Case-Based Discussion: Early M1 CRPC and Advanced M1 CRPC Podcast (2021)
As a direct result of the significant increase in multiple FDA-approved therapeutic agents for use in patients with advanced prostate cancer, clinicians are challenged with a multitude of treatment options and potential sequencing of these agents that, consequently, make clinical decision-making more complex. This activity will build upon the newly updated 2020 AUA Guidelines on Metastatic Hormone Sensitive Prostate Cancer (HSPC) and Castration-Resistant Prostate Cancer (CRPC). Topics will include the latest on Genetic Testing in Advanced Prostate Cancer and the Role of Immunotherapy and PARP Inhibitors.
To extend the educational reach, the AUA will capture the live case study discussions and develop three podcasts with a faculty interview segment. This activity will focus on the following topics:
Early M1 CRPC & Advanced M1 CRPC
Presented by Kelly Stratton, MD and Deborah Kaye, MD
Support provided by independent educational grants from:
- Bayer HealthCare Pharmaceuticals Inc.
- Exact Sciences Corporation
- Pfizer, Inc.
- Sanofi Genzyme
- Advanced Practice Provider (Nurse Practitioners & Physician Assistants)
At the conclusion of this activity, participants will be able to:
PRACTICE GAP #1 (DISEASE STATE)
- Describe the natural course of advanced prostate cancer from non-metastatic (M0) to metastatic hormone-sensitive disease (mHSPC), with progression to the development of castration-resistant disease (CRPC).
- Describe the treatment options and outcomes for patients with biochemical recurrence after failed local therapy.
- Identify available imaging and indications for use including next generation PET imaging in the assessment of men with biochemical recurrence after failed local therapy.
- Describe the treatment options and outcomes for newly diagnosed mHSPC.
- Explain the implications of CRPC on the management of both M0 and M1.
- Discuss the molecular mechanisms and characterization of CRPC.
- Discuss the incorporation of genetic testing (both germline and somatic testing) into the management of men with high risk, metastatic prostate cancer and CRPC.
PRACTICE GAP #2 (GUIDELINES)
- Discuss specific recommendations within the AUA Clinical Practice Guidelines.
- Define M0 CRPC and the treatment options.
- Discuss clinically meaningful endpoints in clinical trials of patients with M0 CRPC.
- Describe gaps in the knowledge for treatment and sequencing of agents in the management of CRPC.
- Discuss challenges in incorporating AUA Guidelines and management of advanced mHSPC and CRPC into community practice.
PRACTICE GAP #3 (ANDROGEN AXIS)
- Identify approved androgen biosynthesis and receptor blockers for treatment of CRPC.
- Appraise the clinical use and efficacy of approved androgen-axis therapeutics for CRPC.
- Anticipate, manage and treat adverse events from therapeutic interventions directed at the androgen-axis used in the treatment of CRPC.
- Discuss new uses for androgen axis agents in M0 CRPC.
PRACTICE GAP #4 (CHEMOTHERAPY, IMMUNOTHERAPY, PARP INHIBITORS AND CO-MORBIDITY)
- Identify approved chemotherapeutics, immunotherapy and PARP Inhibitors for mCRPC.
- Describe indications and contraindications for chemotherapy, immunotherapy and PARP Inhibitors in patients with mCRPC.
- Identify co-morbid states and recognize their impact on treatment options for mCRPC.
- Identify germline and somatic mutations and implications for treatment in mCRPC including indications for PAPR Inhibitors and pembrolizumab.
- Discuss treatment sequencing in the advanced, metastatic and CRPC disease state.
PRACTICE GAP #5 (BONE HEALTH AND RADIONUCLIDE THERAPY)
- Integrate advances in bone health management into patient-specific care plans.
- Identify patients and prescribe radionuclide therapy in appropriate patients with symptomatic mCRPC.
- Discuss known adverse events associated with androgen biosynthesis inhibitors and radionuclide therapy.
PRACTICE GAP #6 (PAIN MANAGEMENT AND PALLIATIVE CARE)
- Assess and manage pain in patients with symptomatic mHSPC and mCRPC.
- Discuss the role of chemotherapy, performance status and pain management in patients with mCRPC.
- Review the role of palliative care and supportive services in the management of late stage CRPC.
Education Council Disclosures
Education Council Disclosures_ June 2021.pdf
COI Review Work Group Disclosures
COI Review Work Group Disclosures 2021.pdf
AUA Office of Education Staff has nothing to disclose.
All relevant financial relationships have been mitigated.
Michael Cookson, MD,MHA
David Jarrard, MD
Deborah Kaye, MD, MS
Kelly Stratton, MD
METHOD OF PARTICIPATION:
Learners will participate in this online educational activity by taking the pretest, listening to the podcast and completing the posttest and evaluation. To claim CME credit for this enduring material, learners must complete the posttest, passing with 80% accuracy and submit the program evaluation.
Estimated time to complete this activity: 1.00 hours
Release Date: October 2021
Expiration Date: October, 2022
The American Urological Association (AUA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The American Urological Association designates this live activity for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The AUA is not accredited to offer credit to participants who are not MDs or DOs. However, the AUA will issue documentation of participation that states that the activity was certified for AMA PRA Category 1 Credit™.
EVIDENCE BASED CONTENT:
It is the policy of the AUA to ensure that the content contained in this CME activity is valid, fair, balanced, scientifically rigorous, and free of commercial bias.
AUA DISCLOSURE POLICY:
All persons in a position to control the content of an educational activity (i.e., activity planners, presenters, authors) are required to disclose to the provider any relevant financial relationships with any commercial interest. The AUA must determine if the individual’s relationships may influence the educational content and resolve any conflicts of interest prior to the commencement of the educational activity. The intent of this disclosure is not to prevent individuals with relevant financial relationships from participating, but rather to provide learners information with which they can make their own judgments.
MITIGATION OF IDENTIFIED CONFLICT OF INTEREST:
All disclosures will be reviewed by the AUA Conflict of Interest (COI) Review Work Group for identification of conflicts of interest. The AUA COI Review Work Group, working with the program directors and/or editors, will document the mechanism(s) for management and mitigation of the conflict of interest and final approval of the activity will be documented prior to implementation. Any of the mechanisms below can/will be used to mitigate conflict of interest:
- Peer review for valid, evidence-based content of all materials associated with an educational activity by the course/program director, editor, and/or AUA COI Review Work Group.
- Limit content to evidence with no recommendations
- Introduction of a debate format with an unbiased moderator (point-counterpoint)
- Inclusion of moderated panel discussion
- Publication of a parallel or rebuttal article for an article that is felt to be biased
- Limit equipment representatives to providing logistics and operation support only in procedural demonstrations
- Divestiture of the relationship by faculty
OFF-LABEL OR UNAPPROVED USE OF DRUGS OR DEVICES:
The audience is advised that this continuing medical education activity may contain reference(s) to off-label or unapproved uses of drugs or devices. Please consult the prescribing information for full disclosure of approved uses.
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- 1.00 AMA PRA Category 1 Credit™
- 1.00 Non-Physician Participation