Ca ncer de pro stata hormono-sensible metasta sico y alta carga tumoral
|
|
- Janice Ross
- 5 years ago
- Views:
Transcription
1 Ca ncer de pro stata hormono-sensible metasta sico y alta carga tumoral Dra. Aránzazu González del Alba Servicio de Oncologia Médica Hospital Universitario Son Espases Palma de Mallorca Formigal, 29 de junio de 2018
2 Introduction Aprox 5-20% of new PCa diagnosis present with metastatic disease: 4-10% in Europe, US Prevalence of metastasis at diagnosis varies geographically, depending on screening programs, access to health system, etc 80% patient present without metastatic disease. In Spain up to 50% CRPC- M1 will present after being initially diagnosed with localized disease Siegel, Ca Cancer J Clin,2017; Castro et al. ESMO
3 Introduction Androgen deprivation has been the standard of care of advanced prostate cancer during the past 7 decades Orchiectomy 1 Huggins 1941 Oestrogens LHRHa/GnRHa 2 Standard of care until recently Alternatives: High vs low doses antiandrogens Maximun Androgen Blockage 3 Intermitent blockage 4 ADT may induce responses >90% of patients, but after a median of months progression to CRPC occurs 1. Huggins C, Can Res, 1941;2. Messing EM, N Eng J Med, 1999; 3. Prostate cancer trialists collaborative group, Lancet,2000; 4. Hussain, N Eng J Med, 2013;
4 Introduction Since 2015, Docetaxel plus LHRHa has become the standard of care for a majority of Castration-Sensitive M1 patients AR-independent clones However, most men progress to castration-resistant status through reactivation of androgen-signalling 1. Gravis G, et al. Eur Urol. 2016:70: Sweeney C, et al. N Engl J Med. 2015;373: ; 3. James N, et al. Lancet. 2016;387:
5
6 What are we learning from long term follow-up of CHAARTED: Overall Population Median Follow-up 28.9 months Median Follow-up: 53.7 months 13 months / HR months / HR 0.73 Vall d'hebron Institute of Oncology (VHIO) Sweeney et al NEJM 2015, Sweeney et al ESMO 2016 Sweeney et al NEJM 2015, Sweeney et al ESMO 2016
7 What are we learning from long term follow-up of CHAARTED: High volume Median Follow-up 28.9 months Median Follow-up: 53.7 months 17 months / HR months / HR 0.6 Vall d'hebron Institute of Oncology (VHIO) Sweeney et al NEJM 2015, Sweeney et al ESMO 2016 Sweeney et al NEJM 2015, Sweeney et al ESMO 2016
8 CHAARTED: Total patient population HVD LVD Kiriakopoulos JCO 2018
9 CHAARTED: De novo metastatic patients Kiriakopoulos JCO 2018
10 CHAARTED QOL
11 FACT-P Total CHAARTED Quality of Life (FACT-P) High volume Low volume 120 ADT + DOC ADT alone ADT alone 112 ADT + DOC Significant improvement in FACT-P at 1 year with ADT + DOC No significant difference at 1 year between both arms FACT-P: Functional Assessment of Cancer Therapy Prostate (higher values=improvement) Sweeney CJ et al. Ann Oncol 2016;27(suppl 6):abstract 720
12 THE STAMPEDE TRI AL: A MULTI -ARM, MULTI -STAGE DESI GN ASCO 2015 ASCO 2017 No DOC 2:1 randomization against SOC= ADT +/-RT
13 Slide 10 Presented By Neeraj Agarwal at 2018 ASCO Annual Meeting
14 Overall survival STAMPEDE OS ( primary endpoint) ( n= 1,776) 61% M1; 15% N1M0; 24% N0M0; median follow-up: 43 mo SOC + DOC Median 81 mo 0.6 SOC Median 71 mo HR= 0.78 (95% CI: ) P= SOC by Kaplan Meier SOC + DOC by Kaplan Meier SOC by flexible parametric model SOC + DOC by flexible parametric model Time from randomization ( months) James, ND et al. Lancet. 2016;387:
15 Slide 12 Presented By Neeraj Agarwal at 2018 ASCO Annual Meeting
16 ADT + docetaxel in mhspc GETUG-15 1,2 CHAARTED 3,4 STAMPEDE 5 Accrual Total sample size, n ,776 Patients with mhspc, % Patients with high-volume mhspc, % (513) a NE Patients with de novo M1, % Median follow-up, months Median age, years Treatment duration Docetaxel cycles Prednisone No No Yes Not head-to-head comparison studies. a Data are presented as % (n). * p value non-significant. mhspc, metastatic hormone-sensitive 1. Gravis G, et al. Lancet prostate Oncol. 2013;14: cancer; 2. Gravis G, NE, et al. Eur not Urol. evaluable. 2016;70: Sweeney CJ, et al. N Engl J Med. 2015;373: Sweeney C, et al. Ann Oncol. 2016;27:abstr 720PD. 5. James ND, et al. Lancet. 2016;387: Vall d'hebron Institute of Oncology (VHIO) Dr J Carles
17 ADT + docetaxel in mhspc (cont.) GETUG-15 1,2 CHAARTED 3,4 STAMPEDE 5 Patients, n ,776 1,086 OS Experimental arm (median), months Benefit, months All HVD All HVD All M (48.6 to 62.1) 4.7 (35.1 to 39.8) 10.4 (47.2 to 57.6) 16.8 (34.42 to 51.2) 10 (71 to 81) 15 (45 to 60) HR for OS 0.88* 0.78* Progression cpfs Time to clinical progression FFS Experimental arm (median), months Benefit, months 23.5 NE NA 8.1 (15.4 to 23.5) NE 13.2 (19.8 to 33.0) 14.3 (13.0 to 27.3) 17 (20 to 37) HR for progression 0.75 NE NA Not head-to-head comparison studies. a Data are presented as % (n). * p value non-significant 1. Gravis G, et al. Lancet Oncol. 2013;14: Gravis G, et al. Eur Urol. 2016;70: Sweeney CJ, et al. N Engl J Med. 2015;373: Sweeney C, et al. Ann Oncol. 2016;27:abstr 720PD. 5. James ND, et al. Lancet. 2016;387: cpfs, clinical progression free survival, FFS, failure-free survival; HR, hazard ratio; HVD, high-volume disease; NA, not available, NE, not evaluated. Vall d'hebron Institute of Oncology (VHIO) Dr J Carles
