The Evolving Landscape of Advanced Prostate Cancer Treatment: A Guidelines and Case-Based Discussion Webcast (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.
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.
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.
The Evolving Landscape of Advanced Prostate Cancer Treatment:
A Guidelines and Case-based Discussion
Presented Live on Thursday, September 9, 2021
|Identification of High Risk Disease and Initial Management of Biochemical Recurrence|
|Imaging of Advanced Prostate Cancer and Impact on Cancer Management|
|M0 CRPC: Treatment Options and Goals of Therapy|
|Manipulating the Androgen Axis: New Agents in mHSPC and CRPC|
|Genetic Testing in Advanced Prostate Cancer|
|mHSPC: Maximal Androgen Targeted vs Chemohormonal Therapy for mHSPC and Management of Oligometastatic Disease|
Dr. Jarrard & Dr. Lang
|Bone Health and Radionuclide Therapy|
|Role of Immunotherapy and PARP Inhibitors|
|Role of Chemotherapy, Treatment Sequencing in mCRPC and Future Directions |
Education Council Disclosures
COI Review Work Group Disclosures
|Name||Company Name||Relationship Type||Financial||End Date|
|Boorjian, Stephen A.||Ferring||Consultant or Advisor||Yes||Current|
|Boorjian, Stephen A.||ArTara||Consultant or Advisor||Yes||Current|
|Boorjian, Stephen A.||FerGene||Consultant or Advisor||Yes||Current|
|Cookson, Michael S.||TesoRx Pharma LLC||Consultant or Advisor||Yes||09/15/2021|
|Cookson, Michael S.||Astellas Pharma, Inc.||Consultant or Advisor||Yes||12/01/2020|
|Cookson, Michael S.||Bayer Healthcare Pharmaceuticals||Consultant or Advisor||Yes||12/01/2021|
|Cookson, Michael S.||Myovant Sciences||Consultant or Advisor||Yes||11/30/2020|
|Cookson, Michael S.||Merck||Consultant or Advisor||Yes||Current|
|Gomella, Leonard G.||Wolters Kluwer||Health Publishing||Yes||Current|
|Gomella, Leonard G.||McGraw Hill||Health Publishing||Yes||Current|
|Gomella, Leonard G.||Merck Manual||Health Publishing||Yes||Current|
|Gomella, Leonard G.||Canadian Journal of Urology||Health Publishing||Yes||Current|
|Gomella, Leonard G.||MDx Health||Consultant or Advisor||Yes||Current|
|Gomella, Leonard G.||Merck Pharmaceuticals||Consultant or Advisor||Yes||Current|
|Gomella, Leonard G.||Astra Zeneca||Consultant or Advisor||Yes||Current|
|Jarrard, David F.||Nothing to disclose|
|Kaye, Deborah||Nothing to disclose|
|Lang, Joshua||Salus Discovery, LLC||Investment Interest||Yes||07/01/2021|
|Lang, Joshua||4D Pharma||Consultant or Advisor||Yes||Current|
|Stratton, Kelly L.||Ebix||Consultant or Advisor||Yes||02/21/2023|
|Stratton, Kelly L.||Oakstone||Consultant or Advisor||Yes||08/11/2022|
|Stratton, Kelly L.||Astellas Pharma||Scientific Study or Trial||Yes||02/01/2021|
|Stratton, Kelly L.||Myovant Sciences||Scientific Study or Trial||Yes||01/07/2021|
|Stratton, Kelly L.||MJH Life Sciences||Consultant or Advisor||Yes||09/14/2021|
|Stratton, Kelly L.||Janssen Pharmaceuticals||Consultant or Advisor||Yes||11/30/2023|
|Stratton, Kelly L.||MJH Life Sciences||Meeting Participant or Lecturer||Yes||12/31/2021|
|Stratton, Kelly L.||Roche/Genentech||Meeting Participant or Lecturer||Yes||Current|
AUA Office of Education Staff has nothing to disclose.
All relevant financial relationships have been mitigated.
METHOD OF PARTICIPATION:
Learners will participate in this online educational activity by taking the pretest, viewing the webcast 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: 3.75 hours
Release Date: September, 2021
Expiration Date: September, 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 enduring material for a maximum of 3.75 AMA PRA Category 1 Credits™. 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.
RESOLUTION 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 resolution 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 resolve 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.
- 3.75 AMA PRA Category 1 Credit™
- 3.75 Non-Physician Participation