講者:張延驊
日期:2016-05-10
觀看: 1451
  • 00:00 1.
    Novel Life-Prolonging Endocrine Therapies for Metastatic CRPC
  • 00:52 2.
    CRPC Definition (2016 EAU Guidelines)
  • 01:32 3.
    Androgen Receptor Signaling - A Pivotal Driver of Prostate Cancer
  • 02:03 4.
    Phase III Trials in mCRPC with OS Advantage
  • 03:54 5.
    Systemic Therapy for M0 CRPC
  • 04:19 6.
    Systemic Therapy for M1 CRPC
  • 04:30 7.
    Subsequent Systemic Therapy for M1 CRPC
  • 05:03 8.
    Traditional Hormonal Therapy for CRPCAddition of Anti-androgens
  • 05:24 9.
    Traditional Hormonal Therapy for CRPCAnti-androgen Withdrawal
  • 05:36 10.
    Traditional Hormonal Therapy for CRPCCorticosteroids / Estrogens
  • 05:46 11.
    Traditional Hormonal Therapy for CRPCCorticosteroids / Estrogens
  • 06:16 12.
    Traditional Hormonal Therapy for CRPCKetoconazole
  • 06:23 13.
    mCRPC Management: EAU Guideline (Update 2016)
  • 07:20 14.
    mCRPC Management: EAU Guideline (Update 2016)
  • 07:43 15.
    24. Metastatic CRPC: First Line Treatment: Asymptomatic /Minimally Symptomatic Patients
  • 08:14 16.
    25. Metastatic CRPC: First Line Treatment Symptomatic Patients
  • 08:50 17.
    Targeting the Androgen Pathway
  • 09:19 18.
    Abiraterone Acetate (Zytiga) : Androgen Biosynthesis (CYP17) Inhibitor
  • 10:12 19.
    Abiraterone Increases Steroids with Mineralocorticoid Activity Upstream of CYP17A1
  • 10:38 20.
    COU-AA-301 Post-Chemo Study Design
  • 10:54 21.
    COU-AA-301: Abiraterone Significantly Prolongs OS and rPFS in Post-docetaxel mCRPC Patients
  • 11:01 22.
    COU-AA-302 Pre-Chemo Study Design
  • 11:29 23.
    COU-AA-302: Radiographic PFS and OS
  • 11:38 24.
    COU-AA-302: Pre-specified Secondary and Exploratory Efficacy End Points
  • 12:50 25.
    COU-AA-302: Safety Profile Remains Consistent
  • 13:10 26.
    Incidence of Mineralocorticoid Excess (ME)-Associated Treatment-Emergent Adverse Events (TEAE)
  • 13:55 27.
    Study Design and Timelines
  • 14:39 28.
    Primary Endpoint: Patients Experiencing ME-Associated TEAEs: Hypertension and Hypokalemia
  • 14:57 29.
    Confirmed PSA Response Rate (≥50%) after 12 Weeks
  • 15:14 30.
    61. When to Discontinue Life-prolonging Treatment (Excluding treatment change for toxicity)
  • 16:14 31.
    What if PSA does not Decline following Abiraterone ?
  • 17:11 32.
    Slide 33
  • 17:37 33.
    Enzalutamide (Xtandi, MDV3100): A New Anti-androgenAndrogen Receptor Signaling Inhibitor (ARSI)
  • 18:30 34.
    Phase III Enzalutamide (MDV-3100) vs Placeboin Post-chemotherapy Treated CRPC
  • 18:53 35.
    AFFIRM: Enzalutamide Prolongs OS and PFS
  • 19:10 36.
    AFFIRM: Response and Progression Indicators
  • 19:23 37.
    AFFIRM: Safety Outcomes
  • 19:54 38.
    Phase III Pre-chemotherapy Enzalutamide (MDV3100) Prostate Cancer Trial (PREVAIL)
  • 20:05 39.
    PREVAIL Co-Primary Endpoints: Radiographic PFS and OS for Final and Extended Analysis
  • 20:43 40.
    Subsequent Therapies were Used More Commonly in the Placebo Group
  • 21:13 41.
    Enzalutamide (PREVAIL):Important Secondary Endpoints
  • 21:23 42.
    PREVAIL: Most Common AE* and AEs of Interest
  • 21:29 43.
    Slide 47
  • 21:41 44.
    PREVAIL: rPFS and OS in the Non-visceral & Visceral Subgroup
  • 21:55 45.
    PREVAIL: rPFS and OS by Number of Bone Mets at Screening
  • 22:05 46.
    Inclusion/Exclusion Criteria of the Pivotal Trials
  • 23:04 47.
    Second-line Treatment Options in mCRPCComparison of the Efficacy Results in the TROPIC, COU-AA-301 and AFFIRM trials
  • 23:20 48.
    Primary Resistance & Predictive Factors in mCRPC
  • 24:00 49.
    Slide 53
  • 24:30 50.
    Primary Resistance to AR-Targeted Agents
  • 24:59 51.
    Slide 55
  • 25:59 52.
