Post on 22-Jan-2018
Prostate Cancer“Highlights from ASCO GU – 2017”
Mohamed Abdulla M.D.
Prof. of Clinical Oncology
Cairo University
Astellas Astellas Symposium02/04/2017Grand Nile Tower
Member of Advisory Board, Consultant, and Speaker for:
• Amgen, Astellas, AstraZeneca, Hoffman la Roche, Janssen Cilag, Merck Serono, Novartis, Pfizer, Mundipharma, MSD
Speaker Disclosures:
Outline:
1. Disease demographics and screening.
Demographics of Prostate Cancer:Metastatic Disease at Presentation:
Gilbert Welch et al. NEGM. 2015;373:1685-1687
50%
Demographics of Prostate Cancer:Changes in Mortality Rates:
Kelly et al. EUROPEAN UROLOGY 71 (2017) 195–201
Demographic: Context
Demographic: Metastases
Demographics & USPSTF
Demographics & USPSTF
Screening: PLCO
Outline:
1. Disease demographics and screening.
2. Pathology – Classification.
Pathology - Classification
Pathology - Classification
Outline:
1. Disease demographics and screening.
2. Pathology – Classification.
3. Localized Disease: Treatment.
Localized disease - Treatment
Localized disease - Treatment
Localized disease - Treatment
Localized disease - Treatment
Localized disease - Treatment
Localized disease – Secondary Ca
Localized disease - Surgery
Localized disease - Surgery
Localized disease - Surgery
Localized disease - Surgery
Localized disease - Radiation
Localized disease - Radiation
Localized disease - Radiation
Salvage Radiotherapy: GETUG-AFU 16
Salvage Radiotherapy: GETUG-AFU 16
Salvage Radiotherapy: RTOG 9601
Salvage Radiotherapy: RTOG 9601
Outline:
1. Disease demographics and screening.
2. Pathology – Classification.
3. Localized Disease: Treatment.
4. Metastatic Disease: Treatment.
Metastatic disease: Stampede
Metastatic disease: Stampede
Metastatic disease: Stampede
Metastatic disease: Docetaxol
Metastatic disease: Docetaxol
Metastatic disease: TERRAIN RCT
Metastatic disease: STRIVE RCT
Outline:
1. Disease demographics and screening.
2. Pathology – Classification.
3. Localized Disease: Treatment.
4. Metastatic Disease: Treatment.
5. DNA Repair Genes.
Slide 75
TOPARP Phase 2 Trial:
Mateo etl. N Engl J Med.2015:373;18.
DNA Repair & Metastatic PCa
DNA Repair & Metastatic PCa
Outline:
1. Disease demographics and screening.
2. Pathology – Classification.
3. Localized Disease: Treatment.
4. Metastatic Disease: Treatment.
5. DNA Repair Genes.
6. Intrinsic Subtypes of Prostate Cancer.
Introduction
PAM50 clustering readily identifies luminal (A & B) and basal subtypes in prostate cancer
Luminal B prostate cancers have worse outcomes compared to Luminal A or Basal subtypes
Multivariable analysis for metastatic progression
Different biological pathways are up- or down-regulated in luminal versus basal subtypes<br />
Does subtype predict response to ADT?
Which patients should receive androgen deprivation early in the course of recurrence?
Which patients should receive androgen deprivation early in the course of recurrence?
Not all patients benefit from the addition of anti-androgen therapy to salvage radiotherapy
The next step: Molecular stratification
Conclusions
Thank You