Develop personalised treatment plans for diverse patients with advanced prostate cancer

Summary

Join this invaluable on-demand teaching session with Dakim Gaines, focusing on the personalized treatment of diverse patients suffering from advanced prostate cancer. Delve into the intricacies of patient-centered care and explore the various treatment options - from surgery, radiation, and Androgen Deprivation Therapy (ADT) to chemotherapy. Understand how these treatments fit into a patient's care, learn about potential side effects, and examine detailed clinical case studies that provide a realistic understanding of prostate cancer management. You'll also explore recent clinical trial data that influences the current treatment standard. Ideal for any aspiring medical professional, this session imparts practical knowledge to help you deliver optimal, individualized care to sufferers of advanced prostate cancer.

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Description

This program is funded by an independent grant from Merck. This online education program has been designed solely for healthcare professionals in the USA. The content is not available for healthcare professionals in any other country.

Join our global experts for this accredited CME course on Advanced Prostate Cancer. The course is presented by leading Urology & Oncology experts, integrating the latest clinical insights into monotherapy and combination treatments for advanced prostate cancer. Hone your skills in developing personalized treatment plans for a diverse range of patients and settings, while integrating a multidisciplinary approach.

Appraise and apply current clinical trial data to clinical practice

Our expert speakers will translate existing and emerging data from clinical trials on both monotherapy and combination therapy into practical treatment approaches for patients with advanced prostate cancer. This course is designed to equip physicians with the knowledge to integrate the latest research findings into effective patient care strategies, critically appraising the quality and relevance of clinical studies to ensure that treatment decisions are centered around reliable and applicable evidence.

Develop personalized treatment plans for diverse patients

Our experts will share how to integrate detailed patient information with data from clinical trials on prostate cancer monotherapies and combination therapies. They will provide a framework to guide treatment approaches that are tailored to the individual needs of each patient. Attendees will be trained to balance the potential risks and benefits of various therapy options, ensuring that the chosen approach aligns with patient preferences and clinical requirements. This comprehensive strategy is aimed at optimizing treatment outcomes by addressing the unique circumstances of each patient.

Integrate multidisciplinary approaches when developing management plans for patients Attendees will learn to engage and collaborate effectively with a diverse team of professionals, including radiologists, pathologists, palliative care clinicians, urologists, oncologists, and research professionals. This collaboration is crucial for guiding comprehensive treatment planning for advanced prostate cancer. The course will cover how to optimize the unique resources and strengths of different treatment settings to enhance the multidisciplinary care of patients. This approach aims to foster a cohesive and holistic treatment environment that leverages the expertise of various specialists to improve patient outcomes.

Who is this course for

This online education program has been designed solely for healthcare professionals in the USA. The course provides continuing education for:

✅ Urologists

✅ Radiation oncologists

✅ Medical oncologists

✅ Clinical oncologists

✅ Urologic oncologists

✅ Pathologists

✅ Genetic testing experts

✅ Nuclear medicine physicians

✅ Family Physicians

✅ Physicians

✅ Physician Assistants

✅ Nurse Practitioners

✅ Other Health Professionals

Faculty

Professor Shawn Dason

Professor Dason specializes in surgical treatments for a range of cancers, including those of the prostate, kidney, and bladder, employing advanced techniques such as robotic and laparoscopic surgery. His practice is deeply rooted in understanding patient needs, tailoring care plans to individual goals, and ensuring clarity in communication about disease and treatment paths. Beyond surgery, Professor Dason is an advocate for multidisciplinary care and considers alternative treatments when they offer better outcomes. As an assistant professor in the Department of Urology at The Ohio State University College of Medicine, he contributes significantly to the field through both teaching and research. Recognized for his contributions, particularly in bladder cancer genomics, Professor Dason has received national awards and has an extensive publication record. His work at The James signifies a commitment to excellence in patient care, education, and research at one of the country's foremost cancer centers.

Professor Dakim Gaines

Professor Dakim Gaines is an Assistant Professor of Radiation Oncology at the Vanderbilt-Ingram Cancer Center. He earned his M.D./Ph.D. from Rutgers University after studying molecular biology at St. Mary's College of Maryland. Dr. Gaines completed his residency at Vanderbilt University Medical Center, engaging in the ABR Holman Pathway to research immunologic responses in kidney cancer post-SBRT. He specializes in genitourinary cancers and palliative radiotherapy and has been honored with multiple awards, including the 2021 ECOG-ACRIN Minority Scholarship Award.

