AUANews Inside Tract

Today’s podcast episode is part of the “Voices” series and is brought to you by the Diversity, Equity & Inclusion Committee. Join Dr. Gjanje Smith-Mathus, a female pelvic medicine and reconstructive surgeon at WakeMed and the founder of the Susu Health Foundation, as she talks with Dr. Jennifer Miles-Thomas, Vice Chair of Integration and Innovation at the Northwestern Medicine Department of Urology and the AUA’s treasurer-elect, about her journey to making AUA history as the first woman, and woman of color, on the Board of Directors, and the importance of representation.

• Host - Karen Johnson, Director, Quality and Measurement
• Matt Nielsen, MD, MS, FACS
• Dave Friedlander, MD, MPH

Today’s podcast episode is part of the “Voices” series and is brought to you by the Diversity, Equity & Inclusion Committee. Join Dr. Kymora Scotland, Assistant Professor and Director of Endourology Research at UCLA Health, the AUA’s most recent Rising Star in Urology and a 2023 recipient of the Humanitarian Grant Program, as she talks with Dr. Ian Metzler, a urologist at OHSU Healthcare and a 2022 recipient of the Humanitarian Grant Program, about their projects and how they are making a lasting impact with their humanitarianism.

Welcome to the AUANews Inside Tract podcast. Today's episode, brought to you by the AUA's Medical Student Membership Workgroup, features a conversation between workgroup member Vivian Wang and Dr. Brett Teplitz, the Northeastern Section Representative to the AUA Residents and Fellows Committee, on how medical students can best prepare for their Sub I rotations. If you are interested in getting involved, please visit us at https://www.auanet.org/membership or email us at [email protected].

Today’s podcast episode is part of the “Voices” series and is brought to you by the Diversity, Equity & Inclusion Committee. Join Dr. Lourdes Guerrios Rivera, urologic surgeon at the San Juan VA Medical Center and Assistant Professor of Surgery at the University of Puerto Rico as she talks with urologist, life coach and the founder of Physician Coach Support, Dr. Diana Londoño, on the increasing disability of the Latinas in the urologic field, as well as how important it is to take care of yourself.

Today’s podcast episode is part of the “Voices” series and is brought to you by the Diversity, Equity & Inclusion Committee. Join Dr. Nathan Grunewald, Chief Innovation Officer, Urology Medical Director, and urologic surgeon at Sauk Prairie Healthcare, and Dr. Ruchika Talwar, Associate Medical Director and Assistant Professor of Urology at Vanderbilt University Medical Center, as they discuss the importance of diversity for urology in rural areas. 

Today’s podcast episode is part of the “Voices” series and is brought to you by the Diversity, Equity & Inclusion Committee. Join Dr. Amanda North, Chief of Urology at Children's Hospital at Montefiore Einstein and AUA Data Committee Chair, and Dr. Kevin Koo, Associate Professor of Urology at Mayo Clinic College of Medicine and Science, as they discuss the 10-year anniversary of the census and statistics that are important for identifying where diversity is needed in urology. 

This podcast “Apalutamide in Metastatic Castration-Sensitive Prostate Cancer (mCSPC): A Case-Based Discussion” was originally presented as an AUA newsworthy webinar and contains data regarding the clinical efficacy and safety of apalutamide. It is presented on behalf of Janssen and is not certified for CME; speakers were compensated. For full details, see the video webinar here.

TITAN, a Phase 3 double-blind study, randomized patients with metastatic castration-sensitive prostate cancer (mCSPC) to apalutamide (Apa; 240 mg oral once daily) + androgen deprivation therapy (ADT; n=525) or placebo + ADT (n=527).1,2 All patients received a concomitant gonadotropin-releasing hormone analog or had prior bilateral orchiectomy.3 Patients who received prior treatment for localized disease or received but did not progress on docetaxel were permitted. Dual primary endpoints were radiographic progression-free survival and overall survival (OS).1,2

At primary analysis (median follow-up: 22.7 months), Apa + ADT reduced the risk of radiographic progression or death by 52% vs placebo + ADT (HR: 0.48; 95% CI: 0.39–0.60). Apa + ADT also reduced the risk of death by 33% vs placebo + ADT (HR: 0.67; 95% CI: 0.51–0.89).1 At primary analysis cutoff, TITAN was unblinded and 39.5% of patients who received placebo + ADT crossed over to receive Apa + ADT; these patients were analyzed as part of the placebo + ADT population in the intent-to-treat analyses. The IPCW log-rank test was performed to account for crossover and showed a 48% reduction in the risk of death for Apa + ADT vs placebo + ADT (HR: 0.52; 95% CI: 0.42–0.64). At final analysis (median follow-up: 44.0 months), Apa + ADT reduced the risk of death by 35% vs placebo + ADT (median OS: NE vs 52.2 months; HR: 0.65; 95% CI: 0.53–0.79).

In a prespecified subgroup analysis, Apa + ADT improved OS vs placebo + ADT, regardless of disease volume. In patients with high-volume disease, Apa + ADT reduced the risk of death by 30% vs placebo + ADT (HR: 0.70; 95% CI: 0.56–0.88); for low-volume disease, Apa + ADT reduced the risk of death by 48% vs placebo + ADT (HR: 0.52; 95% CI: 0.35–0.79).2

The following post hoc analyses data are not included in the full ERLEADA® (apalutamide) Prescribing Information.

Post hoc exploratory analyses investigated PSA kinetics.4,5 After 3 months of Apa treatment, median OS was not reached in patients with a PSA response. In patients without a PSA response, median OS was 37.7 months.5 Most Apa + ADT-treated patients had undetectable PSA at 3 months. By 12 months, 64% of Apa-treated patients had undetectable PSA vs 23% of patients treated with placebo + ADT.5

Please see the full Prescribing Information for ERLEADA® (apalutamide) at www.erleadahcp.com.

1. Chi KN, et al. N Engl J Med. 2019;381:13–24.
2. Chi KN, et al. J Clin Oncol. 2021;39:2294–2303.
3. ERLEADA® (apalutamide) [Prescribing Information]. Horsham, PA: Janssen Biotech, Inc.
4. Chowdhury S, et al. Ann Oncol. 2023;34:477–485.
5. Chi KN, et al. Presented at AUA; September 10–13, 2021; Las Vegas, Nevada.

Dr. Andrew Lai, a University of Illinois College of Medicine Co-Chief Resident and author of the AUANews article, “My Journey as an Out and Proud Urology Resident,” talks with his fellow Co-Chief Resident Dr. Rabun Jones about the challenges they have faced being gay and bi-sexual throughout their residency, and the importance of representation as they prepare to graduate this year.