The changing landscape in the management of prostate cancer recurrence

Thematic Session 03

  • Location:
    Room Stockholm (Hall B2, level 0)
  • Chair:
     A. De La Taille, Créteil (FR)
  • Aims and objectives of this session

    The approach to recurrent prostate cancer (PCa) after curative treatment has dramatically changed over the recent years due to significant advances in imaging technologies and a better understanding of disease biology. This has opened new horizons in the context of administration of individualised treatments which include systemic and metastasis-directed therapies. The aim of this session is to update the biology knowledge of PCa recurrence and to assess the optimal use of individualised imaging and therapeutic approaches for recurrent disease.

State-of-the-art lecture The genomic picture of recurrent prostate cancer
 G.S. Bova, Tampere (FI)
Aims and objectives of this presentation

• Review current knowledge and recent advances in the genomics of metastatic prostate cancer
• Discuss genomic and other molecular analyses in relation to potential “precision medicine” for prostate cancer
• Discuss how clinicians and researchers can come together to accelerate development of effective precision medicine

European Association of Nuclear Medicine (EANM) lecture How to optimise the use of imaging in the recurrent setting: The role of PET/CT
 S. Fanti, Bologna (IT)
Aims and objectives of this presentation

to discuss the usefulness of imaging techniques in the evaluation of recurrent prostate cancer. to clarify the possible role of PET/CT with different tracers

State-of-the-art lecture Early use of hormonal therapy: Evidence or conventional wisdom?
 N.W. Clarke, Manchester (GB)
Aims and objectives of this presentation

To introduce the concept of communication in difficult circumstances in urology both between patients and between professionals

State-of-the-art lecture Imaging guided approaches: A new treatment option for oligometastatic disease
 M. Graefen, Hamburg (DE)
Associated video and abstract presentations
Early experience of robotic salvage pelvic lymph node dissection in the Ga-68 PSMA PET scanning era

By: Murphy D.1, Zargar H.1, Van Den Bergh R.1, Van Bruwaene S.1, Goad J.1, Coughlin G.2, Harewood L.3, Dundee P.3

Institutes: 1Peter Mac Callum Cancer Institute, Dept. of Cancer Surgery, Melbourne, Australia, 2Wesley Hospital, Dept. of Urology, Brisbane, Australia, 3Epworth Hospital, Dept. of Urology, Melbourne, Australia

Aims and objectives of this presentation

68Ga-PSMA PET/CT has recently been introduced and shows much promise for the assessment of recurrence following radical prostatectomy. Our aim was to assess the utility of salvage pelvic lymph node dissection in men with biochemical recurrence after radical prostatectomy selected by 68Ga-PSMA PET/CT.

Next generation sequencing to determine the clonal origin of lymph node metastasis in multifocal prostate cancer: Defining the biologically dominant nodule

By: Salami S.1, Hovelson D.2, Mathieu R.3, Susani M.4, Rioux-Leclercq N.5, Tracey J.1, Shariat S.3, Tomlins S.2, Palapattu G.1

Institutes: 1University of Michigan, Dept. of Urology, Ann Arbor, United States of America, 2University of Michigan, Dept. of Pathology, Ann Arbor, United States of America, 3Medical University Vienna, Dept. of Urology, Vienna, Austria, 4Medical University Vienna, Dept. of Pathology, Vienna, Austria, 5Rennes University Hospital, Dept. of Pathology, Rennes, France

Aims and objectives of this presentation

Although prostate cancer is often multifocal, the clonal origin of multifocal disease is controversial. In addition, it is currently unknown what characterizes the biologically dominant nodule. The objective of this presentation to showcase our data which demonstrate i) that different foci of prostate cancer exhibit molecular heterogeneity suggesting independent clonal origin; and ii) that a biologically dominant nodule possesses the capability to metastasize to lymph node (s).

Efficacy of early and delayed radiation in a prostatectomy cohort adjusted for genomic and clinical risk

By: Ross A.1, Den R.2, Yousefi K.3, Trock B.1, Davicioni E.4, Tosoian J.1, Thompson D.5, Choeurng V.3, Haddad Z.3, Tran P.6, Trabulsi E.7, Gomella L.8, Lallas C.8, Abdollah F.9, Feng F.10, Dicker A.2, Freedland S.11, Karnes J.12, Schaeffer E.1

Institutes: 1Johns Hopkins Hospital, James Buchanan Brady Urological Institute, Baltimore, United States of America, 2Sidney Kimmel Medical College at Thomas Jefferson University, Dept. of Radiation Oncology, Philadelphia, United States of America, 3GenomeDx Biosciences, Dept. of Biostatistics, Vancouver, Canada, 4GenomeDx Biosciences, Dept. of Research and Development, Vancouver, Canada, 5Emmes Canada, Dept. of Biostatistics, Burnaby, Canada, 6Johns Hopkins Hospital, Dept. of Radiation Oncology, Baltimore, United States of America, 7Sidney Kimmel Medical College at Thomas Jefferson University, Dept. of Urology, Epidemiology, Oncology, Environmental Health, Philadelphia, United States of America, 8Sidney Kimmel Medical College at Thomas Jefferson University, Dept. of Urology, Philadelphia, United States of America, 9Henry Ford Hospital, Dept. of Vattikuti Urology Institute, Detroit, United States of America, 10University of Michigan, Dept. of Radiation Oncology, Ann Arbor, United States of America, 11Cedars-Sinai Medical Center, Dept. of Surgery, Division of Urology, Los Angeles, United States of America, 12Mayo Clinic, Dept. of Urology, Rochester, United States of America

Aims and objectives of this presentation

To determine the therapeutic impact of postoperative radiation in the adjuvant and salvage settings after controlling for both genomic and clinico-pathologic risk

Phase III study of intermittent monotherapy versus continuous combined androgen deprivation

By: Calais Da Silva Junior F.1, Calais Da Silva Senior F.E.2, Gonçalves F.3, Kliment J.4, Santos A.5, Spyros P.6, Queimadelos A.7, Robertson C.8

Institutes: 1CHLC – Hospital De São José, Dept. of Urology, Lisbon, Portugal, 2CHLC – H.S.José, Dept. of Urology, Lisbon, Portugal, 3CUIMED A Saint Michal Hospital, Dept. of Urology, Bratislava, Slovakia, 4Jessenius School of Medicine, Dept. of Urology, Martin, Slovakia, 5Hospital De Braga, Dept. of Urology, Braga, Portugal, 6Amalia Fleming Hospital, Dept. of Urology, Athens, Greece, 7Policlinica La Rosaleda, Dept. of Urology, Santiago Compostela, Spain, 8University of Stracthclyde, Dept. of Statistics, Glasgow, United Kingdom

Aims and objectives of this presentation

Intermittent androgen deprivation mono therapy is evaluated in 918 patients with M1 and local advance prostate cancer with a median follow up 5.5 years. Metastatic status PSA and age are all prognostic factores for survival. + 75 years and PSA that falls to 2-4 at randomization have an increase hazard of dying 1.63 ,1.95 , 2.01.
The inicial results shoed no survival diference,but now there is a poor survival in continuos therapy than intermittent principally associated with an excess CDV deaths 119 int 137 cont and the same prostate deaths 96.