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ForwardAUA Annual Meeting Highlights (2018): Advanced and Castration-Resistant Prostate Cancer
There is a growing need for urologists to be able to effectively manage castration resistant prostate cancer (CRPC). CRPC is defined clinically as a failure of castration or androgen ablation therapy to prevent a worsening of a patient's prostate cancer and is associated with advanced disease. Approximately 28% of patients with prostate cancer will advance to CRPC. The median age at diagnosis of CRPC is 77 years and, as might be expected, these patients often have comorbidities, the most common of which are hypertension, dyspnea and anemia. More than 84% of patients diagnosed with CRPC have metastatic disease. Of those patients without metastases, 33% can expect to develop them within 2 years. The median survival of patients with CRPC is 9 to 30 months (median 14 months).
Target Audience
- Urologists
- Urologists in training
- Non-physician providers involved in urology
Learning Objectives
Course 005IC: Chemotherapy and Immunotherapy Options for Genitourinary Malignancies: A Primer for the Advanced Practice Provider
At the conclusion of this CME activity, participants should be able to:
- Describe the standard of care chemotherapy regimens for genitourinary malignancies
- Recognize newer immunotherapy options in the treatment of genitourinary malignancies
- Identify and manage the toxicities with relation to these agents
- Identify the survivorship issues surrounding patients on systemic treatments for genitourinary malignancies
Course 043IC: Novel Agents and Concepts in the Management of Hormone Naïve and Castration-Resistant Prostate Cancer
At the conclusion of this CME activity, participants should be able to:
- Diagnose castrate resistant prostate cancer (CRPC) and have a working knowledge of treatments and the proper order for administration
- Manage CRPC with systemic agents by learning the proper candidates for treatment and be able to counsel patients on the pros and cons of therapy
- Analyze the mechanism of action and risks/benefits of using systemic agents in the treatment of CRPC
- Describe the bone-targeted radiopharmaceutical agent radium-223 and its sequencing
- Review the new generation antiandrogen agent enzalutamide and its sequencing
Course 058IC: Management of Common Dilemmas in Prostate Cancer Diagnosis, Staging and Treatment
At the conclusion of this CME activity, participants should be able to:
- Use shared decision making to test men with PSA, to decide whom to biopsy and how to biopsy
- Understand the pros and cons of different types of biopsy and how to select men for surveillance, surgery or XRT
- Determine the new therapies for advanced and metastatic cancer with ADT, chemotherapy and immunotherapies
- Identify the roles of new staging PET scans
Course 063IC: Prostate Cancer Update
At the conclusion of this CME activity, participants should be able to:
- Cite important new publications in this field during the past year
- Identify the relative strengths and weaknesses of the reports
- Appraise how new studies relate to the existing state-of-the-art in clinical practice
- Analyze whether they and their colleagues should consider changing their practice based on the new information
Course 074IC: AUA Castration-Resistant Prostate Cancer (CRPC) Guidelines
At the conclusion of this CME activity, participants should be able to:
- Identify the active agents and their mechanism of action in the management of mCRPC
- Analyze the evidence and outcomes on the treatment of CRPC as outlined in the AUA guidelines and subsequent amendments
- Improve diagnostic and therapeutic decision making processes by illustrating the application of these guidelines in urological practice
- Understand the sequencing and indications for active treatment with approved agents in the management of mCRPC
Course 078IC: Management of Prostate Cancer: A Case Based Approach with Emphasis on Integrating New Molecular Diagnostics into Clinical Practice
At the conclusion of this CME activity, participants should be able to:
- Design appropriate screening strategies based on individual demographics, risk factors and PSA history, and incorporate new biomarkers into routine clinical practice