18 LATITUDE: Phase III Trial of Abiraterone in patients with newly diagnosed metastatic prostate cancer (n=1,199) Patients Newly diagnosed adult men with high-risk mhnpc Stratification Factors Presence of visceral disease (yes/no) ECOG PS (0, 1 vs 2) R A N D O M I Z E D ADT + Abiraterone acetate 1000 mg QD + Prednisolone 5 mg QD (n = 597) ADT + placebos (n = 602) High-risk defined as meeting at least 2 of 3 high-risk criteria: G easo scoreof 8 Prese ceof 3 esio s o bo esca Presence of measurable visceral lesion Efficacy Endpoints Co-primary: OS rpfs Secondary: Time to pain progression PSA progression next symptomatic skeletal event chemotherapy subsequent PC therapy Fizazi K et al. J Clin Oncol. 2017;35 (suppl; abstr LBA3); Fizazi K et al. N Engl J Med. 2017;377(4):
19 Overall survival (% ) Radiographic progression- free survival (% ) LATI TUDE: Co-primary End Points 38% Risk Reduction for Death 53% Risk Reduction for rpfs HR, 0.62 (95% CI, ) P < ADT + Placebos, 34.7 mo ADT + AA + P, NR Months Patients at risk ADT + AA + P ADT + Placebos Patients at risk ADT + AA + P ADT + Placebos 0 ADT + Placebos, 14.8 mo HR, 0.47 (95% CI, ) P < Months ADT + AA + P, 33.0 mo Median follow up 30.4 m 12 Fizazi K, et al. N Engl J Med. 2017;377: CI, confidence interval; HR, hazard ratio; NR, not reached.
20 LATITUDE: Características basales y subgrupos
21 Slide 13 Presented By Neeraj Agarwal at 2018 ASCO Annual Meeting
22 STAMPEDE- OS Abiraterone ( n= 1,917) Events 262 Control 184 Abiraterone SOC+AAP mixed population of M1 and MO patients This represents a 37% improvement in survival SOC HR % CI 0.52 to 0.76 P-value James ND et al, N Engl J Med Jul 27;377(4):
23 Slide 15 Presented By Neeraj Agarwal at 2018 ASCO Annual Meeting
24 Patients without degradation in FACT-P total score (%) FACT-P total score ADT + AA + P Significantly Improved HRQoL per FACT-P 15% Risk Reduction for HRQoL Degradation 0.6 Mean Change From Baseline Differed from Cycle 5 Onward ADT + AA + P, 12.9 mo 0.2 Better 40 ADT + Placebos, 8.3 mo Patients at risk ADT + AA + P ADT + Placebos *1 cycle = 28 days. HR 0.85 (95% CI, ) P = Months Cycle* ADT + AA + P ADT + Placebos Worse 23
25
26 Failure-free survival Favours SOC+AAP Favours SOC+DocP Summary Head-to-head data in 566 pts (Nov-2011 to Mar-2013) Progression-free survival Strong evidence favouring AAP Metastatic progression-free survival Weak evidence favouring AAP Symptomatic skeletal events No good evidence of a difference Cause-specific survival Overall survival Proportionately different time spent in each disease state Hazard ratio Toxicity profiles quite different and well known
27 Adverse events worst toxicity ever Safety population SOC+DocP SOC+AAP Patients included in adverse event analysis 172 (91%) 373 (>99%) Grade 1+ AE 172 (100%) 370 (99%) Grade 3+ AE 86 (50%) 180 (48%) Grade 3+ AEs by category (incl. expected AEs) Endocrine disorder (incl. hot flashes, impotence) 15 (9%) 49 (13%) Febrile neutropenia 29 (17%) 3 (1%) Neutropenia 22 (13%) 4 (1%) Musculoskeletal disorder: 9 (5%) 33 (9%) Cardiovascular disorder (incl. hypertension, MI, cardiac dysrhythmia): 6 (3%) 32 (9%) Gastrointestinal disorder: 9 (5%) 28 (8%) Hepatic disorder (incl. increased AST, increased ALT): 1 (1%) 32 (9%) General disorder (incl. fatigue, oedema): 18 (10%) 21 (6%) Respiratory disorder (incl. breathlessness): 12 (7%) 11 (3%) Renal disorder 5 (3%) 20 (5%) Lab abnormalities (incl. hypokalaemia): 9 (5%) 11 (3%)
28
29
30
31 Implicaciones de las terapias posteriores a Docetaxel Datos retrospectivos de seguimiento GETUG-15
32 First-line Docetaxel in mcrpc setting in <br />GETUG AFU-15 Trial Presented By Neeraj Agarwal at 2018 ASCO Annual Meeting
33
34
35
36 SIOG classification for advanced prostate cancer Vall d'hebron Institute of Oncology (VHIO) Droz et al. BJU Int 2010, 106,
37 FÁRMACO Docet axel (vial 140 mg) 1 vial Abirat erona (comp. 500 mg) 60 comp Precio unit ario 307, 79 (PVL) (PVL) (* ) Posología 75 mg/m 2 iv c/3 sem 1000 mg/día vo Dosis (Sc =1, 75 m 2 ) Cost e x ciclo Cost e x mes Cost e x mes + pred. Cost e t rat amient o complet o (* * * ) 132 mg 1000 mg = 2 comp/día 290,2 (**) 2.935,3 1 Ciclo = 28 días días (1 mes) , días (1 mes) , , 21 (*): PVL -7,5% RDL 8/2010 (**) Con aprovechamiento de viales para el caso de Docetaxel (***) Calculado para 6 ciclos de docetaxel = 4,5 meses) y 33 meses de tratamiento con Abiraterona (Ensayos CHAARTED y LATITUDE Cortesia de Jordi Gines
38 Conclusiones Docetaxel y Abiraterona son tratamiento estandar en CPHSm En enfermedad de alto volumen ambas opciones han demostrado mismo impacto en SG con diferencias en duración tto, tolerancia y coste Que hacer en enfermedad de bajo volumen? No disponemos de datos prospectivos para la mejor secuencia posterior
