Watch the video and download the slides


Optimising treatment sequence for mCRPC after intensified therapy in mCSPC

Dr. Neal Shore provides his perspective on treatment sequence for mCRPC after intensified therapy in mCSPC.  Dr. Shore considers novel mechanisms of action and treatment resistance and factors guiding treatment decisions such as clinical benefit, QoL and comorbidities.

Watch the video and download the slides.

Optimising treatment sequence for mCRPC after intensified therapy in mCSPC

Hello everyone and welcome to GU Connect.

I’m Neal Shore. I’m the Medical Director of Carolina Urologic Research Centre in South Carolina and the Chief Medical Officer for GenesisCare US for surgery and urology.

It’s a great pleasure to present today ‘Optimising treatment sequence for mCRPC after intensified therapy in mCSPC’.

The goal of this programme is to try and offer some learnings regarding the plethora of amazing level one evidence studies for both mCSPC which has now really changed dramatically the approach to our patients with either low or high volume, metastatic castration sensitive prostate cancer.

In effect, monotherapy ADT is no longer the standard of care.

I will review the combination studies of androgen receptor-targeted inhibitors as well as chemotherapy in conjunction with ADT, which makes me make that claim. And very importantly, how do we think about treatment sequencing, especially once patients become castration-resistant or mCRPC.

Factors affecting treatment sequence decisions

We now have an embarrassment of riches. There are 11 life-prolonging agents that have been approved by the FDA and are within NCCN guidelines. Now this can be confusing, and because there’s so much literature and there’s so much evidence to ponder, but frankly, it’s a great opportunity to optimise patient survival. Making the decision regarding the factors that we choose for sequencing involves the tumour burden, the tumour location, patient comorbidities, other potential polypharmacy drug-drug interactions, additionally, the importance of genomic profiling, and ultimately, even the opportunity to engage our patients to clinical trials.

Importance of selecting therapies with a novel mechanism of action

What’s really important is selecting therapies that have novel mechanisms of action, and not repeating one similar drug of a class of mechanism of action after another. Clearly patients do better when they go through this paradigm of sequencing different mechanisms of action for patients that are approved and where there’s level one evidence, of course, we have different issues regarding very active therapies regarding a radiopharmaceutical such as radium, prior or after docetaxel, so that will be addressed.

Most importantly, we’re still seeing so much monotherapy with ADT, I’ll present information on that as well, and why we must do better.

Potential Future Treatments

A little bit of a teaser at the end is the addition of theranostics, albeit not yet approved by any regulatory agencies recent level one evidence in the VISION trial has been discussed at ASCO 2021, so the life-prolonging agent list continues to grow.

Understanding how to best optimise patient care in mCSPC and mCRPC sequencing decision making is a challenge for all of us but it’s a great challenge to have as we continue to strive to prolong our patient survival with advanced prostate cancer, preserve their quality of life and prevent complications of therapy.

Thank you very much for listening. Please go to the GU CONNECT website where you can download all the slides of the presentation. Thank you very much.

Neal D. Shore, MD, FACS is the Medical Director for the Carolina Urologic Research Center. He practices with Atlantic Urology Clinics in Myrtle Beach, South Carolina. Dr Shore has conducted more than 350 clinical trials, focusing mainly on GU Oncology, and serves on the Executive Boards of: Society of Urologic Oncology Board, Bladder Cancer Advocacy Network, and is Immediate Past President, Large Urology Group Practice Association. He is a founder for both: CUSP Clinical Trials Consortium, as well as for DASHKO, large urology practices data registries. He serves as the National Urology Research Director for 21st Century Oncology. He has served on the AUA Male Health Committee and the AUA Data Committee, the SITC Task Force for Prostate Cancer, the Bladder Cancer Advocacy Think Tank and the editorial boards of Reviews in Urology, Urology Times, Chemotherapy Advisor, OncLive, PLOS ONE(Academic Editor), Urology Practice, World Journal of Urology, and serves as Editor, Everyday Urology-Oncology. He has more than 200 peer reviewed publications and numerous book chapters; he performs peer review for Lancet Oncology, New England Journal of Medicine, European Urology, Journal Urology, Urology, BJUI, PCPD, and numerous other high impact scientific journals. A graduate of Duke University and Duke University Medical School, Dr Shore completed a 6-month clinical research fellowship in Pretoria, South Africa, and then completed his General Surgery/Urology training at New York Hospital Cornell Medical Center and at Memorial Sloan-Kettering Cancer Center in New York City. He is a Fellow of the American College of Surgeons.

