Neal D. Shore, MD, FACS

Neal D. Shore, MD, FACS, medical director and certified physician investigator at the Carolina Urologic Research Center, discusses the current treatment landscape and upcoming drugs being reviewed by the FDA for the treatment of patients with bladder cancer.

Pembrolizumab (Keytruda) was recently approved in 2020 for patients with persistent carcinoma 

. The FDA will be reviewing 2 intravesical agents, nadofaragene firadenovec (Adstiladrin) and oportuzumab monatox (Vicinium) for potential approval in 2021.

Patients who suffer from high-risk non-muscle invasive bladder cancer and are unresponsive to Bacillus Calmette-Guerin only had the option of having their bladders removed before the approval of pembrolizumab, and hopefully 2 more in 2021, according to Shore.

Shore thinks that the current and upcoming options in this setting are extremely exciting. These options include systemic therapy for metastatic urothelial carcinoma in the bladder, new intravesical treatments for high-risk non-muscle invasive bladder cancer, studies looking at tri-modal bladder-sparing treatments combining neoadjuvant chemotherapy with radiation and immunotherapy, and even the role for immunotherapy checkpoint inhibitors as neoadjuvant strategies. This field continues to evolve at an exponential pace, he says.

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Neal D. Shore, MD, FACS, discusses the current treatment landscape and upcoming drugs being reviewed by the FDA for the treatment of patients with bladder cancer.

Current and Upcoming Treatments Provide Options in Bladder Cancer

Neal D. Shore, MD, FACS, medical director and certified physician investigator at the Carolina Urologic Research Center, discusses the results of the retrospective review on real-world patterns of genomic testing in patients with metastatic castration-resistant prostate cancer (mCRPC).

Patients being seen in the community setting made up about 90% of the Flatiron database population used in this analysis, while the other 10% were in the academic setting. Shore and his colleagues looked at about 5000 patients over a several-year period. He says they found that the incidence of patients who were tested in 2013 came to 0% and raised to about 11% by 2018.

Other databases show that the likelihood of homologous recombination repair alteration is about 25% to 30%, which shows a discrepancy in the rate of testing to how many patients are likely to have this alteration, according to Shore. He and his colleagues broke down the most commonly tested gene alterations such as 

This retrospective analysis of a large registry shows that physicians in this field need further education, especially since these alterations have 2 actionable PARP inhibitors approved as of this year, Shore explains.

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Neal D. Shore, MD, FACS, discusses the results of the retrospective review on real-world patterns of genomic testing in patients with metastatic castration-resistant prostate cancer.

Expert Discusses Results of Analysis on Genomic Testing in mCRPC

Neal D. Shore, MD, FACS, medical director, Carolina Urologic Research Center, managing partner, Atlantic Urology Clinics, discusses glypican-1 as a biomarker for prostate cancer.

Glypican-1 is a new receptor found to be involved in many different growth processes of malignant cells, says Shore. It is demonstrable in blood, urine, serum, and plasma. He and his colleagues conducted a preliminary pilot study of 300 patients, and they were able to find a cut point, where they could see a very high specificity for demonstrating patients who had cancer versus those who did not.

Traditionally, other biomarkers have had a fairly high sensitivity for true positives or true negatives, but they do not have the specificity at the same time, adds Shore.

Neal D. Shore, MD, FACS, Atlantic Urology Clinics, discusses glypican-1 as a biomarker for prostate cancer.


Dr. Shore Discusses Glypican-1 as a Biomarker for Prostate Cancer

Neal D. Shore, MD, FACS, medical director, Carolina Urologic Research Center, Myrtle Beach, on the utility of the androgen receptor inhibitor ODM-201 for the treatment of castration-resistant prostate cancer (CRPC).

In phase I and II multinational trials, favorable results have been observed regarding PSA kinetics modulation

The organic structure of ODM-201 seems to cause the agent to have a much lower penetration through the blood-brain barrier

The efficacy of ODM-201 is being measured in terms of its impact on radiographic disease, PSA, and the androgen receptor

ODM-201 has been studied in patients prior to and following chemotherapy, as well as in patients who have and have not received abiraterone

Additional trials are being planned to analyze safety, efficacy, and tolerability

ODM-201 will be studied in a large trial of non-metastatic patients

Neal D. Shore, MD, FACS | Authors

Articles

Current and Upcoming Treatments Provide Options in Bladder Cancer

Expert Discusses Results of Analysis on Genomic Testing in mCRPC

Dr. Shore Discusses Glypican-1 as a Biomarker for Prostate Cancer

The Utility of ODM-201 in CRPC