39 GRACIAS
Current role of chemotherapy in hormone-naïve patients Elena Castro
Current role of chemotherapy in hormone-naïve patients Elena Castro Spanish National Cancer Research Centre Lugano, 17 October 2017 Siegel, Ca Cancer J Clin,2017 Buzzoni, Eur Urol, 2015 -Aprox 15-20% of
More informationHormone sensitive prostate cancer To add abiraterone or docetaxel? Dr Lisa Pickering
> Hormone sensitive prostate cancer To add abiraterone or docetaxel? Dr Lisa Pickering Disclosures Institutional Research Support/P.I. Employee Consultant Major Stockholder Speakers Bureau Honoraria Scientific
More informationFocus sulla malattia metastatica ormonosensibile (mhspc) ADT e Terapia ormonale: quando e a chi?
Focus sulla malattia metastatica ormonosensibile (mhspc) ADT e Terapia ormonale: quando e a chi? Paolo Andrea Zucali Dipartimento di Oncologia HUMANITAS CANCER CENTER Rozzano - Milano AGENDA Literature
More informationÁLVARO PINTO. Servicio de Oncología Médica Hospital Universitario La Paz IdiPAZ, Madrid
ACTUALIZACIÓN EN EL ABORDAJE DEL CÁNCER DE PRÓSTATA METASTÁSICO HORMONO--SENSIBLE HORMONO ÁLVARO PINTO Servicio de Oncología Médica Hospital Universitario La Paz IdiPAZ, Madrid ADT + docetaxel: a new standard
More informationFrancesco Massari Oncologia Medica Azienda Ospedaliero Universitaria di Bologna Policlinico S. Orsola-Malpighi
Focus sulla malattia metastatica ormonosensibile (mhspc) ADT e Chemioterapia: quando e a chi? Francesco Massari Oncologia Medica Azienda Ospedaliero Universitaria di Bologna Policlinico S. Orsola-Malpighi
More informationPerspective on endocrine and chemotherapy agents. Cora N. Sternberg Department of Medical Oncology San Camillo & Forlanini Hospitals Rome, Italy
Perspective on endocrine and chemotherapy agents Cora N. Sternberg Department of Medical Oncology San Camillo & Forlanini Hospitals Rome, Italy Disclosures Dr. Sternberg has received research funding for
More informationWhat will change for men with advanced prostate cancer in the next 24 months? ESO Observatory: Perspective on endocrine and chemotherapy agents
Perspective on endocrine and chemotherapy agents Cora N. Sternberg Department of Medical Oncology San Camillo & Forlanini Hospitals Rome, Italy Disclosures Dr.Sternberg has received research funding for
More informationChemohormonal Therapy For Prostate Cancer. What is old, is new again!
Chemohormonal Therapy For Prostate Cancer What is old, is new again! Mount Tremblant January 20, 2017 Kala S. Sridhar MD, MSc, FRCPC Medical Oncologist, Princess Margaret Hospital Head, GU Medical Oncology
More informationESMO SUMMIT AFRICA Practice changing studies in Prostate Cancer in 2016 and 2017 and cost-effectiveness Ronald de Wit
ESMO SUMMIT AFRICA 2018 Practice changing studies in Prostate Cancer in 2016 and 2017 and cost-effectiveness Ronald de Wit CONFLICT OF INTEREST DISCLOSURE Sub-title Sanofi Roche Merck Lilly 14 years of
More informationEarly Chemotherapy for Metastatic Prostate Cancer
Early Chemotherapy for Metastatic Prostate Cancer Daniel P. Petrylak, MD Professor of Medicine and Urology Smilow Cancer Center Yale University Medical Center Disclosure Consultant: Sanofi Aventis, Celgene,
More informationmcrpc 2014 TRA EVOLUZIONE E RIVOLUZIONE: COME ORIENTARSI NEL LABIRINTO DELLE TERAPIE
mcrpc 2014 TRA EVOLUZIONE E RIVOLUZIONE: COME ORIENTARSI NEL LABIRINTO DELLE TERAPIE IL CARCINOMA PROSTATICO, UNA MALATTIA ETEROGENEA? RAZIONALE E RISULTATI DEL TRATTAMENTO CHEMIOTERAPICO ASSOCIATO ALL
More informationNuevas perspectivas en el cáncer de próstata hormono-sensible metastásico Tratamiento actual del cáncer de próstata. Situación de Enzalutamida
Nuevas perspectivas en el cáncer de próstata hormono-sensible metastásico Tratamiento actual del cáncer de próstata. Situación de Enzalutamida Dr Pablo Maroto Hospital Sant Pau Dr Pablo Maroto Hospital
More informationCancer de la prostate métastatique: prise en charge précoce
Cancer de la prostate métastatique: prise en charge précoce Stéphane Oudard, MD, PhD Georges Pompidou Hospital, Oncology Department, Paris, France stephane.oudard@egp.aphp.fr SAGB.CAB.14.08.0382c 3/02/2016
More informationInitial Hormone Therapy
Initial Hormone Therapy Alan Horwich Institute of Cancer Research and Royal Marsden Hospital, London, UK Alan.Horwich@icr.ac.uk MANAGEMENT OF PROSTATE CANCER Treatment windows Subclinical Localised PSA
More informationSESSIONE PLATINUM SERIES (Best Papers Poster o Abstract on Prostate Cancer) In Oncologia
SESSIONE PLATINUM SERIES (Best Papers Poster o Abstract on Prostate Cancer) In Oncologia Divisione di Oncologia Medica Unità Tumori Genitourinari SESSIONE PLATINUM SERIES (Best Papers Poster o Abstract
More informationUPDATE ON RECENT CUTTING-EDGE TRIALS: TREATMENTS NOW AVAILABLE FOR NEWLY DIAGNOSED mhspc PATIENTS
