Prostate Cancer Personalized Therapy

CE / CME

Expert Think Tank on Applying the Latest Data to Individualize Treatment in Prostate Cancer

Pharmacists: 1.00 contact hour (0.1 CEUs)

Nurses: 1.00 Nursing contact hour

Physicians: Maximum of 1.00 AMA PRA Category 1 Credit

Released: August 16, 2023

Expiration: August 15, 2024

Activity

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Introduction

In this module, Alicia K. Morgans, MD, MPH, leads a discussion with colleagues—Tanya B. Dorff, MD; Rana R. McKay, MD; Michael T. Schweizer, MD; and David VanderWeele, MD, PhD—on incorporating the latest evidence on prostate cancer therapy into clinical practice including challenging case scenarios.

The key points discussed in this module are illustrated with thumbnails from the accompanying downloadable PowerPoint slideset that can be found here or downloaded by clicking any of the slide thumbnails in the module alongside the expert commentary.

Clinical Care Options plans to measure the educational impact of this activity. Several questions will be asked twice: once at the beginning of the activity, and then once again after the discussion that informs the best choice. Your responses will be aggregated for analysis, and your specific responses will not be shared.

Before continuing with this educational activity, please take a moment to answer the following questions.

For those providing patient care, how many patients with prostate cancer do you provide care for in a typical month?

A 58-year-old man presents with recent onset of diffuse bone pain. His digital rectal examination was abnormal and his prostate-specific antigen (PSA) was 228 ng/mL. A prostate biopsy reported adenocarcinoma Gleason 4+5 in multiple cores. A bone scan revealed extensive bone metastases.

In your current practice, what would you recommend for this patient?

Your patient is 72 years of age and an active hiker. He previously received docetaxel, abiraterone, and cabazitaxel for mCRPC. He has no actionable germline or tumor genetic mutations. His disease is progressing by imaging with metastatic bone disease and his PSA levels are increasing. He states he has no bone pain. His primary goal of therapy is improved survival.

How would you counsel this patient about his next available therapeutic options?

The patient is a 62-year-old man with recurrent, metastatic prostate cancer. He initially underwent prostatectomy. On PSA recurrence he was treated with salvage radiotherapy to the prostate bed. His PSA continues to increase over the next year, and he receives treatment with leuprolide monotherapy. After 2 years, conventional imaging reveals new bone and several small pulmonary metastases, his PSA continues to rise, and he now has metastatic castration-resistant prostate cancer (mCRPC). Somatic testing reveals that his tumor has a BRCA2 mutation. The patient prefers to avoid chemotherapy and wishes to be aggressive in managing his disease.

Which of the following would you recommend?

With which of the following patients would you discuss the possibility of enrolling on the phase III CYCLONE 3 trial of abemaciclib plus abiraterone/prednisone?