Dr Chris Sweeney

Joseph Ischia: I’m Talking Urology with Chris Sweeney from the Dana-Farber Cancer Institute in United States. We’re gonna get the key two or three points of his talk which was You’ve Got One Opportunity, The Case For Treating High Risk Volume With Combination Therapy In Prostate Cancer. So, Chris what do you want us to remember from that talk?

Chris Sweeney: Recognizing that we’ve got a lot of new treatments for prostate cancer, castration resistant prostate cancer specifically, where the drugs have some activity but what we’re learning is if we use these drugs sooner and we’re evaluating them in clinical trials and documenting that they are much more effective. So don’t wait for using these therapies sequentially. Just get them into the patients early especially in the patient who has a lot of cancer on their bone scans or the lymph nodes or the liver. They’re the patients who have the worst survival and they’re the ones who need the best treatments sooner. So we are also doing numerous trials especially in the perioperative setting especially with radiation therapy given with curative intent and it’s hoped that we can actually stop patients relapsing by adding these new therapies there and actually decrease the death rate from prostate cancer.

Joseph: So what do you see as the ideal combination therapy you’d like to see?

Chris: Alright now, we can show the men with metastatic prostate cancers, especially those who have a high burden of disease, giving hormonal therapy and docetaxel upfront per the CHAARTED study and the STAMPEDE study. There is new data with abiraterone having the same degree of effect but access to that in Australia is a little bit difficult as it’s not listed but docetaxel is a very good option and as effective and in the right setting can be given with some side effects but manageable.

Joseph: And you also gave a talk on immune checkpoint inhibitors in prostate cancer, what do you think is the key point from about this? Why have they not worked or what do you see as the future?

Chris: Well they have worked to some degree in some patients even in prostate cancer but the other studies in kidney cancer, bladder cancer really did lead the way and so prostate cancer is the second wave and the slides that I will show actually do show there are a number of patients who had substantial benefits but we need to find the biomarkers to find who those 15% to 20% of patients are because it’s the same 15% to 20% that are responding in the other diseases where we see these drugs are beneficial, but it’s harder to measure prostate cancer responses to some degree and it’s just not been as easy but now there are some major studies ongoing and one that I’m study chair but it’s also opened up in the United States and Australia and throughout Europe of enzalutamide with or without atezolizumab and it’s recruiting well and almost 800 patients will be recruited to it over the next 12 months and hopefully we’ll show that it works.

Joseph: Fantastic! Thank you very much Chris. We really appreciate you coming out to Australia, back home.

Chris: Always a pleasure Joseph.