UPDATE ON RECENT CUTTING-EDGE TRIALS: TREATMENTS NOW AVAILABLE FOR NEWLY DIAGNOSED mhspc PATIENTS Dr. Neal Shore, Carolina Urologic Research Centre, USA Assoc. Prof. Neeraj Agarwal, Huntsman Cancer Institute,
More informationReview of the Stampede Results. Charles Ryan MD University of California San Francisco
Review of the Stampede Results Charles Ryan MD University of California San Francisco Se#ng and hypothesis Se
More informationADVANCES IN METASTATIC HORMONE-SENSITIVE PROSTATE CANCER. ALICIA K. MORGANS, MD, MPH Associate Professor of Medicine Northwestern University, USA
ADVANCES IN METASTATIC HORMONE-SENSITIVE PROSTATE CANCER ALICIA K. MORGANS, MD, MPH Associate Professor of Medicine Northwestern University, USA MAY 2018 DISCLAIMER Please note: The views expressed within
More informationNOVITÀ IN TEMA DI NEOPLASIA DELLA PROSTATA L ALGORITMO TERAPEUTICO NEL CARCINOMA DELLA PROSTATA METASTATICO SENSIBILE ALLA CASTRAZIONE
NOVITÀ IN TEMA DI NEOPLASIA DELLA PROSTATA L ALGORITMO TERAPEUTICO NEL CARCINOMA DELLA PROSTATA METASTATICO SENSIBILE ALLA CASTRAZIONE S.S. Oncologia Medica Genitourinaria Outline 1. Clinical case 2. Chemotherapy
More informationInitial Hormone Therapy
Initial Hormone Therapy Alan Horwich Institute of Cancer Research and Royal Marsden Hospital, London, UK Alan.Horwich@icr.ac.uk MANAGEMENT OF PROSTATE CANCER Treatment windows Subclinical Localised PSA
More informationOptimizing Outcomes in Advanced Prostate Cancer
Optimizing Outcomes in Advanced Prostate Cancer Module 3: Focus on Recent CRPC Guidelines and Advanced Hormone-Sensitive Disease Sébastien J. Hotte, MD, MSc (HRM), FRCPC Medical Oncologist and Head, Phase
More informationMETASTATIC PROSTATE CANCER MANAGEMENT K I R U B E L T E F E R A M. D. T R I H E A LT H C A N C E R I N S T I T U T E 0 1 / 3 1 /
METASTATIC PROSTATE CANCER MANAGEMENT K I R U B E L T E F E R A M. D. T R I H E A LT H C A N C E R I N S T I T U T E 0 1 / 3 1 / 2 0 1 8 Prostate Cancer- Statistics Most common cancer in men after a skin
More information2014 Treatment Paradigms in mcrpc Docetaxel in hormone sensitive PC
Ronald de Wit Erasmus MC Cancer Institute The Netherlands 2014 Treatment Paradigms in mcrpc Docetaxel in hormone sensitive PC Disclosures Sanofi ; research grant support, consultancy and speaker fees Astellas;
More informationManagement of Prostate Cancer
Management of Prostate Cancer An ESMO Perspective Alan Horwich Conflicts of Interest Disclosure Alan Horwich I have no personal conflicts of interest relating to prostate cancer. European Incidence and
More informationProstate cancer Management of metastatic castration sensitive cancer
18 th Annual Advances in Oncology - 2017 Prostate cancer Management of metastatic castration sensitive cancer Urothelial carcinoma Non-muscle invasive urothelial carcinoma Updates in metastatic urothelial
More informationInitial hormone therapy (and more) for metastatic prostate cancer
Initial hormone therapy (and more) for metastatic prostate cancer Silke Gillessen, MD Medical Oncology Kantonsspital St.Gallen Switzerland silke.gillessen@kssg.ch Conflicts of interest Speakers Bureau
More informationAdvanced Prostate Cancer. SAMO Masterclass 17 th of March 2017 PD Dr. med. Aurelius Omlin
Advanced Prostate Cancer SAMO Masterclass 17 th of March 2017 PD Dr. med. Aurelius Omlin aurelius.omlin@kssg.ch Conflicts of Interest Research Support: TEVA, Janssen Advisory Rolle: Astra Zeneca, Astellas,
More informationPLAATS VAN DE CHEMOTHERAPIE IN DE BEHANDELING VAN EEN PROSTAATCARCINOOM: EEN UPDATE. Daan De Maeseneer, Medisch Oncoloog
PLAATS VAN DE CHEMOTHERAPIE IN DE BEHANDELING VAN EEN PROSTAATCARCINOOM: EEN UPDATE Daan De Maeseneer, Medisch Oncoloog 1 Overview DEAT PSA/Tumor Burden METASTASES INITIAL DIAGNOSIS & THERAPY ADT CRP SREs/
More informationAdvanced Prostate Cancer
Advanced Prostate Cancer SAMO Masterclass 4 th March 2016 Aurelius Omlin Conflicts of interest Advisory Rolle: Astra Zeneca, Astellas, Bayer, Janssen, Pfizer, Sanofi Aventis Research support: TEVA, Janssen
More informationSIMPOSIO. Radioterapia stereotassica e nuovi farmaci nel tumore e della prostata metastatico
SIMPOSIO Radioterapia stereotassica e nuovi farmaci nel tumore e della prostata metastatico Definition of Oligometastatic PCa 1-3 synchronous metastases (bone and/or lymph nodes) 2-5 synchronous metastases
More informationPlease consider the following information on ZYTIGA (abiraterone acetate). ZYTIGA - Compendia Communication - NCCN LATITUDE and STAMPEDE June 2017
Page 1 of 2 Janssen Scientific Affairs, LLC 1125 Trenton-Harbourton Road PO Box 200 Titusville, NJ 08560 800.526.7736 tel 609.730.3138 fax June 08, 2017 Joan McClure 275 Commerce Drive #300 Fort Washington,
More informationPhilip Kantoff, MD Dana-Farber Cancer Institute
CHEMOTHERAPY FOR MCRPC Philip Kantoff, MD Dana-Farber Cancer Institute Harvard Medical School 1 Disclosure of Financial Relationships With Any Commercial Interest Name Nature of Financial Commercial Interests
