Expert opinions on mCRPC management

Emerging pharmacological strategies that could help meet unmet needs in mCRPC

Professor Merseburger (University Hospital Schleswig-Holstein, Germany) reflects on the role of investigational treatments that do not rely on the patient’s biomarker status for meeting unmet needs in mCRPC management.

Clinical barriers to uptake of clinical practice guidelines for mCRPC

Professor Merseburger considers why uptake of clinical practice guideline recommendations for mCRPC management remains low.

What is the most important factor for patient populations in mCRPC trials?

According to Professor Agarwal (Huntsman Cancer Institute, University of Utah, USA), the most important factor to consider for the patient population in phase 3 first-line mCRPC trials relates to evidence of disease progression when patients on novel hormonal therapy “reach the mCRPC space”.

Differences in clinical trial design for PARP inhibitors and novel hormonal therapies

Professor Agarwal outlines three trials that investigated PARP inhibitors for mCRPC (MAGNITUDE, PROPEL, TALAPRO-2) and analyses similarities and differences (minor and major) in the design of these trials.

Meet the experts

Dr Bárbara Vieira Lima Aguiar Melão

Dr Bárbara Melão is a full member urologist of the Brazilian Society of Urology (SBU) and Director of Oncology at the Adventist Hospital, Manaus, Brazil. She is a Professor in the Department of Uro-oncology at SBU. Dr Melão is dedicated to advancing knowledge and treatment in the field of urology and oncology.

Disclosures: Clinical trials: Janssen. Speaker fees: Aspen and Janssen.

Axel Merseburger

Axel Merseburger is Professor of Urology and Chairman of the Department of Urology at University Hospital Schleswig-Holstein, Campus Lübeck, Germany. He studies biomarkers and prognostic factors for prostate cancer, renal cell carcinoma, and transitional cell carcinoma. He is Editor-in-Chief of the European Journal of Haematology and Oncology and Aktuelle Urologie.

Disclosures: Lectures/Speaker/Honoraria: Astellas, AstraZeneca, Bayer, Bristol Myers Squibb, Eisai, Ferring, Ipsen, Janssen, Merck Serono, MSD, Novartis, Pfizer, Recordati, Roche, Takeda, and Teva.

Consultancy: Astellas, AstraZeneca, Bayer, Bristol Myers Squibb, EUSA Pharma, Ferring, Ipsen, Janssen, Merck Serono, MSD, Novartis, Pfizer, Recordati, Roche, Takeda, and Teva.

Research and clinical trials: Astellas, AstraZeneca, Bayer, Bristol Myers Squibb, EUSA Pharma, Ipsen, Janssen, Merck Serono, MSD, Novartis, Pfizer, Roche, Takeda, and Teva.

Neal Shore

Neal Shore is Medical Director for the Carolina Urologic Research Center and Chief Medical Officer, Strategic Growth and Pharmacy, GenesisCare, USA. He is Chair of the Prostate Cancer Academy and the Bladder/Kidney Cancer Academy for LUGPA/Specialty Network. Dr Shore serves on the Society for Immunotherapy of Cancer (SITC) Guidelines Committee for Bladder Cancer, the boards of the Bladder Cancer Advocacy Network, Maple Tree Alliance, and the Duke Global Health Institute.

Disclosures: AbbVie, Alessa Therapeutics, Alkido Pharma, Amgen, Arquer Diagnostics, Asieris, Astellas, AstraZeneca, Bayer, Boston Scientific, Bristol Myers Squibb, Clarity, Clovis, Cold Genesys, Dendreon, Exact Images, Exact Sciences, FerGene, Ferring, Foundation Medicine, GC Oncology, Genentech, GenesisCare, Guardant Health, ImmunityBio, Incyte, Invitae, Janssen, Lantheus, Lilly, Mdxhealth, Merck, Minomic, Myovant Sciences, Myriad, NGM Bio, Nonagen Bioscience, Novartis, Nymox Pharmaceutical Corporation, Pacific Edge, Pfizer, Photocure, PlatformQ, Profound Pharma, Promaxo, Propella Therapeutics, Protara Therapeutics, Sanofi, Sesen Bio, Speciality Networks, Telix, Tolmar, UroGen Pharma, Vaxiion Therapeutics, and Vessi Medical.

