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Current Controversies, Recent Developments and Emerging Strategies in the Practical Management of Prostate Cancer: A Clinical Investigator Think Tank
Released January 2013

Video excerpts from a clinical investigator Think Tank held on September 7, 2012. Featuring perspectives from Drs Tomasz M Beer, Robert Dreicer, Mario A Eisenberger, William K Oh, Daniel P Petrylak, A Oliver Sartor, Susan F Slovin and Matthew R Smith. (Video Program)

CE Disclosures and Faculty Information


    This activity is intended for medical oncologists and other healthcare providers involved in the treatment of prostate cancer.


    Prostate cancer is the most frequently diagnosed cancer in men, with an estimated 241,740 new cases in 2012 in the United States. Although virtually all locally advanced or metastatic sites of tumor are initially reliant on androgen stimulation for growth and respond to treatment with androgen deprivation therapy, inevitably resistance to hormone blockade eventually develops, culminating in the recurrence of highly aggressive castration-resistant prostate cancer (CRPC). Recently published randomized controlled studies focused specifically on this population have led to the emergence of novel therapeutic strategies for patients with CRPC and resulted in a paradigm shift to the multidisciplinary care of patients with this disease. A number of pivotal data sets illustrating the benefits of several novel agents indicate that additional therapeutic options may soon be available that will warrant consideration and integration into prostate cancer care. The treatment landscape and available options for prostate cancer have thus broadened, making choices more challenging for many healthcare professionals and patients, and a once-stagnant systemic treatment algorithm, largely confined to medical or surgical castration, has evolved into delivery of cutting-edge antineoplastic therapy necessitating learning opportunities for urologists and medical oncologists. This CME program uses a roundtable discussion with leading prostate cancer clinical investigators to assist practicing clinicians in formulating up-to-date and appropriate clinical management strategies.

    • Recall existing and emerging research demonstrating the effects of secondary hormonal interventions and novel agents on quality and quantity of life for patients with advanced prostate cancer, including metastatic CRPC, and use this information to guide treatment planning for these patients.
    • Efficiently identify and educate patients with skeletal metastases about the efficacy and safety of emerging systemic bone-directed treatments.
    • Employ case-based learning to effectively apply evidence-based research findings in the determination of best-practice sequencing of available systemic agents for patients with metastatic prostate cancer.
    • Counsel appropriately selected patients with minimally symptomatic or asymptomatic advanced prostate cancer about sipuleucel-T as a treatment option, and define an approach to patient monitoring after treatment with this agent.

    Research To Practice is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.


    Research To Practice designates this enduring material for a maximum of 1.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


    This CME activity consists of a video component. To receive credit, the participant should watch the video, complete the Post-test with a score of 75% or better and fill out the Educational Assessment and Credit Form located at ResearchToPractice.com/PCUTT112


    Research To Practice (RTP) is committed to providing its participants with high-quality, unbiased and state-of-the-art education. We assess potential conflicts of interest with faculty, planners and managers of CME activities. Real or apparent conflicts of interest are identified and resolved through a conflict of interest resolution process. In addition, all activity content is reviewed by both a member of the RTP scientific staff and an external, independent physician reviewer for fair balance, scientific objectivity of studies referenced and patient care recommendations.

    — The following faculty (and their spouses/partners) reported real or apparent conflicts of interest, which have been resolved through a conflict of interest resolution process:

    Tomasz M Beer, MD
    Grover C Bagby Endowed Chair for Prostate Cancer Research
    Professor of Medicine, Hematology and Medical Oncology
    Deputy Director
    OHSU Knight Cancer Institute
    Portland, Oregon

    Consulting Agreements: Dendreon Corporation, GTx Inc; Paid Research: Bayer HealthCare Pharmaceuticals, Bristol-Myers Squibb Company, Cell Therapeutics Inc, Cougar Biotechnology Inc, Dendreon Corporation, ImClone Systems, a wholly owned subsidiary of Eli Lilly and Company, Medivation Inc, Novartis Pharmaceuticals Corporation, OncoGenex Pharmaceuticals Inc; Speakers Bureau: Sanofi.

    Robert Dreicer, MD, MS
    Chairman, Department of Solid Tumor Oncology
    Taussig Cancer Institute Cleveland Clinic
    Professor of Medicine
    Cleveland Clinic Lerner College of Medicine
    Cleveland, Ohio

    Advisory Committee: EMD Serono Inc, Janssen Pharmaceuticals Inc, Lilly USA LLC, Millennium: The Takeda Oncology Company, Novartis Pharmaceuticals Corporation.

    Mario A Eisenberger, MD
    R Dale Hughes Professor of Oncology and Urology
    The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
    Baltimore, Maryland

    Advisory Committee: Sanofi; Consulting Agreements: Bristol-Myers Squibb Company, Millennium: The Takeda Oncology Company; Paid Research: Genentech BioOncology, Sanofi.

    William K Oh, MD
    Chief, Division of Hematology and Medical Oncology
    Professor of Medicine and Urology
    Ezra M Greenspan, MD Professor in Clinical Cancer Therapeutics
    Mount Sinai School of Medicine
    Associate Director of Clinical Research
    The Tisch Cancer Institute
    New York, New York

    Consulting Agreements: Amgen Inc, Astellas, Bayer HealthCare Pharmaceuticals, Bellicum Pharmaceuticals Inc, Dendreon Corporation, Janssen Pharmaceuticals Inc, Medivation Inc, Pfizer Inc, Sanofi; Paid Research: Millennium: The Takeda Oncology Company.