More informationConvegno Nazionale AIOM Giovani 2016: News in Oncology. Daniele Alesini. Istituto Nazionale dei Tumori Regina Elena
Convegno Nazionale AIOM Giovani 2016: News in Oncology Daniele Alesini Istituto Nazionale dei Tumori Regina Elena Something Old Something New Something Borrowed Something Blue DOCETAXEL: BACK AND FORTH
More informationLATITUDE and other coordinates in quality of life of prostate cancer patients
Editorial LATITUDE and other coordinates in quality of life of prostate cancer patients Maria Lucia Reale 1,2, Consuelo Buttigliero 1,2, Marcello Tucci 1,2, Rosario F. Di Stefano 1,2, Francesca Vignani
More informationSUMMARY. 3. Emerging understanding of mechanisms of resistance to current treatments
SUMMARY 1. Discuss the active agents in prostate cancer currently available in Australia 2. Celebrate the growing role for Prostate Medical Oncologists in Multi Disc Teams active treaments overall survival
More informationUntil 2004, CRPC was consistently a rapidly lethal disease.
Until 2004, CRPC was consistently a rapidly lethal disease. the entry in systemic disease is declared on a an isolated PSA recurrence after local treatment so!!! The management of CRPC and MCRPC is different
More informationACTUALIZACIONES EN TRATAMIENTOS DIRIGIDOS AL HUESO. COMBINACIÓN CON OTRAS ESTRATEGIAS TERAPÉUTICAS.
ACTUALIZACIONES EN TRATAMIENTOS DIRIGIDOS AL HUESO. COMBINACIÓN CON OTRAS ESTRATEGIAS TERAPÉUTICAS. ÁLVARO PINTO Servicio de Oncología Médica Hospital Universitario La Paz IdiPAZ, Madrid INTRODUCTION High
More informationOligometastasis. Körperstereotaxie bei oligo-metastasiertem Prostatakarzinom wann und wie in Kombination mit Systemtherapie?
Körperstereotaxie bei oligo-metastasiertem Prostatakarzinom wann und wie in Kombination mit Systemtherapie? Daniel M. Aebersold 09. Dezember 2016 Oligometastasis JCO, 1995 1 Oligometastasis: Chance for
More informationSession 4 Chemotherapy for castration refractory prostate cancer First and second- line chemotherapy
Session 4 Chemotherapy for castration refractory prostate cancer First and second- line chemotherapy October- 2015 ESMO 2004 October- 2015 Fyraftensmøde 2 2010 October- 2015 Fyraftensmøde 3 SWOG 9916 OS
More informationNovel treatment for castration-resistant prostate cancer
Novel treatment for castration-resistant prostate cancer Cora N. Sternberg, MD, FACP Chair, Department of Medical Oncology San Camillo and Forlanini Hospitals Rome, Italy Treatment options for patients
More informationUpdates in Prostate Cancer Treatment 2018
Updates in Prostate Cancer Treatment 2018 Mountain States Cancer Conference Elaine T. Lam, MD November 3, 2018 Learning Objectives Understand the difference between hormone sensitive and castration resistant
More informationADT vs chemo + ADT as initial treatment for advanced prostate cancer
ADT vs chemo + ADT as initial treatment for advanced prostate cancer By Hussein Khaled Prof. Medical Oncology Cairo University Possible Levels of Prostate Cancer At Diagnosis Local-Regional Disease Spread
More informationSYSTEMIC THERAPIES FOR CRPC: Chemotherapy and Radium-223
SYSTEMIC THERAPIES FOR CRPC: Chemotherapy and Radium-223 ELENA CASTRO Spanish National Cancer Research Centre Prostate Preceptorship. Lugano 4-5 October 2018 Disclosures Participation in advisory boards:
More informationManagement of castrate resistant disease: after first line hormone therapy fails
Management of castrate resistant disease: after first line hormone therapy fails Rob Jones Consultant in Medical Oncology Beatson Cancer Centre Glasgow Relevant Disclosure I have received research support
More informationSequencing Strategies in Metastatic Castration Resistant Prostate Cancer (MCRPC)
Sequencing Strategies in Metastatic Castration Resistant Prostate Cancer (MCRPC) Amit Bahl Consultant Oncologist Bristol Cancer Institute Clinical Director Spire Specialist Care Centre UK Disclosures Advisory
More informationASCO 2012 Genitourinary tumors
ASCO 2012 Genitourinary tumors Post ASCO Bern 14-06-2012 Dr. med. Richard Cathomas leitender Arzt Onkologie, KSGR, Chur Renal cell cancer Changes in first line treatment? Prostate cancer 3 positive phase
More informationStrategic decisions for systemic treatment. metastatic castration resistant prostate cancer (mcrpc)
Strategic decisions for systemic treatment metastatic castration resistant prostate cancer (mcrpc) SAMO Luzern 14.09.2012 Richard Cathomas Onkologie Kantonsspital Graubünden richard.cathomas@ksgr.ch mcrpc
More informationAdvanced Prostate Cancer
Advanced Prostate Cancer January 13, 2017 Sindu Kanjeekal MD FRCPC Medical Oncology and Hematology Regional Systemic Quality Lead Erie St Clair Adjunct Professor Schulich School of Medicine and University
More informationSecondary Hormonal therapies in mcrpc
Secondary Hormonal therapies in mcrpc Ravindran Kanesvaran Consultant,Division of Medical Oncology National Cancer Centre Singapore 1 Disclosures Research Support/P.I. Sanofi Consultant Major Stockholder
