On recurring and metastatic diseases: Special EAU, EANM, ESMO and ESTRO session
The special joint session of the European Association of Urology (EAU), European Association of Nuclear Medicine (EANM), European Society for Medical Oncology (ESMO), and European SocieTy for Radiotherapy and Oncology (ESTRO) “Modern diagnostic and therapeutic approaches in PCa” provided delegates with multidisciplinary insights on recurring and metastatic diseases.
Led by Chair Dr. Jochen Walz (FR), the session initially focused on recurring disease. In the presentation “Salvage treatment options for the PSMA avid lesion: Surgery”, urologist Prof. Tobias Maurer (DE) stated that SLND (salvage lymph node dissection) and prostate-specific membrane antigen (PSMA)-radioguided surgery still represent an individual treatment approach. “It’s not a Guidelines recommendation. There are only retrospective data present,” said Prof. Maurer. He added that careful selection of patients is necessary, and oncological outcomes seem promising.
During her presentation “Treatment landscape of hormone-sensitive recurring M1 prostate cancer”, oncologist Prof. Ursula Vogl (CH) stated that high-level evidence exists for systemic treatment for metachronous low-volume and high-volume metastatic hormone-sensitive prostate cancer (mHSPC). She added that for oligometastatic recurrent mHSPC, SABR (stereotactic ablative body radiotherapy) is a promising therapeutic approach. However, its overall survival (OS) benefit has yet to be proven. “It should be considered experimental until the results of ongoing trials are available,” said Prof. Vogl.
During the “Metastatic disease” part of the special session, nuclear medicine physician Asst. Prof. Matthias Eiber (DE) shared the key messages of his presentation “The role of PSMA radioligand treatment in castrate resistant M1 prostate cancer” such as:
- Lutetium-177 (177Lu) prostate-specific membrane antigen (177Lu-PSMA) is safe and shows OS benefit in a 3+ line mCPRC (metastatic castration-resistant prostate cancer) setting which was the basis of the FDA approval in March this year.
- Data published from the TheraP trial showed similar rPFS (radiographic progression-free survival) and OS at lower serious adverse events.
Prof. Eiber’s presentation was followed by the lecture “Possible synergies between radioligand and systemic treatment in M1 prostate cancer? Future perspectives” by Dr. Ken Herrmann (DE). He stated that the aim of combination therapy is synergism, which is considered the “Holy Grail”. He added that there are some early indicators for potential synergism e.g. combinations such as checkpoint inhibitors (PSMA RLT [radioligand therapy] + pembrolizumab) and ARDT (androgen receptor-directed therapy).
(Re)watch the full presentations of this session via EAU22 On Demand on the Virtual Platform.