Prostate cancer (PC) is the most frequently diagnosed cancer in men, with an estimated 241,740 new cases every year in the United States. Emerging data increasingly allow individualized treatment decision-making for localized PC, including the option of active surveillance and radiation therapy for those with high-risk disease after prostatectomy. In addition, while 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, resistance to hormone blockade inevitably develops, culminating in the recurrence of highly aggressive castration-resistant PC (CRPC). Recently published randomized, controlled studies have signaled the emergence of novel therapeutic strategies for patients with CRPC. This has led to a paradigm shift in the multidisciplinary care of patients with this disease. The treatment landscape and available options for PC 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 PC investigators to assist practicing clinicians in formulating up-to-date and appropriate clinical management strategies.

LEARNING OBJECTIVES

• Review emerging research data and ongoing trials evaluating the use of novel biomarkers and gene signatures to help patients with localized PC refine their risk of recurrence, and use this information to guide clinical decision-making, particularly regarding the role of active surveillance.
• Apply evidence-based decision-making regarding the role of adjuvant versus salvage radiation therapy in patients with adverse pathologic features after prostatectomy.
• Explore emerging data on the use of cytotoxic therapy in the setting of hormone-sensitive advanced PC, and consider this information when designing initial treatment plans for appropriate individuals.
• Recall existing and emerging research demonstrating the effects of secondary hormonal interventions on quality and quantity of life for patients with metastatic CRPC, and use this information to guide treatment planning.
• Consider available research data and expert perspectives on the efficacy and safety of radium-223 as monotherapy or in combination with other treatment modalities, and use this information to appropriately integrate this novel radiopharmaceutical into clinical practice.
• Effectively apply evidence-based research findings in the determination of best-practice sequencing of available immunotherapeutic, chemotherapeutic and secondary hormonal agents for patients with metastatic PC.
• Explore the emerging data and active research evaluating novel agents in the setting of PSA-only recurrent or advanced PC, and discuss the biologic basis for their clinical activity.

ACCREDITATION STATEMENT

CME credit is no longer available for this issue

CREDIT DESIGNATION STATEMENT

CME credit is no longer available for this issue

HOW TO USE THIS CME ACTIVITY
This activity contains an audio component. The participant should listen to the audio MP3s.

CME credit is no longer available for this issue

CONTENT VALIDATION AND DISCLOSURES
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.

FACULTY — 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: Dr Badani — Contracted Research: Genomic Health Inc. Dr Dreicer — Advisory Committee: Astellas Scientific and Medical Affairs Inc, Janssen Biotech Inc, Med-Direct International Ltd, Merck, Roche Laboratories Inc, Takeda Oncology. Dr Gomella — Consulting Agreements: Astellas Scientific and Medical Affairs Inc, Bayer HealthCare Pharmaceuticals, Dendreon Corporation, Janssen Biotech Inc, MDxHealth. Dr Petrylak — Consulting Agreements: Bayer HealthCare Pharmaceuticals, Bellicum Pharmaceuticals Inc, Dendreon Corporation, Ferring Pharmaceuticals, Johnson & Johnson Pharmaceuticals, Medivation Inc, Pfizer Inc, Sanofi, Takeda Oncology; Contracted Research: Celgene Corporation, Sanofi, Takeda Oncology; Grant Support: Dendreon Corporation, Johnson & Johnson Pharmaceuticals, OncoGenex Pharmaceuticals Inc, Progenics Pharmaceuticals Inc. Dr Sartor — Advisory Committee: Bayer HealthCare Pharmaceuticals, Sanofi; Consulting Agreements: Algeta ASA, Bavarian Nordic, Bayer HealthCare Pharmaceuticals, Biscayne Pharmaceuticals Inc, Medivation Inc, OncoGenex Pharmaceuticals Inc, Sanofi; Contracted Research: AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Progenics Pharmaceuticals Inc, Sanofi, Takeda Oncology.