More informationManagement of chronic pre-existing or treatment-emergent adverse events of the other systemic therapies. Michael J. Morris, MD
Management of chronic pre-existing or treatment-emergent adverse events of the other systemic therapies Michael J. Morris, MD www.mskcc.org Disclosures Research funding (institutional contracts): Sanofi
More informationGroup Sequential Design: Uses and Abuses
Group Sequential Design: Uses and Abuses Susan Halabi Department of Biostatistics and Bioinformatics, Duke University October 23, 2015 susan.halabi@duke.edu What Does Interim Data Say? 2 Group Sequential
More informationJoelle Hamilton, M.D.
Joelle Hamilton, M.D. www.urologycentersalabama.com Case Presentation: CRPC, Rising PSA 70 yo healthy, fit, active man post RALP 8 years prior with rising PSA Rising PSA from 0.02 nadir to 3.4 thus ADT
More informationAdvanced Prostate Cancer. November Jose W. Avitia, M.D
Advanced Prostate Cancer November 4 2017 Jose W. Avitia, M.D In 2017 161,000 new cases of prostate cancer diagnosed in US, mostly with elevated PSA 5-10% will present with metastatic disease In 2017: 26,000
More informationSecond line hormone therapies. Dr Lisa Pickering Consultant Medical Oncologist ESMO Preceptorship Singapore 2017
Second line hormone therapies Dr Lisa Pickering Consultant Medical Oncologist ESMO Preceptorship Singapore 2017 Disclosures Institutional Research Support/P.I. Employee Consultant Major Stockholder Speakers
More informationAdvanced Prostate Cancer. Searching for Optimal Therapy Sequence and Assessing Emerging Treatment Options
Advanced Prostate Cancer Searching for Optimal Therapy Sequence and Assessing Emerging Treatment Options Disclaimer This slide deck in its original and unaltered format is for educational purposes and
More informationPublished on The YODA Project (
Principal Investigator First Name: David Last Name: Lorente Degree: MD Primary Affiliation: Medical Oncology Service, Hospital Provincial de Castellón E-mail: lorente.davest@gmail.com Phone number: +34
More informationLONDON CANCER NEW DRUGS GROUP RAPID REVIEW
LONDON CANCER NEW DRUGS GROUP RAPID REVIEW Abiraterone for the treatment of metastatic castration-resistant prostate cancer that has progressed on or after a docetaxel-based chemotherapy regimen Disease
More informationSergio Bracarda MD, Medical Oncology, Dept. Of Oncology Az. Ospedaliera S. Maria, Terni; Italy. Milano, 2 marzo 2019
Sergio Bracarda MD, Medical Oncology, Dept. Of Oncology Az. Ospedaliera S. Maria, Terni; Italy Milano, 2 marzo 2019 My Disclosure Adv. Board Member for: Pfizer, BMS, Novartis, MSD, Roche, Genentech, Astellas,
More informationManagement of castrate resistant disease; after first line hormone therapy fails
Management of castrate resistant disease; after first line hormone therapy fails Dr. Syed A Hussain Clinical Senior Lecturer and Consultant in Medical Oncology University of Liverpool and Clatterbridge
More informationFrancesco Massari Oncologia Medica Azienda Ospedaliero Universitaria di Bologna Policlinico S. Orsola-Malpighi
Prostata: Oral Communications Emerging strategies and controversial topics in advanced prostate cancer Francesco Massari Oncologia Medica Azienda Ospedaliero Universitaria di Bologna Policlinico S. Orsola-Malpighi
More informationManagement of mcrpc: Hormonal therapy and treatment sequence for CRPC
Management of mcrpc: Hormonal therapy and treatment sequence for CRPC Professor Bertrand Tombal, MD, PhD Cliniques universitaires Saint-Luc Université catholique de Louvain Brussels, Belgium Credentials
More informationChallenging Genitourinary Tumors: What s New in 2017
Challenging Genitourinary Tumors: What s New in 2017 David J. Vaughn, MD Genitourinary Medical Oncology Professor Please note that some of the studies reported in this presentation were presented as an
More informationNon metastatic castrate-resistant prostate cancer (M0 CRPC) Karim Fizazi, MD, PhD Institut Gustave Roussy Villejuif, France
Non metastatic castrate-resistant prostate cancer (M0 CRPC) Karim Fizazi, MD, PhD Institut Gustave Roussy Villejuif, France Disclosure Participation to advisory boards/honorarium for: Amgen, Astellas,
More informationHormonal Manipulations in CRPC. NW Clarke Professor of Urological Oncology Manchester UK
Hormonal Manipulations in CRPC NW Clarke Professor of Urological Oncology Manchester UK Standard Treatment of CRPC Pre 2004 (and in 2013?) PSA progression 99m Tc BS negative CT scan large lymph node component
More information8/31/ ) Intermittent androgen deprivation in androgen-sensitive PCa. 1) Alpharadin (Ra223) in CRPC with bone metastases
Bruce J. Roth, M.D. Clinical Trials: Medivation, Oncogenix 1) Alpharadin (Ra223) in CRPC with bone metastases 2) Enzalutamide (MDV-31) in CRPC and prior docetaxel 3) Abiraterone in chemo-naïve CRPC 4)
More informationHave we optimized the use of Androgen Receptor pathway targeted drugs in Castrate-Resistant Prostate Cancer?