    Slide 56
  • 26:33 53.
    Duration of Response to First ADT May Help to Guide Treatment Choice?
  • 27:19 54.
    Is Baseline Gleason Score Predictive of Response to Therapies?
  • 28:32 55.
    PSA Response According to ARv7 Status
  • 29:07 56.
    ARv7 and Resistance to ABI or ENZ:Clinical or Radiological PFS
  • 29:19 57.
    ARv7 and Resistance to ABI or ENZ – Updated OS (All Combined)
  • 29:47 58.
    Treatment Sequencing in mCRPC
  • 30:43 59.
    Evidences of Earlier Use of Novel Endocrine Therapies in Metastatic CRPC Patients
  • 31:10 60.
    Slide 64
  • 31:17 61.
    TERRAIN: A Study of Enzalutamide vs Bicalutamide in Men with Metastatic CRPC
  • 32:12 62.
    TERRAIN: PFS and Radiographic PFS
  • 32:22 63.
    TERRAIN: Pre-specified Subgroup Analysis of PFS
  • 32:38 64.
    TERRAIN: Time to PSA Progression
  • 32:47 65.
    TERRAIN: Safety Overview
  • 33:00 66.
    STRIVE: A Study of Enzalutamide vs Bicalutamide in Men with Prostate Cancer Who Failed Primary ADT
  • 33:21 67.
    The STRIVE Trial: Results
  • 33:46 68.
    Longer Time to PSA Progression in CRPC Patients Treated with Enzalutamide Earlier
  • 35:10 69.
    Slide 75
  • 36:04 70.
    ARN-509 blocks AR signaling, impairs AR nuclear translocation and inhibits DNA binding
  • 36:17 71.
    Slide 84
  • 36:33 72.
    Combination Trials
  • 36:39 73.
    ALLIANCE Study Design Phase III Pre-chemo
  • 37:21 74.
    PLATO: Continued enzalutamide treatment in prostate cancer patients
  • 37:52 75.
    Combination Phase III Study Design of ARN-509 andAbiraterone (n ~ 960)
  • 39:03 76.
    Key Consideration for Treatment Sequencing
  • 40:19 77.
    Thank You for Your Attentions
  • 索引
  • 筆記
  • 全螢幕
【醫藥護人員場】12. Novel Life-Prolonging Endocrine Therapies for Metastatic Castration-Resistant Prostate Cancer
長度: 41:28, 瀏覽: 1452, 最近修訂: 2017-05-09
演講時間:12:10-13:10
講者:張延驊主任  
現任職位/稱:
臺北榮民總醫院泌尿部一般泌尿科主任
國立陽明大學外科學系副教授
台灣泌尿科醫學會理事
國立陽明大學醫學博士 
 
 
    • 00:00 1.
      Novel Life-Prolonging Endocrine Therapies for Metastatic CRPC
    • 00:52 2.
      CRPC Definition (2016 EAU Guidelines)
    • 01:32 3.
      Androgen Receptor Signaling - A Pivotal Driver of Prostate Cancer
    • 02:03 4.
      Phase III Trials in mCRPC with OS Advantage
    • 03:54 5.
      Systemic Therapy for M0 CRPC
    • 04:19 6.
      Systemic Therapy for M1 CRPC
    • 04:30 7.
      Subsequent Systemic Therapy for M1 CRPC
    • 05:03 8.
      Traditional Hormonal Therapy for CRPCAddition of Anti-androgens
    • 05:24 9.
      Traditional Hormonal Therapy for CRPCAnti-androgen Withdrawal
    • 05:36 10.
      Traditional Hormonal Therapy for CRPCCorticosteroids / Estrogens
    • 05:46 11.
      Traditional Hormonal Therapy for CRPCCorticosteroids / Estrogens
    • 06:16 12.
      Traditional Hormonal Therapy for CRPCKetoconazole
    • 06:23 13.
      mCRPC Management: EAU Guideline (Update 2016)
    • 07:20 14.
      mCRPC Management: EAU Guideline (Update 2016)
    • 07:43 15.
      24. Metastatic CRPC: First Line Treatment: Asymptomatic /Minimally Symptomatic Patients
    • 08:14 16.
      25. Metastatic CRPC: First Line Treatment Symptomatic Patients
    • 08:50 17.
      Targeting the Androgen Pathway
    • 09:19 18.
      Abiraterone Acetate (Zytiga) : Androgen Biosynthesis (CYP17) Inhibitor
    • 10:12 19.
      Abiraterone Increases Steroids with Mineralocorticoid Activity Upstream of CYP17A1
    • 10:38 20.
      COU-AA-301 Post-Chemo Study Design
    • 10:54 21.
      COU-AA-301: Abiraterone Significantly Prolongs OS and rPFS in Post-docetaxel mCRPC Patients
    • 11:01 22.
      COU-AA-302 Pre-Chemo Study Design
    • 11:29 23.
      COU-AA-302: Radiographic PFS and OS
    • 11:38 24.
      COU-AA-302: Pre-specified Secondary and Exploratory Efficacy End Points
    • 12:50 25.