Dr Andrew Laccetti

Dr. Andrew Laccetti earned his M.D. from Albany Medical College and an M.S. in Healthcare Leadership from Union College, NY. His residency in internal medicine was at UT Southwestern, Dallas, where he was also chief resident. He further specialized in medical oncology at the University of Texas MD Anderson Cancer Center. Now an Assistant Attending Physician at Memorial Sloan Kettering Cancer Center's Genitourinary Oncology Service, Dr. Laccetti's research focuses on androgen receptor signalling inhibitors in prostate cancer, investigating their long-term toxicities, and exploring remote monitoring techniques for cancer patients using innovative healthcare technologies.

Jeremy Patch, Director of Patient Programs at ZERO Prostate Cancer

For more than 25 years, ZERO Prostate Cancer has helped people and families impacted by prostate cancer. Jeremy Patch, ZERO's Director of Patient Programs & Education, brings a wealth of experience from the nonprofit and public health sectors to his role. Based in St. Louis, he has a history of leadership in cancer-focused nonprofits, including a notable stint at Susan G. Komen. With a B.A. in Psychology from Truman State University and an MPH from Saint Louis University, Jeremy has dedicated himself to public health, focusing on grantmaking, community needs assessment, and educational initiatives in oncology. At ZERO, he is driven by the goal to support cancer patients and families, aiming to reduce the impact of prostate cancer.

Faculty, planners, and staff disclosure information

Current Concepts Institute/MedAll staff and the planners and reviewers of this educational activity have no relevant financial or non-financial interests to disclose.

Shawn Dason, Dakim Gaines & Jeremy Patch have no relevant financial or non-financial interests to disclose.

Andrew Laccetti has research contracts with ESSA and Bayer. He has received research funding from Johnson & Johnson. He is on a steering committee for Bayer. He has provided consulting for Guidepoint & Musculo. He has Stock options in Musculo

Unapproved and/or off-label use disclosure

Current Concepts Institute/MedAll requires CE faculty to disclose to the participants:

1. When products or procedures being discussed are off-label, unlabeled, experimental, and/or investigational (not US Food and Drug Administration [FDA] approved); and

2. Any limitations on the information presented, such as data that are preliminary or that represent ongoing research, interim analyses, and/or unsupported opinion.

Accreditation statement

AMA PRA Category 1 Credits™ are available for this activity.

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Current Concepts Institute and MedAll Education. Current Concepts Institute is accredited by the ACCME to provide continuing medical education for physicians.

Current Concepts Institute designates this online activity a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity

This continuing education activity is active starting June 5 2024 and will expire on June 5 2025. Estimated time to complete this activity: 1.25 hours.

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Learning objectives

Understand the presentation, diagnosis, and treatment of advanced prostate cancer in diverse patient populations.
Gain knowledge of personalized treatment plans including surgery, radiation, androgen deprivation therapy (ADT), and chemotherapy for patients with advanced prostate cancer.
Develop the ability to interpret and apply clinical trials data to patient care, specifically the STAMPEDE, LATITUDE, and ORIOLE trials.
Understand the potential side effects of the various treatment options for advanced prostate cancer and how to manage these side effects.
Improve patient-centered communication skills, with an emphasis on discussing sensitive topics such as sexual side effects, morbidity, and quality of life with patients who have advanced prostate cancer.

