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Yesterday's conference still on line on YouTube

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2020 Moyad and Scholz Mid-year PCRI Update

If you did not see this streamed conference yesterday, it appears to still be online.

Some features

Different from any Australian conference, the PCRI conferences start with a religious invocation.

https://youtu.be/zCHbul3OvP4?t=358

Most interesting if your interest is in advanced prostate cancer, Dr Evan Yu brought us Updates in Advanced Prostate Cancer.

https://youtu.be/zCHbul3OvP4?t=1467

Always a highlight of the conferences is Mark Moyad's putting presenters on the spot with his key questions and questions from the audience. He speaks to Dr Evan Yu here.

https://youtu.be/zCHbul3OvP4?t=3549

Dr Matthew Rettig spoke on today's treatment challenges, concentrating on a new drug Apalutamide (Erlyand® in Australia, Erleada® in USA).

https://youtu.be/zCHbul3OvP4?t=6236

Dr Jeffrey Demanes spoke about radiation treatments.

https://youtu.be/zCHbul3OvP4?t=7990

And faced questioning from Mark Moyad here:

https://youtu.be/zCHbul3OvP4?t=11155

Finally, the highlight of every PCRI conference I've been to (five in Los Angeles + this one at my desk) is the final event where Dr Mark Moyad and Dr Mark Scholz discuss everything that has been raised, and answer questions that did not emerge earlier.

https://youtu.be/zCHbul3OvP4?t=14001

Thanks to Nev Black for drawing my attention to this.

Jim

 

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alanbarlee
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alanbarlee
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Thanks for the reminders, Jim. I’ve watched the Youtube version, which was excellent - some useful new tit-bits there.


 The presentation describing the comparative track record of robotic HDR brachytherapy was interesting. It seems to now provide the most precise primary treatment over a wide range of prostate volumes, with the least impact on sexual and urinary performance, and the least risk of damage to rectum and bladder. Hydrogel spacing further increases the safety margin. Only two treatments one week apart are needed.  This technology has been has been available in Oz for at least the last several years.

There was a lot of discussion on non-metastatic advanced PCa treatments and the multiple candidate anti-androgens now available (apalutamide, enzalutamide, daralutamide) - but I think not yet available in Oz under the present PBS rules.

Still no definitive recommendations on intermittent therapy for advanced patients with very low or undetectable PSA - but adding back testosterone for similar local PCa patients is interesting.

For advanced metastatic PCa, third line treatment with cabazitaxel seems to be clearly beneficial, and is available in Oz under the PBS rules.  

Germline (inherited) gene analysis for all metastatic patients, looking for high mutation burden via MSI ('micro satellite instability)' and and DDR ('DNA damage repair') mutations (e.g. in BRCA2/1 genes), indicating immunotherapy with a PD-1 inhibitor (pembrolizumab)  got some attention. (Peter Mac at least does this analysis). 

Liquid biopsy for somatic (tumour) mutations in mets - especially bone mets, that are hard to biopsy - was covered. Here the targets are HRR ('homologous recombination repair' gene mutations  - especially double strand breaks in the DNA) and the success of PARP inhibitors (olaparib or rucaparib) was well addressed. Again, I’m not sure where liquid biopsies are at in Oz ,outside the trials context. Biopsies of metastatic lymph nodes under PET/CT or PET/MRI guidance wasn’t mentioned, but seems to be a reasonable possibility.

Cheers,

Alan 

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Admin

Alan: Robotic HDR brachytherapy does indeed appear to have the best effect with the fewest side effects.

I had robotic HDR brachytherapy + 5 weeks external beam in 2009.

I was very unsophisticated in those days about these matters, but it seems I got the very best treatment, despite my strong wishes to have surgery at that stage.

It is available at a number of centres in capital cities around the country.

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