Dr. Heath on Remaining Challenges in Nonmetastatic CRPC

Elisabeth I. Heath, MD, FACP, associate center director of Translational Sciences, lead of the Genitourinary Oncology Multidisciplinary Team, medical director of the Infusion Center, and director of Prostate Cancer Research at Barbara Ann Karmanos Cancer Institute, and professor of oncology at Wayne State University School of Medicine, discusses a remaining challenge in nonmetastatic castration-resistant prostate cancer (CRPC).

The FDA approvals of 3 antiandrogen agents, apalutamide (Erleada), enzalutamide (Xtandi), and darolutamide (Nubeqa) SPARTAN, PROSPER, and ARAMIS trials, respectively, have shifted the treatment paradigm in nonmetastatic CRPC, says Heath.

The CRPC space is one that is recognized based on imaging, says Heath. With improved imaging technology, such as PET scans, micrometastases are now more frequently identified in patients. In the past, these micrometastases may not have been picked up by traditional imaging modalities such as CAT scans or bone scans, explains Heath.

Historically, it was difficult to find sites of micrometastases, despite the patient having a rising prostate specific antigen level, adds Heath. Now the key remaining challenge will be determining how best to categorize these men, concludes Heath