Andrew John Armstrong, MD, MSc

Articles

Biomarkers, Disease Tracking, and Tumor Evolution

December 16th 2025

A panel of experts discuss emerging data and future directions in AVPC/NEPC and mCRPC, including novel biomarkers for monitoring disease progression and treatment response (ctDNA, CTCs, CEA, LDH, chromogranin, imaging frequency) when PSA is unreliable, and promising therapeutic strategies such as MYC inhibitors, bispecific antibodies, antibody-drug conjugates, and radioligand therapies.

Balancing Intensity, Duration, and Maintenance in Treatment

December 16th 2025

A panel of experts discuss first-line treatment selection for AVPC/NEPC comparing platinum-etoposide regimens versus carboplatin with cabazitaxel or docetaxel, including considerations of dose reductions, cycle length, and doublet intensity.

Integrating Immunotherapy – Lessons from Small Cell Lung Cancer

December 16th 2025

A panel of experts discuss immunotherapy's potential role in complementing platinum-based chemotherapy for AVPC/NEPC based on small-cell lung cancer evidence, including the rationale for PD-1/PD-L1 combinations, the CHAMP trial investigating chemo-immunotherapy, limited efficacy of PD-1 monotherapy, and emerging bispecific T-cell engager options.

Recognizing and Treating AVPC

December 16th 2025

A panel of experts discuss defining and recognizing aggressive variant prostate cancer (AVPC) and neuroendocrine prostate cancer (NEPC) through clinical and molecular features, first-line treatment selection comparing platinum-etoposide versus taxane-platinum regimens, and individualized application of treatment guidelines based on disease characteristics and patient factors.

Individualizing Chemotherapy: Dosing, Tolerability, and Treatment Duration

December 16th 2025

A panel of experts discuss cabazitaxel monitoring strategies (PSA kinetics, imaging, symptom assessment, neutropenia, fatigue, dose adjustments) and perspectives on FDA's overall survival emphasis relative to progression-free survival benefits in therapies like 177Lu-PSMA-617, including patient expectations, tolerability, and shared decision-making.

Overcoming Barriers to Cabazitaxel and Optimizing Sequencing

November 14th 2025

Evidence-based approaches to cabazitaxel use in mCRPC, addressing treatment sequencing after prior therapies, real-world underutilization trends, patient counseling on benefits and risks, and FDA guidance on dosing strategies to optimize outcomes while managing toxicity.

The Role of Chemotherapy in Today’s mCRPC Landscape

November 14th 2025

Evolution of chemotherapy's role in metastatic castration-resistant prostate cancer treatment, including its positioning relative to ARPIs, PARP inhibitors, and targeted therapies, with discussion of treatment sequencing strategies and practical considerations for docetaxel use in high-volume versus low-volume disease.