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Dakim Gaines Develop personalized treatment plans for diverse patients with advanced prostate cancerClinical Case Mr. Smith is a 65-year-old man who presented to his PCP for annual check up. He has PSA drawn along with routine labs. PSA trend: • January 25, 2021: 3.5 • April 29, 2022: 4.3 • January 9, 2024: 12.2Clinical Case Reviewof systems Daytimeurinary frequency,nocturia two timesper nigh PMH/PSH Hypertension,Gastroesophagealreflux Medications Lisinopril, omeprazole SH Married,twogrown children,retired teacher,enjoy a glass of wine with dinneroccasionally,nohistory of tobaccoor drug use.He lives an activelifestyleandenjoys hiking and cycling Physicalexam No evidenceof mass, normal rectal tone.Prostate was non-tender, firmness on the left sideClinical Case Patient gets referred to a urologist. Then he undergoes an MRI prostate. MRI prostate Radiologist discovers a lesion in the left posterior peripheral zone, there is loss of defined capsule overlying the lesion both inferiorly and superiorly suggestive of extraprostatic extension.Clinical Case Patientreturns to urologistto review hisMRI and undergoesanMRI fusionprostate biopsy Pathologyresultsshow: • 13 core biopsy (3targeted at Regionof Interest[ROI] basedonMRI) • A)BenignProstatic Tissue • B)BenignProstatic Tissue • C)BenignProstatic Tissue • D)ROI 1, Leftperipheralzone 1: Grade Group 4 (GS 4+4=8), involving90% of submitted tissue • E)ROI 1, Left peripheralzone 2:Grade Group 4 (GS 4+4=8), involving100% of submitted tissue • F)ROI 1, Left peripheralzone 3:Grade Group4 (GS 4+4=8), involving100% submittedtissue • G) ROI 1, Leftperipheral zone 4: Grade Group (GS 4+3=7), involving90%of submitted tissue • H) Benign Prostatic Tissue • I)Grade Group 3 (GS 4+3=7), involving20% of submittedtissue • J) Grade Group 4 (GS4+4=8), involving90% of submitted tissue • K) Grade Group 3 (GS4+3=7), involving50% of submitted tissue • L)Benignprostatic tissue • M) Benignprostatic tissueClinical Case Patient newly diagnosed high risk prostate cancer. He undergoes body (systemic) imaging with a PSMA-PET scan where an avid lymph node and avid sclerotic bone metastasis are identified. PSMA PET scan PSMA PET scan is a newer type of body imaging for patient with advanced prostate cancer Use radioactive tracer that specifically binds prostate cancer cellsSummary 73-year-old man in overall good health who has been newly diagnosed with early (oligo) metastatic prostate cancer. What are his treatment options and what do treatments entail? • Surgery? • Radiation? • Androgen Deprivation Therapy (ADT)? • or/and Chemotherapy? How do treatments fit into Mr. Smiths’ care goals?TreatmentOptionsfor OligometastaticProstateCancer Oncology Treatment Team Urologist Medical Oncologist Radiation Oncologist Radiologist Pathologist Cardiologist***TreatmentOptions • Involve input and expertise from several specialties • Best outcomes are in combination and multimodality treatment strategies • Several recent clinical trials drive the current treatment standardClinical Trial Data- Stampede Arm H All patientswere treatedwith lifelongADT • Radiotherapyarm-received prostateradiation • Control-no additionaltherapy Radiationtherapyimprovedall canceroutcomes and overall survival inpatientlow metastaticburden • Not seen in patientswith high metastaticburdenClinical Trial Data- LATITUDE trial All patientswere treatedwith lifelongADT • Abirateronearm- abiraterone+ prednisone • Control-placebo+ placebo Menwithnewly diagnosed,metastaticprostatecancerthat receivedabirateroneand prednisone: • Increasedoverall survival • Lower chance of diseaseprogression on imaging LATITUDE (2013-2014)[Fizazi, NEJM ’17]Clinical Trial Data- ORIOLE trial Menwho were oligometastaticprostatecancer • Did not receive any ADT • SABR arm- metastaticsitestreatedwith radiation • Observation-notreatment tometastases Radiation(SBRT/SABR)improvedcanceroutcome • Less likely tohave progression • Some men had over2 years without progression ORIOLE [Protocol, Phillips R, JAMA Onc '20]Treatment recommendations Offerpatientradiationtoprostate,pelviclymphnodes, and sitesof metastasis • Extrapolationsfromseveral clinicaltrials • Current investigationlookingintodetailsof therapy Less aggressive regimens of ADT and abiraterone for patientswantingtoavoidradiationPotentialSideEffects ADT (prescribed by urologist, medical oncologist, radiation oncologist) • Sexual side effects: Loss of libido, erectile dysfunction, hot flashes • Physiologic effects: weight gain, changes in lipids, increase cholesterol • Other side effects: Loss of bone mineral density, anemia, hair changes, psychological distress • Cardiovascular side effects: Increased risk of cardiovascular disease and diabetes o Cardiac evaluation and clearance for men with cardiac diseasePotentialSideEffects Radiation therapy (prescribed by radiation oncologist) • Local therapy, effects