Daniel C. Danila, MD, medical oncologist, Memorial Sloan Kettering Cancer Center, discusses ​the rationale for examining immunotherapy in early-stage prostate cancer.

To navigate the field of in early-stage prostate cancer more effectively, several clinical trials are evaluating the utility of immunotherapy in this disease stage, Danila says. This research is interesting because early-stage disease has the potential to be the state where minimal metastatic disease can be effectively controlled in immunotherapy. Moreover, tumor profiling in this state may be based on genetic analysis or genome-wide sequencing, Danila explains.

These advancements will be coupled with an improved understanding of imaging, Danila continues. Additionally, established agents could have further utility if moved to earlier lines of treatment for patients with castration-sensitive disease and rising prostate-specific antigen, Danila concludes.

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Daniel C. Danila, MD, discusses ​the rationale for examining immunotherapy in early-stage prostate cancer. 

Dr. Danila on Examining Immunotherapy in Early-Stage Prostate Cancer 

Daniel C. Danila, MD, medical oncologist, Memorial Sloan Kettering Cancer Center, discusses factors to consider when selecting a treatment option for patients with nonmetastatic castration-resistant prostate cancer (CRPC).

Comorbidities play a significant role in informing treatment decisions for this patient population, according to Danila. Currently, a significant amount of data are available on enzalutamide (Xtandi), due to its long use in clinical practice. This agent would be a good treatment option if access to imaging to not available, Danila notes. However, those treated with darolutamide (Nubeqa) may experience less fatigue, making it a good choice for elderly patients, Danila explains.

Other treatment considerations include drug–drug interactions and adverse effects, such as cardiovascular risk factors, Danila adds. It is difficult to generalize for all patients, although enzalutamide would be the standard choice if there is doubt about patient histology or limited access to imaging, Danila concludes. 

Daniel C. Danila, MD, discusses factors to consider when selecting a treatment option for patients with nonmetastatic castration-resistant prostate cancer.

Dr. Danila on Considerations for Treatment Selection in Nonmetastatic CRPC 

Daniel C. Danila, MD, medical oncologist, Memorial Sloan Kettering Cancer Center, discusses the integration of advanced imaging in prostate cancer.

On May 27, 2021, the FDA approved piflufolastat F 18 (Pylarify) injection, a prostate-specific membrane antigen (PSMA)–targeted positron emission tomography (PET) imaging agent, to identify suspected metastasis or recurrence of prostate cancer. The regulatory decision introduced the first PSMA-targeted PET imaging tool to the paradigm of prostate cancer. 

Moreover, because PSMA-targeted therapy has demonstrated a survival advantage in prostate cancer, the integration of the PSMA-targeted imaging tool is clinically valuable, Danila explains. 

Although the uptake of the tool has been relatively slow because of availability and insurance coverage, PSMA-targeted PET imaging can provide insight into a patient’s disease, Danila says. Moreover, this could precisely inform optimal treatment selection for individual patients, Danila concludes. 

Daniel C. Danila, MD, discusses the integration of advanced imaging in prostate cancer.  



Daniel C. Danila, MD

Articles

Dr. Danila on Examining Immunotherapy in Early-Stage Prostate Cancer

Dr. Danila on Considerations for Treatment Selection in Nonmetastatic CRPC

Dr. Danila on the Integration of Advanced Imaging in Prostate Cancer