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Management of Unfavorable Intermediate-Risk Prostate Cancer: Role of SBRT, Brachytherapy and Androgen Deprivation
Unfavorable intermediate-risk prostate cancer is commonly encountered in clinical practice but there is relatively little data focusing on treatment outcomes specific and limited to this patient cohort, with most clinical trials grouping these patients with favorable intermediate-risk disease or with high-risk disease. There is considerable interest in using SBRT or brachytherapy in this patient population as well as interest in use of genomic risk stratification tools (e.g., Decipher assay) to make decisions on the use and duration of ADT. The NRG recently opened the first trial in unfavorable intermediate-risk disease, NRG GU 010, to explore the use of genomic risk stratification to identify patients who could be candidates for treatment de-intensification or treatment intensification with systemic therapy.
Topics:
- SBRT for Unfavorable Intermediate-Risk Prostate Cancer
Daniel E. Spratt, MD - Role of ADT and Advanced Risk Stratification Tools for Patients with Unfavorable Intermediate-Risk Prostate Cancer
Neil B. Desai, MD - Management of Unfavorable Intermediate-Risk Prostate Cancer: Role of Brachytherapy
Cynthia Menard, MD - Q and A
Brian Christopher Baumann, MD - Moderator
Full Panel
This activity is available from March 11, 2025, through 11:59 p.m. Eastern time on March 10, 2027.
The content was originally presented and recorded at the 2024 ASTRO Annual Meeting.
Target Audience
The activity is designed to meet the interests of medical oncologists, radiation oncologists and residents.
Learning Objectives
Upon completion of this activity, participants should be able to:
- Describe the optimal patients with unfavorable intermediate-risk disease who are candidates for prostate SBRT, analyze the appropriate dose of SBRT, and gain comfort in defining the MR-detected lesion(s) to do focal micro-boost to gross disease.
- Describe the potential value of EBRT plus brachytherapy boost for unfavorable intermediate-risk vs. brachytherapy without EBRT and to analyze the role of ADT in combination with brachytherapy for unfavorable intermediate-risk disease.
- Analyze the role of genomic risk stratification tools to make determinations on the use of ADT as well as the duration of ADT including discussion of the currently accruing NRG GU 010 trial in this disease space.
- Brian Christopher Baumann, MD, is employed by University of Pennsylvania/Springfield Clinic. Dr. Baumann receives grant/research funding and compensation from Varian Medical Systems, Boston Scientific, Blue Earth and Myovant. Dr. Baumann serves as Co-Chair of the NCI Bladder Cancer Task Force with the NIH.
- Daniel E. Spratt, MD is employed by University Hospitals Cleveland Medical Center/Seidman Cancer Center. Dr. Spratt receives honoraria from Bayer, Boston Scientific, Astellas, Janssen, GSK, Novartis and Myovant/Pfizer. .
- Neil B. Desai, MD, is employed by University of Texas Southwestern Medical Center. Dr. Desai receives grant/research funding and compensation/payment from Boston Scientific, Telix, RefleXion and Astellas/Seagen (Pfizer). Dr. Desai serves as the institutional representative for prostate cancer guidelines with NCCN.
- Cynthia Menard, MD, is employed by Centre de Recherche du Centre Hospitalier de l’Universite de Montreal (CRCHUM). Dr. Menard receives grant/research funding from Varian Medical Systems, Lantheus Medical and Tersera.
The person(s) above served as the developer(s) of this activity. Additionally, the ASTRO Education Committee had control over the content of this activity. All relevant financial relationships have been mitigated.
The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Available Credit
- 1.00 AMA PRA Category 1 Credit™The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education for physicians. ASTRO designates this Enduring material for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
- 1.00 Certificate of AttendanceThis activity was designated for 1.00 AMA PRA Category 1 Credit™.
Price
Course Fees:
ASTRO members must log in to the ASTRO website to view and receive the member rate.
- Nonmember: $149
- Member: $99
- Member-in-Training: $49
- Student/Graduate Student/PGY-1 Member: $49
- Postdoctoral Fellow Member: $49
If you are an ASTRO member from a low or lower-middle income country, as identified by the World Bank, you can receive a 50% discount off your corresponding registration for this activity. Please email [email protected] to inquire about the discount.
Policies:
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The activity and its materials will only be available on the ASTRO website until March 10, 2027, regardless of purchase date. At the expiration of the activity, participants will no longer have access to the activity or its materials. ASTRO reserves the right to remove an activity before its expiration date.
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