- Distinguish and understand the use of new molecular and genomic based tests for decisions on initial and re-biopsy, and choosing and following men on surveillance
- Appraise the role of surveillance, focal therapy, surgery, and various forms of radiation therapy in patients with low and intermediate risk disease, including adjuvant and salvage radiation
- Review the role of surgery in the multimodality treatment of men presenting with oligometastatic disease
- Describe new therapeutic agents for the management of castrate resistant disease and outline a coherent strategy for their use
Urologic Care for the Advanced Practice Provider: 2018 Prostate Cancer Update: Clinical Guidelines & Management
At the conclusion of this CME activity, participants should be able to:
- Review the latest guidelines from the AUA (ASTRO/SUO) for localized prostate cancer
- Identify when to use biomarkers and MRI
- Describe high intensity focused ultrasound (HIFU) as a primary form of treatment
- Discuss the latest update on clinical trials
Course 005IC: Chemotherapy and Immunotherapy Options for Genitourinary Malignancies: A Primer for the Advanced Practice Provider
Costas D. Lallas, MD, FACS, Course Director
Vice Chair and Professor of Urology
Thomas Jefferson University Hospital
Philadelphia, PA
Disclosures: Nothing to disclose
Anne E. Calvaresi, MSN, CRNP
Nurse Practitioner, Urologic Oncology
Thomas Jefferson University
Philadelphia, PA
Disclosures: Nothing to disclose
Edouard J. Trabulsi, MD, FACS
Professor and Vice Chair, Department of Urology
Sidney Kimmel Medical College at Thomas Jefferson University
Philadelphia, PA
Disclosures: Nothing to disclose
Course 043IC: Novel Agents and Concepts in the Management of Hormone Naïve and Castration-Resistant Prostate Cancer
Judd W. Moul, MD, FACS, Course Director
Professor of Surgery
Duke University
Durham, NC
Disclosures: Sanofi-Aventis: Health Publishing, Meeting Participant or Lecturer; Dendreon: Consultant or Advisor, Meeting Participant or Lecturer; Theralogix: Consultant or Advisor; Ferring Pharmaceuticals Inc: Consultant or Advisor, Meeting Participant or Lecturer; Medivation-Astellas: Consultant or Advisor; Janssen- J and J: Consultant or Advisor, Meeting Participant or Lecturer; Myriad Genetics Inc: Consultant or Advisor, Meeting Participant or Lecturer; Genomic Health: Meeting Participant or Lecturer
Lawrence I. Karsh, MD, FACS
Director, Clinical Research Department
The Urology Center of Colorado
Denver, CO
Disclosures: Astellas: Consultant or Advisor, Meeting Participant or Lecturer, Scientific Study or Trial; Dendreon: Consultant or Advisor, Meeting Participant or Lecturer, Scientific Study or Trial; Bayer: Consultant or Advisor, Meeting Participant or Lecturer, Scientific Study or Trial; Janssen: Consultant or Advisor, Meeting Participant or Lecturer, Scientific Study or Trial; Medivation: Consultant or Advisor, Meeting Participant or Lecturer, Scientific Study or Trial; Genomic Health: Consultant or Advisor, Meeting Participant or Lecturer, Scientific Study or Trial; Augmenix: Consultant or Advisor, Scientific Study or Trial; Precision Biopsy: Consultant or Advisor, Scientific Study or Trial; 3D Biopsy: Consultant or Advisor, Scientific Study or Trial; GenomeDx BIosciences: Consultant or Advisor, Scientific Study or Trial; Precision Med: Scientific Study or Trial; Spectrum Pharmaceuticals: Consultant or Advisor, Scientific Study or Trial; FKD: Scientific Study or Trial; Pfizer: Consultant or Advisor; Sanofi: Consultant or Advisor; AbbVie: Consultant or Advisor; AstraZeneca: Consultant or Advisor; Myriad Genetics: Consultant or Advisor, Scientific Study or Trial; Swan Valley Medical: Consultant or Advisor, Investment Interest; Amgen: Scientific Study or Trial; Heat Biologics: Scientific Study or Trial; MDxHealth: Scientific Study or Trial; Lawrence Karsh: Health Publishing, Consultant or Advisor, Meeting Participant or Lecturer, Scientific Study or Trial, Investment Interest
Christopher Sweeney, MBBS
Medical Oncologist
Dana-Farber Cancer Institute
Boston, MA
