Shore says that, currently, the answers are unknown but with the multitude of investigator-initiated trials going on, the oncology community will soon be able to find combinations and sequencing methods that are not deleterious. Once a patient’s disease is confirmed, Shore believes the most impactful and well tolerated therapies should be introduced, such as sipuleucel-T.

After that, there is no pre-chemotherapy drug that is approved by the FDA, but there are high hopes for abiraterone acetate in that space. Enzalutamide is a similar drug to abiraterone in the space it’s approved in and overall efficacy. Shore believes enzalutamide in the pre-chemotherapy stage is farther off than abiraterone.

Shore admits that there will not be a single combination or sequence that will cure prostate cancer for everyone. The goal for urologists and oncologists is to cause prostate cancer to be considered a controllable, chronic disease. The only path to this endpoint is by way of data.

Peer Exchange Panel:

Raoul S. Concepcion, MD

Moderator

Editor-in-Chief,

Urologists in Cancer Care

Director of Clinical Research

Urologic Surgeon

Urology Associates, PC

Nashville, TN

Steve Dobbs

CEO, Urologic Associates of Oklahoma,

Tulsa, Oklahoma

Bryan A. Mehlhaff, MD

Principal Investigator, Division of Clinical Research, Oregon Urology Institute, Springfield, Oregon

Neal D. Shore, MD

Director, CPI, Carolina Urologic Research Center,

Grand Strand Urology/Atlantic Urology Clinics,

Myrtle Beach, South Carolina

Daniel R. Saltzstein, MD

Medical Director, Urology San Antonio Research,

San Antonio, Texas