By Prof. Tsaur
The recent AUA 2022, which took place from 13 to 16 May 2022 in New Orleans, delivered crucial updates on prostate cancer (PCa) treatment and management. Here are some of the PCa highlights and vital findings presented at the annual meeting.
Localized PCa
On diagnostics
The focus on personalised medicine is becoming more prominent. The use of the Oncotype DX® GPS™ Assay in the decision-making process of individualised treatment aids in the improvement of stratifying patients with intermediate PCa. The genomic assay helps determine whether they have a favourable or unfavourable disease. This approach optimises the selection of male patients for AS (active surveillance), as well as, the prediction of pT3 (pathological stage 3) disease and ECE (extracapsular extension).
In the detection of clinically significant prostate cancer (csPCa), growing evidence has shown that transperineal MRI-TRUS fusion prostate biopsy is presumably superior in detecting anterior and apical lesions than the transrectal route, and has a lower rate of infectious complications.
PSMA-PET/CT is able to detect csPCa missed by MRI-fusion biopsies, warranting further research on PET/CT-US fusion and determining which patients would benefit the most from this modality.
On therapy
In terms of improved functional outcomes, opting for Retzius-sparing prostatectomy is still extensively debated. However, current evidence is still not robust enough to favour this technique over thoroughly performed standard prostatectomy.
Research on better stratification of patients with high-risk PCa (those who would truly benefit from adjuvant radiotherapy based on histological parameters) is still ongoing.
Metastatic PCa
The long-term survival benefit of enzalutamide combined with ADT (androgen deprivation therapy) was observed in patients with mHSPC (metastatic hormone-sensitive prostate cancer) irrespective of receiving local therapy previously.
A new cytoskeleton targeting agent, Sabizabulin, demonstrated promising efficacy in patients with mCRPC (metastatic castration-resistant prostate cancer) progression upon at least one treatment line of ARTAs (androgen receptor targeting agents).
Selected AUA22 abstracts on PCa: