter of time and pilot programs are starting to yield some practical results.&nbsp;

Arjun V. Balar, MD, co-physician editor in chief of <em>Targeted Therapies in Oncology</em>, discusses&nbsp;recent data for bone-seeking radiopharmaceuticals in prostate cancer.

The novel targeted radiation therapy, lutetium 177 prostate-specific membrane antigen, demonstrated safety and therapeutic efficacy in 22 patients with metastatic castration-resistant prostate cancer, based on findings presented during the ESMO 2019 International Congress on Targeted Anticancer Therapies.

Edwin M. Posadas, MD, medical director, Urologic Oncology Program, co-director, Translational Oncology Program, associate professor, Medicine, Cedars-Sinai Medical Center, discusses key takeaways from the ARAMIS trial of darolutamide in high-risk nonmetastatic castration-resistant prostate cancer.

Mark T. Fleming, MD, medical oncologist, Virginia Oncology Associates, The US Oncology Research, discusses exciting data seen with antiandrogen agents for the treatment of prostate cancer.

Under the 2019 update to the&nbsp;National Comprehensive Cancer Network guidelines, the recommendation&nbsp;on the management of&nbsp;advanced clear cell renal cell carcinoma has undergone a major shift in defining the risk category used to define preferred and alternative first-line treatments.

The first patient has been dosed in a phase II study investigating the safety and tolerability of the novel agent LiPlaCis for the treatment of advanced or refractory prostate cancer.

The healthcare community is still awaiting a response from the Centers for Medicare &amp; Medicaid Services to the opposition of the agency&rsquo;s proposal to substantially revise the Medicare Part D protected drug classes.

Overtreating men 70 years or older with prostate cancer cost Medicare more than $1.2 billion from 2004 to 2007, according to the results of a retrospective study using the Surveillance, Epidemiology, and End Results&ndash;Medicare linked database.