University of North Carolina Medical Center University of North Carolina Eshelman School of Pharmacy Chapel Hill, North Carolina
During this session updates in both metastatic hormone sensitive prostate cancer (mHSPC) as well as metastatic castration resistant prostate cancer (mCRPC) will be discussed. There has been a trend towards treatment intensification in mHSPC since 2015. Since then, docetaxel, abiraterone, enzalutamide and apalutamide have been approved in combination with androgen deprivation therapy (ADT) and all have been shown to improve overall survival. Now with the data from two new studies, PEACE-1 and ARASENS, there may be a shift towards triple therapy. Treatment with ADT, docetaxel and an androgen receptor axis inhibitor may become a new standard in certain patient populations. In addition prostate cancer imaging with prostate specific membrane antigen (PSMA) positron emission tomography (PET) scans have emerged as a more accurate imaging strategy for assessing patients with prostate cancer. In the past 2 years the FDA has approved 2 PSMA-PET imaging agents for suspected metastasis and prostate cancer recurrence. The PSMA-PET has also allows for assessing patients who may be candidates for PSMA directed therapy with 177Lutetium-PSMA-617 (177Lu-PSMA-617). 177Lu-PSMA-617 is a novel radiotherapy that delivers beta particle radiation to PSMA positive cells and surrounding microenvironment. 177Lu-PSMA-617 has been studied in the VISION trial and TheraP trial and pending FDA approval will be another agent added to the treatment landscape for men with metastatic castration resistant prostate cancer.
Learning Objectives:
Discuss trend towards treatment intensification in metastatic hormone sensitive prostate cancer.
Apply data from PEACE-1 and ARASENS to current landscape of treatment options in metastatic hormone sensitive prostate cancer.
Assess data surrounding the use of 177-Lutetium-PSMA-617 in metastatic castrate resistant prostate cancer