Genitourinary Cancers Symposium

GU 2017 Daily News - Thursday

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Dr. Charles G. Drake to Discuss Immunotherapy During Prostate Cancer Keynote Lecture C harles G. Drake, MD, PhD, of Columbia Uni- versity, will discuss re- cent advances in the de- velopment of immunotherapy for prostate cancer during his keynote lecture on February 16. As an MD/PhD student at the National Jewish Center for Immunology and Respiratory Medicine, Dr. Drake's research focused on autoimmunity, studying the role of genetics in mouse models of systemic lupus erythematosus. He completed a residency in internal medicine and a fellowship in medical on- cology at Johns Hopkins Uni- versity before returning to the laboratory—performing post- doctoral research with Drew M. Pardoll, MD, PhD. At Johns Hopkins, he studied the oppo- site immunological problem, cancer—in which the immune system fails to adequately re- spond to evolving tumors. For this work, he developed a novel animal model of pros- tate cancer, in which mice spontaneously develop prostate tumors that express a model antigen. This system allowed Dr. Drake and his colleagues to more precisely understand what happens when immune cells encounter cancer cells. The re- sults were clear: tumor recogni- tion rapidly led to a deep state of tolerance, in which the im- mune cells failed to respond by generating effector cytokines. "There was a silver lining, though," Dr. Drake said. "It turned out that androgen-abla- tion, which is commonly used to treat human prostate cancer, led to a break in tolerance dur- ing which vaccination could be effective." Those data led to several clinical trials combining andro- gen-ablation with vaccination. One of these trials was recently published and showed that per- forming vaccination prior to androgen ablation likely gen- erates an improved immune response versus the opposite sequence. In a second clinical trial, pa- tients with high-risk prostate cancer were treated with the combination of vaccination and hormonal therapy prior to surgery. Although analysis of those samples is still in prog- ress, preliminary results show a profound immune infi ltration in prostate glands of patients re- ceiving therapy. Dr. Drake and his team are hopeful that this reaction will lead to improved clinical outcomes, specifi cally to a prolonged PSA relapse-free survival. During the keynote lecture, Dr. Drake will discuss these clinical trials along with others, includ- ing data recently published by Julie N. Graff, MD, showing that anti–PD-1 has clear activity in a subset of patients whose disease progressed on enzalutamide. Dr. Drake said that although the fi eld of immunotherapy is still developing, he's confi dent that in the future, immune-based treatment regimens will lead to long-term remissions in patients with prostate cancer. –Danielle Prieur Surgery, Radiation, or Active Surveillance? Findings From the ProtecT Trial for Prostate Cancer Neha Vapiwala, MD T o say that publication of the ProtecT trial results 1,2 was highly anticipated is an understatement. Various stakeholders in the prostate cancer community have patiently awaited answers to the perennial question of whether surgery or radiation is "better"—and the more topical question of whether either of these is better than active surveillance—in patients with clinically local- ized prostate cancer. As the fi rst, and likely only, level 1 evidence comparing the rela- tive long-term impact of surgery, radiation, and active surveillance on outcomes and quality of life (QOL) of patients with prostate cancer, the successful conduct of this trial is a feat in and of itself. More than 1,600 men with localized prostate cancer, derived from a larger group of more than 2,600 men diagnosed with localized prostate cancer, were randomly assigned to active surveillance (545 patients), radical prostatectomy (553 patients), or external-beam radiotherapy (RT; 545 patients). The primary outcome was prostate cancer–specifi c mortality; secondary outcomes included the rates of disease progression, metastases, and all-cause deaths. With a median follow-up of 10 years, there was no statistically signifi cant difference in either prostate cancer–specifi c mortality or overall mortality among the three groups. Notably, the rates of death from prostate cancer were low in all three groups 1 —which I will discuss in greater detail later. In terms of the patient-reported outcomes, the authors reported on multiple domains, including Attendee Tip of the Day The Attendee Resource Center is an all-in-one location for links to useful Symposium materials, including: ➤ Abstracts ➤ Find a Colleague directory ➤ Virtual Meeting ➤ CE Request ➤ Visit the Attendee Resource Center: gucasym.org/arc. Second-Line Treatment Options for Urothelial Carcinoma C ora N. Sternberg, MD, FACP, answers a ques- tion posed by an attendee during a Best of ASCO ® Meeting. Dr. Sternberg is chief of medical oncology at the San Camillo Forlanini Hospital, in Rome. Question: In bladder cancer, what do you recommend for second-line treatment once disease progresses after combination gemcitabine/ cisplatin? Answer: Urothelial cancer is a common type of bladder cancer, where patients experi- ence high rates of recurrence, and new treatment approaches are needed. It has been some See ProtecT Trial, Page 8 Attend the Trainee & Early-Career Networking Luncheon 3 To Treat or Not to Treat Adjuvantly in RCC: That Is the Question 10 Symposium Essentials: Networking 12 Why the U.S. and U.K. Use Active Surveillance Differently 12 Dr. Asif Muneer to Discuss Advances in Immunotherapy, Surgical Techniques for Penile Cancer 12 Navigating the Waters of Active Surveillance 16 The Clinical Trials Consortium 16 Attend Ancillary Events 19 Restaurant Recommendations 19 ASTRO Releases Three New Patient Videos 23 My Meeting Experience: A Medical Oncologist's Perspective 24 Symposium Essentials: Stay Connected 24 Symposium Essentials: Audience Participation 25 INSIDE Dr. Charles G. Drake 2017 T H U R S D AY, F E B R U A R Y 1 6 O R L A N D O , F L T A R G E T I N G C A N C E R C A R E See Second-Line Treatment, Page 3 eeting st Clinical Corner

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