    Daniel P Petrylak, MD

    Professor of Medicine
    Program Director, Genitourinary Oncology
    Co-Director, Signal Transduction Program
    Yale Comprehensive Cancer Center
    New Haven, Connecticut

    Advisory Committee: Amgen Inc, Bayer HealthCare Pharmaceuticals, Bristol-Myers Squibb Company, Millennium: The Takeda Oncology Company, Sanofi; Consulting Agreement: Celgene Corporation; Paid Research: Boehringer Ingelheim Pharmaceuticals Inc, Celgene Corporation, Eisai Inc, GlaxoSmithKline, ImClone Systems, a wholly owned subsidiary of Eli Lilly and Company, Lilly USA LLC, Millennium: The Takeda Oncology Company, Sanofi.

    A Oliver Sartor, MD
    Medical Director, Tulane Cancer Center
    Laborde Professor of Cancer Research
    Professor of Medicine and Urology
    Tulane Medical School
    New Orleans, Louisiana

    Advisory Committee: Sanofi; Clinical Investigator: AstraZeneca Pharmaceuticals LP, EMD Serono Inc, Millennium: The Takeda Oncology Company, Sanofi; Consulting Agreements: Algeta ASA, Amgen Inc, Bayer HealthCare Pharmaceuticals, Bristol-Myers Squibb Company, Celgene Corporation, GlaxoSmithKline, Medivation Inc, Millennium: The Takeda Oncology Company, OncoGenex Pharmaceuticals Inc, Pfizer Inc, Sanofi, Teva Oncology.

    Susan F Slovin, MD, PhD
    Associate Attending Physician
    Genitourinary Oncology Service
    Sidney Kimmel Center for Prostate and Urology Cancers
    Memorial Sloan-Kettering Cancer Center
    Associate Professor of Medicine
    Weill-Cornell Medical College
    New York, New York

    No real or apparent conflicts of interest to disclose.

    Matthew R Smith, MD, PhD
    Professor of Medicine
    Harvard Medical School
    Director, Genitourinary Malignancies Program
    Massachusetts General Hospital
    Boston, Massachusetts

    Advisory Committee and Consulting Agreements: Amgen Inc, Bayer HealthCare Pharmaceuticals, Millennium: The Takeda Oncology Company; Paid Research: Amgen Inc, Millennium: The Takeda Oncology Company.

    MODERATORDr Love is president and CEO of Research To Practice, which receives funds in the form of educational grants to develop CME activities from the following commercial interests: Abbott Laboratories, AbbVie Inc, Allos Therapeutics, Amgen Inc, ArQule Inc, Astellas, Aveo Pharmaceuticals, Bayer HealthCare Pharmaceuticals, Biodesix Inc, Biogen Idec, Boehringer Ingelheim Pharmaceuticals Inc, Bristol-Myers Squibb Company, Celgene Corporation, Daiichi Sankyo Inc, Dendreon Corporation, Eisai Inc, EMD Serono Inc, Foundation Medicine Inc, Genentech BioOncology, Genomic Health Inc, Gilead Sciences Inc, Incyte Corporation, Lilly USA LLC, Medivation Inc, Merck, Millennium: The Takeda Oncology Company, Mundipharma International Limited, Novartis Pharmaceuticals Corporation, Onyx Pharmaceuticals Inc, Prometheus Laboratories Inc, Regeneron Pharmaceuticals, Sanofi, Seattle Genetics, Spectrum Pharmaceuticals Inc and Teva Oncology.

    RESEARCH TO PRACTICE STAFF AND EXTERNAL REVIEWERS — The scientific staff and reviewers for Research To Practice have no real or apparent conflicts of interest to disclose.

    This educational activity contains discussion of published and/or investigational uses of agents that are not indicated by the Food and Drug Administration. Research To Practice does not recommend the use of any agent outside of the labeled indications. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings. The opinions expressed are those of the presenters and are not to be construed as those of the publisher or grantors.

    This activity is supported by educational grants from
    Astellas/Medivation Inc, Dendreon Corporation, Millennium: The Takeda Oncology Company, Sanofi and Teva Oncology.

    Hardware/Software Requirements:
    A high-speed Internet connection 
    A monitor set to 1280 x 1024 pixels or more
    Internet Explorer 7 or later, Firefox 3.0 or later, Chrome, Safari 3.0 or later
    Adobe Flash Player 10.2 plug-in or later
    Adobe Acrobat Reader
    (Optional) Sound card and speakers for audio

    Last review date:
    January 2013
    Expiration date:
    January 2014

    After completing the Post-test, learners may download and review the answers
    here in order to identify further areas of study.

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(WiFi is recommended for best performance):

Algorithms for first-line treatment of symptomatic and asymptomatic metastases
Biology of next-generation endocrine agents
Use of abiraterone prior to chemotherapy for metastatic disease
Pivotal Phase III trial of enzalutamide versus placebo
Enzalutamide and seizures
Theoretical sequencing of enzalutamide and abiraterone
Metabolic basis for using corticosteroids with select endocrine agents
Questions about the use of chemotherapy in metastatic disease
Second-line treatment after progression on docetaxel
Use of cabazitaxel in clinical practice
Case: 67 yo man with metastatic disease who received bicalutamide then enzalutamide then sipuleucel-T/enzalutamide
Integration of sipuleucel-T into clinical practice
Case: 75 yo man with PSA-only relapse
Trials of intermittent androgen deprivation
Use of next-generation endocrine agents for PSA-only relapse
ALSYMPCA trial of radium-223
Is radium-223 primarily an anticancer or bone-protective treatment?
Clinical use of radium-223
Case: 83 yo man with diffuse severe bone pain who received radium-223
Phase II trial of orteronel without corticosteroids