      COU-AA-302: Safety Profile Remains Consistent
    • 13:10 26.
      Incidence of Mineralocorticoid Excess (ME)-Associated Treatment-Emergent Adverse Events (TEAE)
    • 13:55 27.
      Study Design and Timelines
    • 14:39 28.
      Primary Endpoint: Patients Experiencing ME-Associated TEAEs: Hypertension and Hypokalemia
    • 14:57 29.
      Confirmed PSA Response Rate (≥50%) after 12 Weeks
    • 15:14 30.
      61. When to Discontinue Life-prolonging Treatment (Excluding treatment change for toxicity)
    • 16:14 31.
      What if PSA does not Decline following Abiraterone ?
    • 17:11 32.
      Slide 33
    • 17:37 33.
      Enzalutamide (Xtandi, MDV3100): A New Anti-androgenAndrogen Receptor Signaling Inhibitor (ARSI)
    • 18:30 34.
      Phase III Enzalutamide (MDV-3100) vs Placeboin Post-chemotherapy Treated CRPC
    • 18:53 35.
      AFFIRM: Enzalutamide Prolongs OS and PFS
    • 19:10 36.
      AFFIRM: Response and Progression Indicators
    • 19:23 37.
      AFFIRM: Safety Outcomes
    • 19:54 38.
      Phase III Pre-chemotherapy Enzalutamide (MDV3100) Prostate Cancer Trial (PREVAIL)
    • 20:05 39.
      PREVAIL Co-Primary Endpoints: Radiographic PFS and OS for Final and Extended Analysis
    • 20:43 40.
      Subsequent Therapies were Used More Commonly in the Placebo Group
    • 21:13 41.
      Enzalutamide (PREVAIL):Important Secondary Endpoints
    • 21:23 42.
      PREVAIL: Most Common AE* and AEs of Interest
    • 21:29 43.
      Slide 47
    • 21:41 44.
      PREVAIL: rPFS and OS in the Non-visceral & Visceral Subgroup
    • 21:55 45.
      PREVAIL: rPFS and OS by Number of Bone Mets at Screening
    • 22:05 46.
      Inclusion/Exclusion Criteria of the Pivotal Trials
    • 23:04 47.
      Second-line Treatment Options in mCRPCComparison of the Efficacy Results in the TROPIC, COU-AA-301 and AFFIRM trials
    • 23:20 48.
      Primary Resistance & Predictive Factors in mCRPC
    • 24:00 49.
      Slide 53
    • 24:30 50.
      Primary Resistance to AR-Targeted Agents
    • 24:59 51.
      Slide 55
    • 25:59 52.
      Slide 56
    • 26:33 53.
      Duration of Response to First ADT May Help to Guide Treatment Choice?
    • 27:19 54.
      Is Baseline Gleason Score Predictive of Response to Therapies?
    • 28:32 55.
      PSA Response According to ARv7 Status
    • 29:07 56.
      ARv7 and Resistance to ABI or ENZ:Clinical or Radiological PFS
    • 29:19 57.
      ARv7 and Resistance to ABI or ENZ – Updated OS (All Combined)
    • 29:47 58.
      Treatment Sequencing in mCRPC
    • 30:43 59.
      Evidences of Earlier Use of Novel Endocrine Therapies in Metastatic CRPC Patients
    • 31:10 60.
      Slide 64
    • 31:17 61.
      TERRAIN: A Study of Enzalutamide vs Bicalutamide in Men with Metastatic CRPC
    • 32:12 62.
      TERRAIN: PFS and Radiographic PFS
    • 32:22 63.
      TERRAIN: Pre-specified Subgroup Analysis of PFS
    • 32:38 64.
      TERRAIN: Time to PSA Progression
    • 32:47 65.
      TERRAIN: Safety Overview
    • 33:00 66.
      STRIVE: A Study of Enzalutamide vs Bicalutamide in Men with Prostate Cancer Who Failed Primary ADT
    • 33:21 67.
      The STRIVE Trial: Results
    • 33:46 68.
      Longer Time to PSA Progression in CRPC Patients Treated with Enzalutamide Earlier
    • 35:10 69.
      Slide 75
    • 36:04 70.
      ARN-509 blocks AR signaling, impairs AR nuclear translocation and inhibits DNA binding
    • 36:17 71.
      Slide 84
    • 36:33 72.
      Combination Trials
    • 36:39 73.
      ALLIANCE Study Design Phase III Pre-chemo
    • 37:21 74.
      PLATO: Continued enzalutamide treatment in prostate cancer patients
    • 37:52 75.
      Combination Phase III Study Design of ARN-509 andAbiraterone (n ~ 960)
    • 39:03 76.
      Key Consideration for Treatment Sequencing
    • 40:19 77.
      Thank You for Your Attentions
    位置
    資料夾名稱
    2016臺大攝護祭-醫藥護人員場
    發表人
    系統管理者
    單位
    泌尿部
    建立
    2016-05-10 12:38:00
    最近修訂
    2017-05-09 09:58:19
    長度
    41:28