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New Era of Theranostics in Prostate Cancer (Apr. 27, 2024) Panel discussion

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💫 Short Summary

The video discusses the sequencing of treatments for MCRPC patients post-Taxane chemotherapy, focusing on options like radium, carbazitaxel, and alternative NHA therapy. It also covers managing PSMA positive and negative lesions, the choice between lutetium therapy and chemotherapy, and nephrotoxicity concerns. The potential of combining Enza with lutetium therapy for enhanced efficacy is highlighted, along with the importance of individualized patient care. The session concludes with gratitude towards participants and support, emphasizing the impact on quality of life in treatment decisions.

✨ Highlights
📊 Transcript
Treatment sequencing for MCRPC patients post-Taxane chemotherapy.
Personal experiences with radium therapy express disappointment in effectiveness and side effects.
Preference towards lutetium-177-PSMA over radium due to ongoing clinical trials combining radium with profito.
Considerations for selecting patients for lutetium-PSMA treatment based on imaging discrepancies.
Emphasis on individual patient characteristics and responses to treatment in decision-making process.
Management of PSMA negative and positive lesions and the choice between lutetium therapy and chemotherapy.
Side effects of lutetium PSMA treatment include dry mouth and fatigue, with patient selection being crucial.
Renal toxicity concerns are highlighted, emphasizing the need for dosage monitoring and adjustment to prevent bone marrow exposure.
Patient recovery before treatment continuation is important to avoid additional toxicity.
Discussion on potential nephrotoxicity of lutetium therapy in patients with renal failure risk and importance of continued monitoring for chronic effects.
Mention of thrombocytopenia risks in elderly patients with late-stage disease and the need for vigilance.
Consideration of re-challenging with actinium instead of lutetium in patients showing PSMA recurrence, with insights into targeting mechanisms and cytotoxin methods.
Lack of phase three trials for actinium PSMA and details on the compassionate use program for lutetium PSMA in Taiwan.
Novartis allowing patients to continue treatment cycles based on affordability and safety.
Promising results in combining Enza with lutetium therapy.
Safety and efficacy of EnzaLutamide combination supported by trials.
PSMA positive prostate cancer lesions may turn negative over time, majority remain positive.
Tumor lysis syndrome not a major concern during lutetium therapy.
Monitoring efficacy involves spec CT scans after each cycle, potential for adaptive therapy based on clinical and PSA response.
Highlights of Treatment Response Monitoring
Timing of PSMA PET scans is crucial in determining treatment continuation based on patient status.
Use of alpha and beta emitters in therapy is discussed, taking into account factors like tumor size and adverse event profiles.
Uncertainty exists regarding the optimal sequence of alpha and beta therapy, highlighting the need for further research on salivary protection.
Individualized patient care and collaboration with medical oncologists are emphasized for making treatment decisions.
Discussion about severe side effects and the impact on quality of life.
Concern expressed over increasing lifespan at the cost of misery.
Thanks given to speakers, moderators, and organizers of the meeting.
Recognition of online participants and utilization of messages in real clinical settings.
Session concludes with multiple farewells and expressions of appreciation.