Have we optimized the use of Androgen Receptor pathway targeted drugs in Castrate-Resistant Prostate Cancer? Karim Fizazi, MD, PhD Institut Gustave Roussy Villejuif, France Disclosure Participation to
More informationProstate cancer update: Dr Robert Huddart Cancer Clinic London
Prostate cancer update: 2013 Dr Robert Huddart Cancer Clinic London Recent developments Improved imaging New radiotherapy technologies Radiotherapy for advanced disease Intermittent hormone therapy New
More informationSequencing treatment for metastatic prostate cancer
11 Sequencing treatment for metastatic prostate cancer SOPHIE MERRICK, STYLIANI GERMANOU, ROGER KIRBY AND SIMON CHOWDHURY In the past 10 years there have been significant advances in the understanding
More informationProstate Cancer 2009 MDV Anti-Angiogenesis. Anti-androgen Radiotherapy Surgery Androgen Deprivation Therapy. Docetaxel/Epothilone
Prostate Cancer 2009 Anti-Angiogenesis MDV 3100 Anti-androgen Radiotherapy Surgery Androgen Deprivation Therapy Docetaxel/Epothilone Abiraterone DC therapy Bisphosphonates Denosumab Secondary Hormonal
More informationAndrogens and prostate cancer: insights from abiraterone acetate and other novel agents
Androgens and prostate cancer: insights from abiraterone acetate and other novel agents Ian Davis Ludwig Institute for Cancer Research Austin Health, Melbourne, Australia Supported in part by an Australian
More informationCastrate-resistant prostate cancer: Bone-targeted agents. Pr Karim Fizazi, MD, PhD Institut Gustave Roussy Villejuif, France
Castrate-resistant prostate cancer: Bone-targeted agents Pr Karim Fizazi, MD, PhD Institut Gustave Roussy Villejuif, France Disclosure Participation in advisory boards or as a speaker for: Amgen, Astellas,
More informationDevelopmental Therapeutics for Genitourinary Malignancies
Developmental Therapeutics for Genitourinary Malignancies Russell Szmulewitz, MD April 2018 Disclosure Information 23 rd Annual Developmental Therapeutics Symposium Name of Speaker I have the following
More informationHave we optimized the use of Androgen Receptor pathway targeted drugs in Castrate-Resistant Prostate Cancer?
Have we optimized the use of Androgen Receptor pathway targeted drugs in Castrate-Resistant Prostate Cancer? Karim Fizazi, MD, PhD Institut Gustave Roussy Villejuif, France Disclosure Participation to
More informationEvolution or revolution in the treatment of prostate cancer
Evolution or revolution in the treatment of prostate cancer de Johann Sebastian de Bono, MB, ChB, FRCP, MSc, PhD Professor of Experimental Cancer Medicine Department of Medicine/ Drug Development Unit
More informationSEQUENCING IN METASTATIC PROSTATE CANCER TREATMENT
SEQUENCING IN METASTATIC PROSTATE CANCER TREATMENT Eleni Maragkouli, Medical Oncologist Oncology Department The University of Thessaly, Medical School University Hospital of Larissa, Greece Tumour volume
More informationWhen exogenous testosterone therapy is. adverse responses can be induced.
Theoretical tips It has been reasoned that discontinuation of ADT in non orchiectomized patients may have detrimental effect on patients with CRPC as discontinuation of ADT can result in renewed release
More informationMAMTA PARIKH, MD, MS CHALLENGING CASE #2: GU CANCER & STATE OF THE ART: CASTRATION RESISTANT PROSTATE CANCER
MAMTA PARIKH, MD, MS CHALLENGING CASE #2: GU CANCER & STATE OF THE ART: CASTRATION RESISTANT PROSTATE CANCER NO RELEVANT FINANCIAL RELATIONSHIPS IN THE PAST TWELVE MONTHS BY PRESENTER OR SPOUSE/PARTNER.
More informationImmune Checkpoint Inhibitors for Lung Cancer William N. William Jr.
Immune Checkpoint Inhibitors for Lung Cancer William N. William Jr. Diretor de Onco-Hematologia Hospital BP, A Beneficência Portuguesa Non-Small Cell Lung Cancer PD-1/PD-L1 Inhibitors in second-line therapy
More informationMaintenance paradigm in non-squamous NSCLC
Maintenance paradigm in non-squamous NSCLC L. Paz-Ares Hospital Universitario Virgen del Rocío Sevilla Agenda Theoretical basis The data The comparisons Agenda Theoretical basis The data The comparisons
More informationPRO STATE of the art. METASTATIC HORMONE SENSITIVE PROSTATE CANCER Clinical case and evidences from literature
PRO STATE of the art METASTATIC HORMONE SENSITIVE PROSTATE CANCER Clinical case and evidences from literature Marcello Tucci, MD Department of Oncology San Luigi Gonzaga Hospital Orbassano, Turin 30 MAY
More informationWhen exogenous testosterone therapy is. adverse responses can be induced.