Dr Neal D. Shore has received financial support/sponsorship for research support, consultation, or speaker fees from the following companies:

Abbvie, Astellas, Amgen, AstraZeneca, Bayer, BMS, Boston Scientific, Clarity, Clovis Oncology, Cold Genesys, Dendreon, Exact Imaging, Exact Sciences, FerGene, Foundation Medicine, Genesis Care, Invitae, Janssen, Lantheus, Lilly, MDxhealth, Merck, Myovant, Myriad, Nymox, Pacific Edge, Pfizer, Phosphorous, Photocure, Propella, PreView, Sanofi Genzyme, Sema4, Speciality Networks, Sesen Bio, Telix, Tempus, Tolmar and Urogen, Vaxiion.

Programme summary
Watch the video now
Share this programme
This educational programme is supported by an Independent Medical Education Grant from Bayer
I agree that this educational programme:

Was valuable to me

1/4
Brought to you by
GU CONNECT

GU CONNECT is an initiative of COR2ED, supported by Independent Educational Medical Grants from Bayer, AstraZeneca and Eisai Europe Limited.

Meet the experts

Other programmes of interest

Podcast
Oncology 
Colorectal cancer: understanding the needs of different patient populations

Exploring the impacts of age, ethnicity, socioeconomic status, and access to healthcare on patients with colorectal cancer

Experts
Prof. Tanios Bekaii-Saab, Deneen Richmond, Oncology Brothers (Moderators)
Endorsed by
COLONTOWN
  • download Downloadable
    Resources
  • clock 25 MIN
  • calendar May 2024

Educational programme supported by an Independent Medical Education grant from Bayer.
Podcast
Oncology 
Interpreting real-world evidence in later-line mCRC

Aligning real-world evidence with clinical trial data 

Experts
Prof. Tanios Bekaii-Saab, Prof. Shubham Pant
  • download Downloadable
    Resources
  • clock 27 MIN
  • calendar May 2024

Educational programme supported by an Independent Medical Education grant from Bayer.
Podcast

Episode

1

of 3

episode
Oncology 
Cáncer de próstata: Dificultades en la fase preanalítica y pruebas de biomarcadores (Spanish)

Moderado por los Oncology Brothers. Episodio 1 de una serie de podcast de video de 3 partes.

Experts
Dr Alexander Wyatt, Dr Petros Grivas, Oncology Brothers (Moderators)
Endorsed by
NASPCC AMP
  • download Downloadable
    Resources
  • clock 30 MIN
  • calendar May 2024

Educational programme supported by an Independent Medical Education grant from AstraZeneca and Amoy Diagnostics.
Podcast

Episode

3

of 3

episode
Oncology 
Câncer de Ovário: Desafios da fase pré-analítica e teste de biomarcadores (Portuguese)

Moderado pelos Oncology Brothers. Episódio 3 da série de podcasts em vídeo de 3 partes

Experts
Assoc. Prof. Martina Murphy, Assoc. Prof. Caterina Marchiò, Oncology Brothers (Moderators)
Endorsed by
AMP
  • download Downloadable
    Resources
  • clock 32 MIN
  • calendar May 2024

Educational programme supported by an Independent Medical Education grant from AstraZeneca and Amoy Diagnostics.
Podcast

Episode

3

of 3

episode
Oncology 
Cáncer de ovario: Dificultades en la fase preanalítica y pruebas de biomarcadores (Spanish)

Moderado por los Oncology Brothers. Episodio 3 de una serie de podcast de 3 partes.

Experts
Assoc. Prof. Martina Murphy, Assoc. Prof. Caterina Marchiò, Oncology Brothers (Moderators)
Endorsed by
AMP
  • download Downloadable
    Resources
  • clock 32 MIN
  • calendar May 2024

Educational programme supported by an Independent Medical Education grant from AstraZeneca and Amoy Diagnostics.
Podcast

Episode

2

of 3

episode
Oncology 
Câncer de Pulmão: Desafios da fase pré-analítica e teste de biomarcadores (Portuguese)

Moderado pelos Oncology Brothers. Episódio 2 da série de podcasts em vídeo de 3 partes

Experts
Dr Bruna Pellini, Dr Semir Vranić, Oncology Brothers (Moderators)
Endorsed by
AMP
  • download Downloadable
    Resources
  • clock 25 MIN
  • calendar May 2024

Educational programme supported by an Independent Medical Education grant from AstraZeneca and Amoy Diagnostics.