Disclosures: Sanofi: Consultant or Advisor, Scientific Study or Trial; Janssen: Consultant or Advisor, Scientific Study or Trial; Astellas: Consultant or Advisor, Scientific Study or Trial; Bayer: Consultant or Advisor, Scientific Study or Trial; Genentech_Roche: Consultant or Advisor, Scientific Study or Trial
Course 058IC: Management of Common Dilemmas in Prostate Cancer Diagnosis, Staging and Treatment
Gerald Andriole, Jr., MD, Course Director
Professor and Chief of Urologic Surgery
Washington University School of Medicine
St. Louis, MO
Disclosures: Augmenix: Consultant or Advisor, Other; Medivation: Scientific Study or Trial; Blue Earth Diagnostics: Scientific Study or Trial; Progenics: Scientific Study or Trial; Tolmar Pharmaceuticals: Consultant or Advisor; 3D Biopsy: Consultant or Advisor
Anthony D'Amico, MD, PhD
Chair and Chief, Genitourinary Radiation Oncology
Dana-Farber Cancer Institute and Brigham and Women’s Hospital
Boston, MA
Disclosures: Nothing to disclose
Adam Kibel, MD
Chief, Urologic Surgery, Brigham and Women’s Hospital
Chief, Urologic Surgery, Dana-Farber Cancer Institute
Professor, Department of Surgery, Harvard University Medical School
Chairman, Harvard Urology Residency Program
Co-Leader, Prostate Cancer Program, Dana-Farber/Harvard Cancer Center
Boston, MA
Disclosures: Profound: Consultant or Advisor; Janssen: Consultant or Advisor
Oliver Sartor, MD
Medical Director, Tulane Cancer Center
Professor, Tulane Medical School
New Orleans, LA
Disclosures: sanofi-aventis: Consultant or Advisor, Meeting Participant or Lecturer, Scientific Study or Trial; Johnson & Johnson: Consultant or Advisor, Scientific Study or Trial; Oncogenex: Consultant or Advisor; Bellicum: Consultant or Advisor ; Bayer: Consultant or Advisor, Scientific Study or Trial; Bristol-Myers Squibb: Consultant or Advisor; AstraZeneca: Consultant or Advisor; Squibb: Consultant or Advisor; Celgene : Consultant or Advisor; Dendreon: Consultant or Advisor; EMD Serono: Consultant or Advisor; Endocyte: Consultant or Advisor, Scientific Study or Trial; Innocrin: Consultant or Advisor, Scientific Study or Trial; NRG: Leadership Position; Bavarian-Nordic: Consultant or Advisor
Eric H. Kim, MD, Author
Assistant Professor, Urologic Surgery
Washington University School of Medicine
St. Louis, MO
Disclosures: Nothing to disclose
Course 063IC: Prostate Cancer Update
Faculty
William J. Catalona, MD, Course Director
Professor, Department of Urology
Director, Clinical Prostate Cancer Program
Northwestern University
Chicago, IL
Disclosures: Beckman Coulter Incorporated: Consultant or Advisor, Meeting Participant or Lecturer, Scientific Study or Trial; deCODE Genetics: Consultant or Advisor, Meeting Participant or Lecturer, Scientific Study or Trial; Nanosphere: Consultant or Advisor; OHMX: Consultant or Advisor, Scientific Study or Trial, Owner, Product Development
Douglas M. Dahl, MD, FACS
Chief, Division of Urologic Oncology
Associate Professor of Urology
Harvard Medical School
Boston, MA
Disclosures: Nothing to disclose
Stanley L. Liauw, MD
Associate Professor, Radiation Oncology
University of Chicago
Chicago, IL
Disclosures: Nothing to disclose
Stacy Loeb, MD, MSc
Assistant Professor, Department of Urology and Population Health
New York University
New York, NY
Disclosures: Lilly: Consultant or Advisor
Robert B. Nadler, MD
Professor, Department of Urology
Northwestern University
Chicago, IL
Disclosures: Allena: Scientific Study or Trial
Russell Szmulewitz, MD
Assistant Professor of Medicine, Section of Hematology/Oncology
University of Chicago
Chicago, IL
Disclosures: Pfizer: Consultant or Advisor; Genentech: Scientific Study or Trial; Exelixis: Consultant or Advisor; Abbvie: Scientific Study or Trial; Incyte: Scientific Study or Trial; Astellas: Scientific Study or Trial
Course 074IC: AUA Castration-Resistant Prostate Cancer (CRPC) Guidelines
Michael Cookson, MD, MMHC, Course Director
Professor and Chair, Department of Urology
University of Oklahoma
Oklahoma City, OK
Disclosures: TesoRx Pharma LLC: Consultant or Advisor; MDx Health: Consultant or Advisor
David Jarrard, MD
Professor and Vice Chair, Urology
University of Wisconsin
Associate Director, UW Carbone Cancer Center
Madison, WI
Disclosures: Gregor Diagnostics: Consultant or Advisor
