Daniel P. Petrylak, MD

Daniel P. Petrylak, MD

Yale University Cancer Center

New Haven, Connecticut

Daniel P. Petrylak, MD, leads the genitourinary cancers medical oncology team at Smilow Cancer Hospital as director of the genitourinary cancer research group, professor, and co-director of the Cancer Signaling Network program. Dr. Petrylak joined Yale from Herbert Irving Cancer Center at Columbia University Medical Center with New York-Presbyterian Hospital, where he served as Professor of Medicine (Medical Oncology) and Urology and began his appointment in September of 2012. Dr. Petrylak is a member of the American Association for Cancer Research (AACR), American Society for Clinical Oncology (ASCO), American College of Physicians (ACP), American Association for the Advancement of Science (AAAS), American Urological Association (AUA), and the Southwest Oncology Group (SWOG). After serving for more than 20 years as the advanced bladder chair for SWOG, Dr. Petrylak is now the Vice Chair of the Genitourinary Committee. He additionally has led multiple national and international studies in prostate and bladder cancer. Dr. Petrylak’s research interests span both prostate and bladder cancer. He led an investigator-initiated trial of docetaxel and estramustine in castration resistant prostate cancer. The results of this study supported a phase 3 trial of this combination in SWOG led by Dr. Petrylak, which in turn, supported the FDA approval of docetaxel for castration resistant prostate cancer. This was one of the first two trials to demonstrate a survival benefit in this state of disease. Dr. Petrylak has also been instrumental in the development of immunotherapy and targeted therapies for refractory bladder cancer. His work with Enfortumab Vedotin has supported the accelerated and full FDA approval of this drug. Dr. Petrylak received his undergraduate degree from Columbia College and his medical degree from Case Western University School of Medicine. He completed his internship and residency at Albert Einstein College of Medicine and his fellowship in medical oncology at Memorial Sloan-Kettering Cancer Center. He has authored more than 200 peer-reviewed articles and book chapters on prostate and bladder cancer research outcomes.

Disclosures:

Dr. Petrylak has the following disclosures:

Consultant fees: *Ada Cap (Advanced Accelerator Applications), *Amgen, Astellas, AstraZeneca,
Bayer, *Bicycle Therapeutics, *Boehringer Ingelheim, Bristol Myers Squibb, *Clovis
Oncology, *Eli Lilly, Exelixis, Gilead Sciences, *Incyte, Infinity Pharmaceuticals,
Ipsen, *Janssen, Merck & Company Inc, *Mirati, Monopteros, Pfizer,
*Pharmacyclics, Regeneron, *Roche, Sanofi Aventis Pharmaceuticals, Seattle
Genetics, *Urogen

Grant Support: Ada Cap (Advanced Accelerator Applications), *Agensys Inc, Arvinas, Astellas,
AstraZeneca, *Bayer, BioXcel Therapeutics, Bristol Myers Squibb, Clovis Oncology,
Daiichi Sankyo Company Limited, *Eisai, *Eli Lilly, Endocyte, Ferring, Genentech,
Gilead Sciences, *Innocrin, *MedImmune, *Medivation, Merck, *Mirati, *Novartis,
Pfizer, *Progenics, *Replimune, *Roche, *Sanofi Aventis, Seattle Genetics

Ownership interest/investment: *Bellicum (Sold 7/2020), *Tyme (sold 10/2019)

*denotes relationships recently terminated

Talks by Daniel P. Petrylak, MD

Advanced Prostate Cancer Challenging Case Discussion

Advanced Prostate Cancer Challenging Case Discussion

Posted by | Nov 2023

Daniel P. Petrylak, MD, moderates this discussion panel on challenging prostate cancer case studies. Dr. Petrylak describes the first case whereby a patient had a prostate specific antigen (PSA) of 24 and underwent radical prostatectomy; his PSA never normalized and rose to 40. Androgen deprivation therapy (ADT) commenced and continued for five years until his PSA rose despite a castrate testosterone level. The patient’s bone scan demonstrated sacral metastases. Testing demonstrated no germline mutations and the patient received Sipuleucel T and began treatment with abiraterone/prednisone; PSA nadired at .4. A year and a half later the patient’s PSA rose to 4.8 and he was found to have stable bone metastases.

