Highlights from AUA2019: Evolving Role of the Urologist in Metastatic and Castration Resistant Prostate Cancer (2019)
The AUA is launching an educational initiative to focus on resident and fellow training in the area of Advanced and Castration-Resistant Prostate Cancer. Based on the documented need for additional education in this area, the AUA has developed multiple educational interventions to improve the ability to care for patients with CRPC. These educational activities may also be of interest to advanced practice providers and urologists.
To extend the educational reach, the AUA will capture the live presentations and develop three podcasts with a faculty interview segment. This activity will focus on the following topics:
1. Genetic Testing in Advanced Prostate Cancer, Presented by Leonard Gomella, MD
2. Identification of High Risk Disease and Initial Management of Biochemical Recurrence, Presented by Steve Boorjian, MD
3. Setting Up and Managing Advanced Prostate Cancer in the Community Setting: Unique Challenges, Presented by Benjamin Lowentritt, MD
4. Role of Chemotherapy, Treatment Sequencing and Future Approaches, Presented by Evan Yu, MD
5. Manipulating the Androgen Axis: Androgen Biosynthesis Inhibitors and Androgen Receptor Signaling Agents, Presented by David F. Jarrard, MD
6. Radionuclide Therapy and Bone Health, Presented by Steve Boorjian, MD
This educational series is supported by independent educational grants from:
- Astellas and Pfizer, Inc.
- Bayer HealthCare Pharmaceuticals Inc.
- Genomic Health
- Sanofi Genzyme
- Advanced practice providers
- This activity may also be of interest to urologists and other health care providers who care for patients with prostate cancer
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 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 MO 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 AND CO-MORBIDITY)
- Identify approved chemotherapeutics and immunotherapy for mCRPC.
- Describe indications and contraindications for chemotherapy and immunotherapy in patients with mCRPC.
- Identify co-morbid states and recognize their impact on treatment options for mCRPC.
- Discuss treatment sequencing.
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.
Education Council Disclosures
AUA Office of Education Staff has nothing to disclose.
METHOD OF PARTICIPATION:
Learners will participate in this online educational activity by taking the pretest, viewing the video 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: 3.00 hours
Release Date: July, 2019
Expiration Date: July, 2020
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 activity for a maximum of 3.00 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.
RESOLUTION OF IDENTIFIED CONFLICT OF INTEREST:
All disclosures will be reviewed by the program/course directors or editors for identification of conflicts of interest. Peer reviewers, 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 Education Content Review Committee or its subgroup.
- 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.