Bobby Liaw, MD: The statistics of prostate cancer are coming out very fast. I think it’s probably best to think about some of the ongoing trends in prostate cancer. 1 The trend we’ve been seeing consistently over the years is that some of our more “advanced drugs” that we used to reserve for castration-resistant prostate cancer are gradually shifting from non-metastatic to castration-resistant prostate cancer. are being transferred to. castration resistant prostate cancer; In hormone-sensitive prostate cancer settings, to the point where I think combination therapy for hormone-sensitive prostate cancer should really be considered standard care at this point. But even on top of that, we’re starting to see drugs like abiraterone in localized prostate cancer. Recent studies and recently stamped data have shown that ADT. addition of abiraterone to [androgen deprivation therapy] Additional benefit for 2 years appears to add up in patients receiving definitive radiation therapy. So, we’re probably going to start seeing our more advanced drugs find their way into earlier stages of the disease. I think we need to be prepared for this.
Because of this trend, I think it is going to be very important, more than ever, to have a more multidisciplinary approach to prostate cancer management. Urologists and radiation oncologists may not necessarily be in a position to cooperate with medical oncologists at certain stages of the disease. We’re going to start to see the standard of care move a little further as some of the new data become more adopted in the guidelines.
I think triple therapy is very exciting, and I’m definitely interested to try and see how to adapt it to my own clinical practice. But for the topic of advancing treatment for better disease control and overall survival to pay very high dividends down the road, I think we need to offer patients a potentially more difficult-to-sell treatment. Need to be more prepared. They don’t necessarily want a ton of treatment already, but we need to set an expectation that we have all the things we can. There are ways for us to optimize our treatments, but our way of optimizing it may be to use a little more of an already aggressive treatment so that we can enjoy better disease control down the line.
Atish Choudhary, MD, PhD: This is a constantly updating space in castration-sensitive prostate cancer, and I think it really requires multi-model evaluation of different patients. This includes communication between the urologist and medical oncologist for evaluation of chemotherapy, and between radiation oncologists for evaluation of radiation at sites of disease.
Certainly, more elderly patients would benefit from geriatric assessment to assess their ability to tolerate various treatments. We need to join hands with our colleagues in cardiology and endocrinology to help manage side effects. Often these patients have social challenges or difficulties with lifestyle. referral for social work, referral for nutrition, and ensuring that people are eating a healthy diet, exercising regularly, and managing their adverse events appropriately is the key to doing.
Therefore, it is up to us as providers to ensure that patients are connected to appropriate supportive care, and then on patients to make good choices in terms of lifestyle, diet, exercise, staying socially active. It takes a lot. Cognitively active, to do as well as possible on these treatments. Much progress has been made in hormone-sensitive prostate cancer.
Survival has become quite long. Some patients can actually stop treatment and still retain benefits, so this is an ever-changing place. We need to be patient-to-patient, and make sure our recommendations are truly personalized.
Transcript edited for clarity.