Adam Kibel, MD
Chief, Urologic Surgery, Brigham and Women’s Hospital
Chief, Urologic Surgery, Dana-Farber Cancer Institute
Professor, Department of Surgery, Harvard University Medical School
Chairman, Harvard Urology Residency Program
Co-Leader, Prostate Cancer Program, Dana-Farber/Harvard Cancer Center
Boston, MA
Disclosures: Profound: Consultant or Advisor; Janssen: Consultant or Advisor
Course 078IC: Management of Prostate Cancer: A Case Based Approach with Emphasis on Integrating New Molecular Diagnostics into Clinical Practice
Faculty
Eric A. Klein, MD, Course Director
Chair, Glickman Urological and Kidney Institute
Professor of Surgery, Lerner College of Medicine
Cleveland Clinic
Cleveland, OH
Disclosures: Nothing to disclose
Andrew J. Stephenson, MD
Director, Center of Urologic Oncology
Cleveland Clinic
Cleveland, OH
Disclosures: Genomic Health: Consultant or Advisor, Meeting Participant or Lecturer
Urologic Care for the Advanced Practice Provider: 2018 Prostate Cancer Update: Clinical Guidelines & Management
Heather Schultz, RN, MSN, NP-C, Course Co-Director
Nurse Practitioner
Department of Urology, University of North Carolina at Chapel Hill
Chapel Hill, NC
Disclosures: SUNA: Meeting Participant or Lecturer
Kenneth Mitchell, MPAS, PA-C, Course Co-Director
Physician Assistant
Meharry Medical College
Nashville, TN
Disclosures: Nothing to disclose
Daniel Park, PA, MHA
Director, Clinical Operations
USC Institute of Urology
Los Angeles, CA
Disclosures: Nothing to disclose
Estimated time to complete this activity: 1.25 hours
Release Date: October 2018
Expiration Date: October 31, 2019
Accreditation Statement: The American Urological Association (AUA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Credit Designation: The American Urological Association designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Other Learners: 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™.
Acknowledgements
The AUA Office of Education would like to thank the companies who support continuing education of physicians. The AUA recognizes the following companies for providing educational grant support:
- AbbVie
- Astellas
- Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC
- Medivation, Inc., a Pfizer company
- Sanofi Genzyme
American Urological Association Education & Research, Inc. ensures that all educational activities are developed and implemented independent of the control and/or influence of any commercial interests (ACCME: SCS1).
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 COI Review Work Group 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
Planners
Manoj Monga, MD, FACS
Director, Center for Endourology & Stone Disease
Cleveland Clinic
Cleveland, OH
Disclosures: Fortec: Other
Victor W. Nitti, MD
Professor, Department of Urology
Professor, Department of Obstetrics and Gynecology
Director, Female Pelvic Medicine and Reconstructive Surgery
Vice Chair, Department of Urology
New York University Langone Medical Center
New York, NY
Disclosures: Astellas: Health Publishing, Scientific Study or Trial; Allergan: Health Publishing, Scientific Study or Trial; Medtronic: Scientific Study or Trial; Serenity Pharmeuticals: Investment Interest
Michael Abern, MD
Assistant Professor, Urology
Director, Urologic Oncology
University of Illinois at Chicago
Chicago, Illinois
Disclosures: Department of Defense Prostate Cancer Research Program: Scientific Study or Trial, Consultant or Advisor
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.
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.
Disclaimer: The opinions and recommendations expressed by faculty, authors and other experts whose input is included in this program are their own and do not necessarily represent the viewpoint of the AUA.
Reproduction Permission: Reproduction of written materials developed for this AUA course is prohibited without the written permission from individual authors and the American Urological Association.
AUA Privacy and Confidentiality Policy
Access the AUA Privacy and Confidentiality Policy online at www.auanet.org/education/confidentiality-statement.cfm.
Available Credit
- 1.25 AMA PRA Category 1 Credit™
- 1.25 Non-Physician Participation