What’s hot at the AUA annual meeting (Sunday morning)?

So lots of posters and and presentations this morning, but not a lot of actionable information for patients (as far a we could tell). Among the more interesting papers were the following:

A poster by Matsumoto et al. (see AUA abstract no. 125) shows the future potential of OGX-011 to be given in combination with MDV3100. This is one of the first papers we are aware of to show that two of the newer agents have the potential to be used in combination. While neither OGX-011 nor MDV3100 has been approved for the treatment of advanced prostate cancer as yet, Matsumoto et al. have been able to show that not only can they be given in combination, but that they appear to have a synergistic effect in an animal model of castration-resistant prostate cancer (i.e., they worked better in combination than either drug did on its own).

Another oral presentation by Chalfin (in behalf of Dinizo et al.; see AUA abstract no, 192), and based on Walsh’s series of > 4,000 men treated at Johns Hopkins between 1982 and 2009, showed that positive surgical margins were associated with an increase in risk for post-surgical biochemical progression but were not an independent predictor of increased risk for prostate cancer-specific mortality. In other words, whether men received adjuvant or salvage therapy (as necessary and appropriate) after first-line surgical therapy, their surgical margin status did not actually impact their long-term risk for prostate cancer-specific mortality.

Reese et al. presented a very interesting idea (see AUA abstract 190) regarding how to better differentiate between patients with all the different types of Gleason 7 disease. In other words, can we find a way to discriminate between the risk of having (a) Gleason score 3 + 4 disease and just 25 percent of 1/12 cores positive for Gleason pattern 4 and (b) Gleason score 3 + 4 disease and just 25 percent of each of 4/12 cores positive for Gleason pattern 4? After all, arguably, the second patient has up to four times the risk for progressive disease as the first of these two patients. To create their new model they came up with a way in which men currently all assessed as having Gleason 3 + 4 or Gleason 4 + 3 disease could be assigned a Gleason score on a sliding scale from 6.1 to 7.9. This model is clearly going to need some more work, but does offer us the potential to think much better about the risks associated with all the very different types of intermediate-risk prostate cancer based on Gleason score.

[Editorial comment: Unfortunately we do not appear to be able to offer direct links to abstracts of papers being presented at the AUA meeting this year. However, if you go to this page on the AUA annual meeting web site, you can simply insert the abstract number given above in the box that says “Search by publication number” and you will be taken to the relevant abstract of the paper discussed above.]

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