Winston Tan, MD, hematologist/oncologist, Mayo Clinic, discusses imaging modalities in prostate cancer.

Access to conventional imaging tools versus some of the more sensitive imaging modalities varies from institution to institution, says Tan. Most academic centers have access to PET scans and MRIs, whereas those who practice in smaller towns may only have access to computed tomography scans and bone scans.

Notably, newer imaging tools have not completely replaced conventional imaging. However, several corporations are building PET centers. In the future, there may be more imaging centers with PET scans, but they will also include different tracers, which are more accurate in locating certain types of metastasis, explains Tan.

There is a need for more sensitive imaging tools, but cost has been a barrier in bringing these modalities to practice, he adds. Right now, fluciclovine or Axumin PET scans are only indicated for patients with rising prostate-specific antigen; they're not indicated for patients with metastasis. Additional scans are being studied in clinical trials, including the PET prostate-specific membrane antigen scans, which might change the treatment paradigm in the metastatic setting, concludes Tan.

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Dr. Tan on Imaging Modalities in Prostate Cancer

Winston Tan, MD, hematologist/oncologist, Mayo Clinic, discusses the FDA approval of darolutamide (Nubeqa) in nonmetastatic castration-resistant prostate cancer (M0CRPC).

The approval of the next-generation androgen receptor inhibitor is based on data from the phase III ARAMIS trial, in which the combination of darolutamide and androgen deprivation therapy (ADT) led to a 59% reduction in the risk of metastases or death compared with placebo/ADT in patients with M0CRPC (HR, 0.41; 95% CI, 0.34-0.50; 2-sided, 

 <.0001). At a median follow-up of 17.9 months, the median metastasis-free survival (MFS) was 40.4 months with the addition of darolutamide compared with 18.4 months with placebo/ADT.

Notably, the oral drug has a lower incidence of falls and fracture rates than other available drugs in this setting, says Tan. The drug may be especially valuable for elderly patients with comorbidities, he adds. Darolutamide also has the potential to be superior to other available agents in this setting in terms of tolerability and cost, says Tan.

Winston Tan, MD, hematologist/oncologist, Mayo Clinic, discusses the FDA approval of darolutamide (Nubeqa) in nonmetastatic castration-resistant prostate cancer (M0CRPC).


Winston Tan, MD

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Dr. Tan on Imaging Modalities in Prostate Cancer

Dr. Tan Discusses the FDA Approval of Darolutamide in M0CRPC