Karim Fizazi

Karim Fizazi is a medical oncologist at Institut Gustave Roussy and Professor in Oncology at the Université Paris-Saclay, France. He has published more than 400 peer-reviewed articles. To push forward clinical research on prostate cancer in Europe, in 2013, Professor Fizazi created the Prostate Cancer Consortium in Europe (PEACE).

Disclosures: Participation in advisory boards and talks for Amgen, Arvinas, Astellas, AstraZeneca, Bayer, Clovis Oncology, CureVac, Daiichi Sankyo, Janssen, MSD, Novartis/AAA, Orion, Pfizer, and Sanofi.

Neeraj Agarwal

Neeraj Agarwal is Professor of Medicine and Presidential Endowed Chair of Cancer Research at the Huntsman Cancer Institute (HCI), University of Utah, USA. He directs the Genitourinary Oncology (GU) Program and the Center of Investigational Therapeutics (CIT) at the HCI. Dr Agarwal is a panel member for the NCCN guideline committees for bladder and kidney cancers. He is advisor to the Oncology Drug Advisory Committee and the US Food and Drug Administration and leads early therapeutics in the SWOG genitourinary cancers committee.

Disclosures: Consultancy: Astellas, AstraZeneca, Aveo, Bayer, Bristol Myers Squibb, Calithera, Clovis Oncology, Eisai, Eli Lilly, EMD Serono, Exelixis, Foundation Medicine, Genentech, Gilead, Janssen, MEI Pharma, Merck, Nektar Therapeutics, Novartis, Pfizer, Pharmacyclics, and Seattle Genetics.

Research funding: Astellas, AstraZeneca, Bavarian Nordic, Bayer, Bristol Myers Squibb, Calithera, Celldex, Clovis Oncology, Eisai, Eli Lilly, EMD Serono, Exelixis, Genentech, Gilead, GlaxoSmithKline, Immunomedics, Janssen, Medivation, Merck, Nektar Therapeutics, NewLink Genetics, Novartis, Pfizer, Prometheus, Rexahn, Roche, Sanofi, Seattle Genetics, Takeda, and Tracon.

Elena Castro

Dr Elena Castro is a Consultant Medical Oncologist in GU tumours at the Virgen de la Victoria University Hospital in Malaga, Spain, where she leads the GU cancers translational research unit as part of the Malaga Biomedical Research Institute (IBIMA). Dr Castro’s research is focused on the clinical and molecular characterisation of BRCA2 mutations, and other DNA repair defects in prostate cancer.

Disclosures: Honoraria or consultation fees: AstraZeneca, Bayer, Daiichi Sankyo, Janssen, Lilly, Medscape, Merck, MSD, Novartis, and Pfizer.

Grants and research support: Bayer (inst), Janssen (inst), and Pfizer (inst).

Speaker fees: Astellas, AstraZeneca, Bayer, Janssen, Novartis, Pfizer, Sandoz, and Telix Pharmaceuticals.

Travel support: AstraZeneca, Janssen, and Pfizer.

Silke Gillessen

Professor Silke Gillessen is the Genitourinary Cancer Systemic Therapy Research Chair at the University of Manchester, UK, Honorary Consultant at The Christie Hospital in Manchester. She is a consultant in the Department of Oncology/Haematology at the Kantonsspital St. Gallen, Switzerland, and Head of the Department of Medical Oncology, Professor at the Università della Svizzera Italiana (USI) in Lugano, and Director of the Oncology Institute of Southern Switzerland (IOSI) in Bellinzona, Switzerland.

Disclosures: Consultation/speaking/travel fees from AAA International, Amgen, AstraZeneca, Astellas, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Daiichi Sankyo, InnoMedica, Ipsen, Meister-ConCept, Modra Pharmaceuticals, MSD, Myriad Genetic, Novartis, Orion, Pfizer, Roche, and Telix Pharmaceuticals.

Patent for a research method for biomarker WO2009138392.