tissue in radiation field • Prostate and pelvic treatment o Acute: Increased urinary frequency, increased urinary urgency, loose stools, diarrhea, blood in urine, blood in bowel movements, fatigue o Late: chronic urinary or bowel changes, bowel scarring/ obstruction (rare) • Bone treatment o Bone pain, increased risk of fractureThank you Dakim Gaines Facilitate patient-centered communication throughout the management journeyClinical Case Mr. Taylor is a 79-year-old man who presented to his PCP with new back pain and difficulty urinating. He hasn’t seen his doctor in several years. His exam revealed a tender mid back pain. He has PSA drawn along with routine labs. PSA trend: January 9, 2024: 65.4Clinical Case Reviewof systems Urinary obstruction. PMH/PSH Chronic kidneydisease,Congestiveheart failure,COPD. Medications Lisinopril, omeprazole. SH Married,twogrown children,retired chef,smoked tobaccofor 20 years but quit2 years ago. Does not drink alcoholor use drugs. Physicalexam Backtenderness midback,Prostate was non-tender,diffuselyenlarged and irregular.BoneScan He undergoes a nuclear medicine bone scan • Imaging technique with radioactive tracer • Detects area of bone turnover o Metastasis o Fractures o Arthritis Sapir E et al. (2006)J Nucl Med 47 https://www.cancer.gov/publications/dictionaries/cancer-terms/def/bone-scanProstateBiopsy He underwenta prostate biopsy withhisurologist Biopsyresults(12 corestaken): • A)Benign Prostatic Tissue • B)BenignProstatic Tissue • C)BenignProstatic Tissue • D)Leftperipheralzone : Grade Group 4 (GS4+4=8), involving90% of submitted tissue • E)Left apex:Grade Group 4 (GS 4+4=8), involving100% of submittedtissue • F)Right transitionzone 3: Grade Group 4 (GS4+4=8), involving100% submitted tissue • G) Leftbase zone 4: Grade Group (GS 4+5=9), involving90% of submitted tissue • H) Benign Prostatic Tissue • I) Grade Group 3 (GS 4+3=7), inv`lving20% of submittedtissue • J) Grade Group 4 (GS4+4=8), invol`ing90% of submitted tissue • K) Grade Group 3 (GS4+3=7), involving50% of submitted tissue • L)Benignprostatic tissueSummary 79-year-old man in with several chronic health conditions who has been newly diagnosed with widespread bony metastatic prostate cancer • High metastatic burden What are his treatment options and what do treatments entail? • Surgery? • Radiation? • Androgen Deprivation Therapy (ADT)? • or/and Chemotherapy? How do treatments fit into Mr. Taylor’s care goals?Clinical Trial Data- STAMPEDE arms B, C, E Menwith high metastaticburden • ADT+ docetaxel • ADT alone Docetaxel+ ADT is betterthan ADT alone • Improvedoverall survival Improvementnot seen inmen withlow metastaticburdenTreatmentrecommendations Mr. Taylor is managed by a medical oncologist to discuss treatment options • Docetaxel + ADT • ADT alone • External Radiation reserved for palliation of painful bony metastases Mr. Taylor elects to undergo Docetaxel (6 cycles) + ADT (lifelong) He completes therapy and his PSA drops to <1.0Clinical Case Mr. Taylor does well for several years and is tolerating ADT reasonably well 3 years later his PSA rises from 1.0 > 7.4 Prostate cancer no longer responds to hormone depreviation • Castrate resistant Now what are his options? • Second line chemotherapy • Target Radionuclide TherapyClinical Trial-VISION trial Men with metastatic castration-resistant prostate cancer • Standard of care (SOC) • SOC + Lu-PSMA-621 (Pluvitco) When Pluvicto was added to SOC it prolonged disease progression and overall survival Current investigation for role of radiopharmaceuticals in early stages of prostate cancerExternal Radiationfor Palliation Short course of palliative radiation well proven treatment for pain control About 75% of patients report at least a partial pain response • Patient require less pain medications, less frequently • 1/3 report complete pain response o No longer need pain medications Newer research on using SBRT for pain control • May have better pain control than conventional radiationPotentialSideEffects Radiation therapy (prescribed by radiation oncologist) • Local therapy, effects tissue in radiation field • Prostate and pelvic treatment o Acute: Increased urinary frequency, increased urinary urgency, loose stools, diarrhea, blood in urine, blood in bowel movements, fatigue o Late: chronic urinary or bowel changes, bowel scarring/ obstruction (rare) • Bone treatment o Bone pain, increased risk of fracturePotentialSideEffects ADT (prescribed by urologist, medical oncologist, radiation oncologist) • Sexual side effects: Loss of libido, erectile dysfunction, hot flashes • Physiologic effects: weight gain, changes in lipids, increase cholesterol • Other side effects: Loss of bone mineral density, anemia, hair changes, psychological distress • Cardiovascular side effects: Increased risk of cardiovascular disease and diabetes o Cardiac evaluation and clearance for men with cardiac diseaseThank you