Overview

The interdisciplinary care of prostate cancer is becoming a reality with urologists and radiation, surgical, and medical oncologists being involved in the management of patients with prostate cancer.  All physicians and health care professionals taking care of patients with prostate cancer must have comprehensive knowledge of the emerging strategies that impact treatment guidelines and constantly keep abreast of the latest clinical trial data to maximize outcomes.  Hence, there is continuous effort to identify unmet educational needs and provide the interdisciplinary management team with the necessary knowledge to effectively care for their patients with prostate cancer.

Topics Include

• Debating the value of PSA screening
• Selecting candidates for active surveillance
• Comparing current options in radiation therapy for prostate cancer
• Integrating available hormonal, cytotoxic and immunotherapeutic agents for CRPC
• Personalizing treatment and sequencing new therapies in individual patients
• Targeting bone metastases
• Emerging biomarkers for prognostication and prediction
• Future directions – combining novel agents
• Multidisciplinary case discussions

Co-Chairs

Leonard G. Gomella, MD, FACS
The Bernard W. Goodwin, Jr. Professor of Prostate Cancer
Chairman, Department of Urology
Associate Director of Clinical Affairs
Jefferson Kimmel Cancer Center
Thomas Jefferson University
Philadelphia, PA
 
Daniel P. Petrylak, MD
Director, Prostate and Genitourinary Cancers
Co Director, Signal Transduction Program
Yale University Cancer Center
New Haven, CT

Faculty

E. David Crawford, MD
Professor of Surgery and Radiation Oncology
Head of Section on Urologic Oncology
University of Colorado Health Sciences Center
Denver, CO
 
Robert Dreicer, MD, MS, FACP
Chairman, Department of Solid Tumor Oncology
Taussig Cancer Institute
Professor of Medicine
Cleveland Clinic of Lerner College of Medicine
Cleveland, OH
 
Howard M. Sandler, MD, MS
Ronald H. Bloom Chair in Cancer Therapeutics
Professor and Chair, Department of Radiation Oncology
Cedars-Sinai Medical Center
Los Angeles, CA

Susan Slovin, MD, PhD
Associate Attending Physician/Associate Professor of Medicine
Memorial Sloan-Kettering Cancer Center/Weill Cornell Medical School
New York, NY

Agenda

Saturday, March 16, 2013
7:00 am	Registration and Continental Breakfast
8:00 am	Introductory Remarks and Pre-activity Assessment	Leonard Gomella, MD, FACS and Daniel Petrylak, MD
8:15 am	Screening for Prostate Cancer - the PSA Debate	Leonard Gomella, MD, FACS
8:45 am	Comparing Current Options in Radiation Therapy	Howard Sandler, MD
9:15 am	Active Surveillance: Pros, Cons, and Optimal Candidates	David Crawford, MD
9:45 am	Challenging Clinical Scenarios: Management of Early-Stage Prostate Cancer - A Case-Based Discussion	All faculty
10:15 am	Break
10:45 am	New Endocrine Options for Advanced Prostate Cancer	Robert Dreicer, MD
11:15 am	Evolving Approaches in Chemotherapy for Advanced Prostate Cancer	Daniel Petrylak, MD
11:45 am	Advances in Immunotherapy	Susan Slovin, MD, PhD
12:15 pm	Lunch On Your Own
1:30 pm	Novel Therapies and Bone-Targeted Therapies	Daniel Petrylak, MD
2:00 pm	Challenging Clinical Scenarios: Sequencing Therapy for Castration-Resistant Prostate Cancer - A case-based Discussion	All faculty
2:30 pm	Can We Combine Novel Agents for Advanced Prostate Cancer?	Robert Dreicer, MD
3:00 pm	Break
3:30 pm	Emerging Biomarkers - Ready for Primetime?	Daniel Petrylak, MD
4:00 pm	Multidisciplinary Tumor Board	All faculty
4:30 pm	Post-Session Survey and Closing Remarks
4:45 pm	Adjourn

Photos from the 6th Annual Interdisciplinary Prostate Cancer Congress® Integrating New Therapies into the Prostate Cancer Continuum (2013)

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PER Pulse Recap: Interdisciplinary Prostate Cancer Congress® – PSA Screening and Active Surveillance

Medical Writer: Jennifer Klem, PhD

On March 16, 2013, the Interdisciplinary Prostate Cancer Congress® was held to discuss and debate the cutting-edge management of men with prostate cancer. This PER Pulse Recap is the first of three presenting key topics from the Interdisciplinary Prostate Cancer Congress®, specifically, the controversial topics of PSA screening and active surveillance:

• Dr. Leonard Gomella undertook the task of presenting the debate surrounding PSA screening. In 2012, the US Preventive Services Task Force published a recommendation statement against PSA screening for any asymptomatic man, suggesting that there is likely no net benefit of screening for prostate cancer. This creates a scenario in which many insurance carriers will not reimburse screening costs for asymptomatic men. Prospective PSA screening clinical trials have produced conflicting results, with one showing no survival benefit but two others reporting a reduction in mortality. However, certain analyses of these trials (ie, removing patients with comorbidities, using longer follow-up) provide a more consistent and favorable picture of PSA screening benefit. The dramatic increase in 10-year prostate cancer relative survival rate since 1975 (from 53.5% to 97.2%) has likely been the result of both improved treatments and increased screenings.
  
  Based on these data, Dr. Gomella concluded that PSA screening is not beneficial for the general population, but it does benefit those men at high risk for prostate cancer who are in good health and have a life expectancy of at least 10-15 years. He advocated for screening these men, but cautioned against overtreatment by considering active surveillance rather than active treatment in many of these PSA screening-detected cases of prostate cancer. 

• Dr. David Crawford provided an in-depth examination of active surveillance, defining it as a means to provide early, curative treatment for localized disease, in contrast to watchful waiting, which aims to delay the palliative treatment of someone with advanced disease. The increasing interest in active surveillance in recent years is due to a number of factors, including a greater recognition of the issue of overtreatment, a better understanding of occult high-grade disease, new surveillance techniques (multiparametric MRI, staging biopsies), and a better grasp of the flaws of tracking disease progression using PSA kinetics. Active surveillance also delays or avoids quality-of-life declines caused by active treatment, such as sexual dysfunction and urinary incontinence caused by radical prostatectomy or radiation therapy.
  
  The PIVOT trial conducted within the VA hospital system demonstrated that survival of patients receiving radical prostatectomy was not improved compared with those receiving observation only, particularly in those patients with low-risk disease. The National Comprehensive Cancer Network recommends active surveillance as the preferred management approach for men with a very low risk of recurrence when life expectancy is <20 years and as one of three reasonable management options for those at low risk of recurrence when life expectancy is <10 years. A number of different follow-up schedules and monitoring techniques (ie, PSA cut-off value, PSA kinetics, Gleason score progression, clinical progression) have been advocated by various groups.
  
  Dr. Crawford recommended that active surveillance should be offered to men with Gleason scores of 6 and PSA ≤ 10 ng/mL, and suggested that a confirmatory biopsy be performed within 1 year and repeat biopsies performed every 3-5 years up to age 80. He emphasized that patients who are appropriately chosen for active surveillance generally do well.

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