LUGPA 2025 Global Prostate Cancer Congress Enduring Program-GPCC 2025 Session 7

Video Transcription

Video Summary

The transcript features a comprehensive discussion on the latest advances and management strategies in advanced prostate cancer, focusing primarily on metastatic hormone-sensitive prostate cancer (MHSPC) and biochemical recurrence (BCR) after radiation. Dr. Maha introduces the evolution from early treatments like orchiectomy to modern therapy intensification involving androgen deprivation therapy (ADT), chemotherapy (docetaxel), novel androgen receptor (AR) inhibitors, and emerging triplet regimens. She highlights key clinical trials demonstrating survival benefits in high-volume disease with triplet therapies and outlines the role of PARP inhibitors and PSMA-targeted treatments in selected genetic profiles and disease stages.<br /><br />A shift to discussing BCR emphasizes the challenges post-radiation, including defining recurrence, advanced imaging (PSMA PET), and the importance of biopsy to guide salvage treatments such as prostatectomy, re-irradiation, or ablation with agents like HIFU or cryotherapy. The goal is to delay systemic ADT while prolonging metastasis-free survival, citing data from trials like EMBARK that support combined ADT and AR inhibitors.<br /><br />Two real-world retrospective analyses compare survival outcomes between AR inhibitors: apalutamide versus abiraterone and apalutamide versus enzalutamide, showing apalutamide with a statistically significant survival advantage at 24 and 48 months.<br /><br />Finally, a study on urinary biomarkers for prostate cancer detection indicates potential promise, though validation in larger cohorts is needed.<br /><br />Throughout, there is emphasis on personalized treatment tailored to disease volume, genetic factors, patient fitness, and quality of life. Multidisciplinary care is key, with attention to managing treatment side effects including cardiovascular, bone health, and psychological risks heightened by hormone therapy. The session underscores significant progress but also the complexity and need for ongoing research in prostate cancer management.

Keywords

advanced prostate cancer

metastatic hormone-sensitive prostate cancer

biochemical recurrence

androgen deprivation therapy

docetaxel chemotherapy

androgen receptor inhibitors

triplet therapy regimens

PARP inhibitors

PSMA-targeted treatments

salvage therapy

PSMA PET imaging

urinary biomarkers