Establishing an Advanced Prostate Cancer Clinic: The Rationale

Transcription

1 The information, views and opinions expressed in this presentation and any accompanying materials are those of the speaker and do not necessarily reflect the views or position of Cardinal Health or VitalSource. Establishing an Advanced Prostate Cancer Clinic: The Rationale

2 Conference Objectives Discuss key steps and insights into establishing an advanced prostate cancer clinic and gain insight into the clinical and operational considerations for managing the treatment of prostate cancer in the urology setting. Provide information on the practical management of patients on CRPC therapies. Learn about the evolving healthcare landscape changes and how to navigate access/affordability. Provide guidance on how community urology practices can effectively partner with other healthcare providers. 2

3 Prostate Cancer 2015 Prostate cancer is the second leading cause of cancer death in American men 1 man in 7 will be diagnosed with prostate cancer during his lifetime. The average age at the time of diagnosis is about million men in the United States who have been diagnosed with prostate cancer at some point are still alive today. 220,800 new cases expected 27,540 deaths expected 3 3

4 Before 2010, The Last Agent Approved for The Treatment mcrpc was Docetaxel LHRH agonists eversible AR blockers Mitoxantrone 1996 Zoledronic Acid 2002 Docetaxel 2004 Denosumab 2011 Cabazitaxel Sipuleucel-T 2010 Abiraterone (postchemo) 2011 Abiraterone (prechemo) 2012 Radium-223 Enzalutamide (post-chemo) 2013 Enzalutamide (prechemo)

5 What is the optimal place for docetaxel in treatment of metastatic prostate cancer? Androgen deprivation therapy (ADT) Death Local therapy Therapies after ADT Hormone sensitive mcrpc asymptomati c (failed ADT) mcrpc mildly symptomatic mcrpc symptomatic mcrpc postdocetaxel ADT ADT + Docetaxel in highvolume disease? Moving indication? Around 40% of patients do not respond to first-line docetaxel Median overall survival of docetaxel + prednisone is 2 years Docetaxel Tannock et al. N Eng J Med 2004; 351(15):1502 6

6 Treatment Landscape Surgery/ Radiation Standard Androgen Deprivation Therapy Denosumab, Zoledronic Acid Radium -223 Enzalutamide Androgen Deprivation Abiraterone Chemotherapy Local Therapy Therapies After GnRH Analogs and Antiandrogens Death Postchemotherapy Sipuleucel-T Docetaxel Cabazitaxel Chen Y, et al. Lancet Oncol. 2009;10: Hofland J, et al. Cancer Res. 2010;70:

7 Summary Therapeutic options for advanced PCa patients now allow for improved patient-physician shared decision making. Specialization and commitment to the treatment and management landscape is essential. Ongoing and future trials will serve to better inform our current unmet needs and questions. 8

8 Summary Urologists are playing a greater role in the care of patients with mcrpc. With this comes the responsibility of keeping up with the advancements and self-education around existing and emerging therapies. Monitoring for both disease progression and AEs is an important aspect of caring for these patients. 9

9 Summary Urologists are in a unique position to offer extended care for patients with mcrpc. Understanding the basics of assessing disease extent as well as the patient's needs is important to offering the right care. The AUA guidelines are driven by knowing the rate of progression and characteristics of the metastatic disease, whether the patient is symptomatic, the patient's overall performance status, and whether the patient has received docetaxel in the past. 10

10 Summary Five new therapies have become available that improve survival in patients with mcrpc. Each has a unique mode of action and strategy to reduce tumor burden. The administration, dosing, cautions, and adverse events are important for urologists to know in order to determine which therapy is right for the individual patient. 11

11 The information, views and opinions expressed in this presentation and any accompanying materials are those of the speaker and do not necessarily reflect the views or position of Cardinal Health or VitalSource. A GUIDE TO ESTABLISHING AN ADVANCED PROSTATE CANCER CLINIC

12 Objective Discuss key insights into establishing an advanced prostate cancer clinic (APCC) Discuss key insights into the integration component for managing the treatment of prostate cancer in the urology setting: o Clinical integration o Operational integration 13

13 Background Rising Healthcare costs Aging population expansion Longer time on treatment Shifting sites of care The demographic, clinical, and economic pressures are influencing the healthcare system Quality of care + Efficient delivery of care Maximizes Value Proposition 14

14 Shifting Paradigm: Volume Value The healthcare landscape is changing rapidly Along with this change begets opportunities for forward thinkers to enhance their urology practice, and Also understand the importance of collaboration and sub-specialization Expanding specialty clinic is an opportunity: Advanced Prostate Cancer Clinic (APCC) Advanced OAB center E/D center 15

15 Why Develop APCC? 16

16 Advanced Prostate Cancer Clinic (APCC) Dedicated Champions Physician Champion Nurse Champion Administrative Champion Clinical and Business Integration Success for patients and the urology practice Collaboration and Subspecialization 17