Theoretical tips It has been reasoned that discontinuation of ADT in nonorchiectomized patients may have detrimental effect on patients with CRPC as discontinuation of ADT can result in renewed release
More informationManagement of castration resistant prostate cancer after first line hormonal therapy fails
Management of castration resistant prostate cancer after first line hormonal therapy fails Simon Crabb Senior Lecturer in Medical Oncology University of Southampton WHAT ARE THE AIMS OF TREATMENT? Cure?
More informationManagement of Incurable Prostate Cancer in 2014
Management of Incurable Prostate Cancer in 2014 Julie N. Graff, MD, MCR Portland VA Medical Center Assistant Professor of Medicine Knight Cancer Institute, OHSU 2014: Cancer Estimates Stage at Diagnosis
More informationwww.drpaulmainwaring.com Figure 1 Androgen action Harris W P et al. (2009) Nat Clin Pract Urol doi:10.1038/ncpuro1296 Figure 2 Mechanisms of castration resistance in prostate cancer Harris W P et al. (2009)
More informationTaxanes and New hormonal agents: How they work?
Taxanes and New hormonal agents: How they work? Taxanes Microtubules are highly dynamic cytoskeletal fibres that are composed of tubulin of which are crucial to mitosis and cell division. Jordan Nat Rev
More informationESMO SUMMIT MIDDLE EAST 2018
ESMO SUMMIT MIDDLE EAST 2018 14 Years of progress in Prostate Cancer Standards of Care and new targets Name Ronald de Wit 6-7 April 2018, Dubai, UAE CONFLICT OF INTEREST DISCLOSURE Sub-title Sanofi Roche
More informationImproving outcomes as rapidly as possible for patients. Multi-arm, multi stage platform, umbrella and basket protocols
Improving outcomes as rapidly as possible for patients Multi-arm, multi stage platform, umbrella and basket protocols Mahesh Parmar MRC Clinical Trials Unit at UCL Institute of Clinical Trials and Methdology
More informationRadical Prostatectomy: Management of the Primary From Localized to Oligometasta:c Disease
Radical Prostatectomy: Management of the Primary From Localized to Oligometasta:c Disease Disclosures I do not have anything to disclose Sexual function causes moderate to severe distress 2 years after
More informationFUJI study: Follow-Up of Jevtana in real life
Pharmacologie médicale Bordeaux PharmacoEpi CIC Bordeaux CIC1401 FUJI study: Follow-Up of Jevtana in real life French retrospective and protective multicenter observational study describing the survival,
More informationPatients Living Longer: The Promise of Newer Therapies
Patients Living Longer: The Promise of Newer Therapies David M. Nanus, MD! Chief, Division of Hematology and Medical Oncology! Weill Cornell Medicine! New York Presbyterian Hospital!! Demographics 180,890
More information- La Terapia Farmacologica -
XXV Congresso Nazionale AIRO Simposio AIRO-AIMN: Trattamento delle Metastasi Ossee nel Paziente con Tumore della Prostata "Ormonorefrattario": - La Terapia Farmacologica - Sergio Bracarda, Medical Oncology
More informationRecent advances in the management of metastatic breast cancer in older adults
Recent advances in the management of metastatic breast cancer in older adults Laura Biganzoli Medical Oncology Dept New Hospital of Prato Istituto Toscano Tumori Italy Important recent advances in the
More informationSOGUG meeting New drugs after docetaxel chemotherapy in patient with mcrpc
SOGUG meeting New drugs after docetaxel chemotherapy in patient with mcrpc Stéphane OUDARD, MD, PhD Head of the Oncology department Georges Pompidou Hospital, Paris France University Rene Descartes, Paris
More informationDr. Tia Higano University of Washington Seattle, USA
AN UPDATE ON THE TREATMENT OF PATIENTS WITH mcrpc WITH RA-223 PLUS AAP Dr. Tia Higano University of Washington Seattle, USA AAP, Abiraterone Acetate and Prednisone/Prednisolone; mcrpc, metastatic Castration-Resistant
More informationInibitori delle chinasi ciclino dipendenti nel trattamento della malattia metastatica HR-positiva Gli studi clinici
Inibitori delle chinasi ciclino dipendenti nel trattamento della malattia metastatica HR-positiva Gli studi clinici Laura Orlando UOC Oncologia & Breast Unit Brindisi Verona 22/04/2016 Summary Studi con
More informationCirculating tumor cells as biomarker for hormonal treatment in breast and prostate cancer. Michal Mego
National Cancer Institute, Slovakia Translational Research Unit Circulating tumor cells as biomarker for hormonal treatment in breast and prostate cancer Michal Mego 2 nd Department of Oncology, Faculty
More informationIndex Patients 3& 4. Guideline Statements 10/11/2014. Enzalutamide Reduced the Risk of Death
//4 Prolonged Radiographic Progression-Free Survival Reduced the Risk of Death Overall ITT Population Estimated median rpfs, months (9% CI): : NYR (.8 NYR); placebo:.9 (.7.4) rpfs (%) ( Enza 9 8 7 4 8
More informationX, Y and Z of Prostate Cancer
X, Y and Z of Prostate Cancer Dr Tony Michele Medical Oncologist Prostate cancer Epidemiology Current EUA (et al) guidelines on Advanced Prostate Cancer Current clinical management in specific scenarios
More informationHormone therapy works best when combined with radiation for locally advanced prostate cancer
Hormone therapy works best when combined with radiation for locally advanced prostate cancer Phichai Chansriwong, MD Ramathibodi Hospital, Mahidol University Introduction Introduction 1/3 of patients
More informationThe State of Cancer Care: Reflections from the 2017 ASCO Annual Meeting
The State of Cancer Care: Reflections from the 2017 ASCO Annual Meeting Margaret Tempero, M.D. Director, Pancreas Center, University of California, San Francisco Editor-in-Chief, Journal of the National
More information