The Evolving Landscape of Advanced Prostate Cancer Treatment: A Guidelines and Case-Based Discussion Webcast (2023)
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. The course will discuss the importance of developing a multidisciplinary approach and key components to establishing a multidisciplinary clinic. This activity will provide guidance around the updated 2023 AUA Guidelines on Advanced Prostate Cancer that includes Metastatic Hormone Sensitive Prostate Cancer (HSPC) and Castration-Resistant Prostate Cancer (CRPC). Topics will include the latest on PSMA PET Imaging, Genetic Testing, Novel Androgen Receptor Targeted Therapy, Chemotherapy, and Treatment Intensification including triple therapy, Immunotherapy, PARP Inhibitors and more.
Needs assessment findings show strong support for continued development of courses and educational materials specifically targeted at residents and fellows that cover the medical management of advanced prostate cancer. This activity may also be of interest to urologists and other health care providers who care for patients with prostate cancer.
This activity will cover the following topics:
- Multidisciplinary Care Model
- Identification of High Risk Disease and Initial Management of Biochemical Recurrence
- Genetic Testing in Advanced Prostate Cancer
- Next Generation Imaging (PSMA) and Introduction to Theranostics
- Manipulating the Androgen Axis: New Agents in mHSPC and CRPC
- mHSPC: Chemo-hormonal Therapy and Treatment Intensification
- M0 CRPC: Treatment Options and Goals of Therapy
- M1 CRPC: First and Second Line Treatment Options
- M1 CRPC: PARP Inhibitors and Precision Medicine
- M1 CRPC: Treatment Sequencing and Future Directions
This educational activity is supported by independent educational grants from:
- • Astellas and Pfizer, Inc.
- • AstraZeneca
- • Lantheus Medical Imaging
- • Merck & Co., Inc.
- Advanced Practice Provider (Nurse Practitioners, Physician Assistants, Nurse Navigators)
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 biochemical recurrence to metastatic hormone-sensitive disease (mHSPC), with progression to the development of non-metastatic (M0CRPC) and metastatic castration-resistant disease (mCRPC).
- Describe the treatment options, goals of therapy and outcomes for patients with biochemical recurrence after failed local therapy.
- Identify available imaging and indications for use of advanced imaging including PSMA PET imaging for detecting and staging metastatic lesions in high-risk patients and for detecting and localizing new lesions at biochemical recurrence after failed local therapy.
- Describe the treatment options, goals of therapy and outcomes for newly diagnosed mHSPC including treatment intensification and novel hormonal therapy agents.
- Explain the implications of CRPC on the management of both M0 and M1, including sequencing of agents and combination therapy.
- 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.
- Explain the role of precision based medicine the treatment of men with advanced prostate cancer (APC).
PRACTICE GAP #2 (GUIDELINES)
- Discuss recommendations within the 2023 Updated AUA Advanced Prostate Cancer Guidelines.
- Discuss the impact of newly approved agents on the management of men with APC.
- 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 APC 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 THERANOSTICS and COMORBIDITIES)
- Identify approved chemotherapeutics, immunotherapy, PARP Inhibitors and theranostics for mCRPC.
- Describe indications and contraindications for chemotherapy, immunotherapy, PARP Inhibitors and theranostics 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 PARP Inhibitors.
- Identify candidates for theranostic therapy using novel PSMA PET imaging.
- 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.
METHOD OF PARTICIPATION:
Learners will participate in this online educational activity by view the webcast and completing the post-test and evaluation. To claim CME credit for this enduring material, learners must complete the post-test, passing with 80% accuracy, and submit the program evaluation.
Estimated time to complete this activity: 4.25 hours
Release Date: May, 2023
Expiration Date: May, 2024
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 enduring material for a maximum of 4.25 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 all financial relationships with any commercial interest (aka ineligible company) during the previous 24 months. The AUA must determine if the individual’s relationships may influence the educational content and mitigate 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.
MTIGATION OF IDENTIFIED CONFLICT OF INTEREST:
All disclosures will be reviewed by the AUA Conflict of Interest (COI) Review Work Group Chair and/or Vice Chair for identification of conflicts of interest. The AUA COI Review Work Group, working with Office of Education staff, 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 by the AUA COI Review Work Group.
- Attestation that clinical recommendations are evidence-based and free of commercial bias.
- Introduction of a debate format (point-counterpoint)
- Inclusion of moderated panel discussion with unbiased moderator
- Publication of a parallel or rebuttal article for an article that is felt to be biased
- Divestiture of the relationship by faculty
- Recusal from controlling relevant aspects of planning
- Selection of alternative faculty for specific topic
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.
- 4.25 AMA PRA Category 1 Credit™
- 4.25 Non-Physician Participation