After the panel decides on a treatment plan for the first case, Dr. Petrylak moves to the second case, whereby a patient presented with celiac, para-aortic and iliac chain lymphadenopathy, early right-side hydronephrosis, a PSA of 19.4, and a biopsy of the left neck lymph node mass showed metastatic adenocarcinoma consistent with prostatic primary. Treatment included bicalutamide/leuprolide, switching to abiraterone/prednisone. In six months, PSA was undetectable. The patient progressed in terms of the soft tissue disease and required a stent for the hydronephrosis, began docetaxel with no response after five cycles, and started cabazitaxel with cycles three and four dose-reduced due to neuropathy.

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Multidisciplinary Approach to the Management of Advanced Prostate Cancer

Multidisciplinary Approach to the Management of Advanced Prostate Cancer

Posted by | Jul 2023

Daniel P. Petrylak, MD, discusses the benefits of a multidisciplinary approach for prostate cancer survival rates and increased clinical efficiency. He emphasizes the need for a prostate cancer management approach involving urologists, medical oncologists, radiation oncologists, and primary care physicians, with references to nutritionists, mental health professionals, and pain management experts.

Dr. Petrylak highlights existing SEER data results, indicating that men with locally advanced and high-risk prostate cancer experience better outcomes when treated with a multidisciplinary approach. He also reviews the University of Colorado’s data on multidisciplinary teams, noting an increased survival rate at each stage of prostate cancer when compared with regional and state data.

Dr. Petrylak then analyzes the benefits of a multidisciplinary approach for other disease states, including optimized patient outcomes, increased access to specialty therapies, more efficient clinician and patient scheduling, better care coordination, and improved communication. Dr. Petrylak concludes by offering considerations pertaining to healthcare challenges, and advocating for a multidisciplinary approach.

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Efficacy of Enzalutamide Plus ADT in Men with De Novo (M1) mHSPC Versus Progression to mHSPC: Post Hoc Analysis of the Phase III ARCHES Trial

Posted by | Oct 2021

Daniel P. Petrylak, MD, Director of Genitourinary Oncology, Professor of Medicine and Urology, Co-Leader of Cancer Signaling Networks, and Co-Director of the Signal Transduction Program at Yale University Cancer Center in New Haven, Connecticut, presents data analysis from the phase III ARCHES trial showing the efficacy of enzalutamide (ENZA) plus androgen deprivation therapy (ADT) in men with metastatic hormone-sensitive prostate cancer (mHSPC). He asserts that urologists should be using next generation anti-androgens more often, citing the fact that only about half of patients are being offered such therapies at the time of mHSPC diagnosis. Dr. Petrylak outlines three reasons for this, including lack of access (driven by high cost and staffing availability), lack of understanding of the data, and lack of education. He then summarizes the ARCHES trial specifications, patient characteristics, and the primary endpoint radiographic progression-free survival (rPFS) data, which demonstrate favored outcomes with ENZA combined with ADT, while specifying that mature overall survival (OS) data is not yet available. Dr. Petrylak then discusses secondary endpoint data, which demonstrate that time to prostate-specific antigen (PSA) progression was significantly better in patients who received ENZA and ADT; similarly, ENZA and ADT reduced the risk of starting a new antineoplastic therapy by 72 percent compared with a placebo and ADT. Data also showed patient benefit in terms of time to first symptomatic skeletal event (SSE) as well as time to castration resistance. Dr. Petrylak addresses the question of disease volume in determining which patients ought to receive these next-generation treatments. He examines rPFS across patient subgroups, from patients with just one metastasis all the way up to those with over six metastases, and asserts that all patients across these groups benefited from the ENZA and ADT therapy, dispelling myths that low-volume patients should not be receiving next-generation treatments. Dr. Petrylak concludes that, for patients with castration-sensitive prostate cancer (CSPC), ENZA used with ADT improves rPFS over ADT alone and that the effect is consistent over all volumes of disease, again stipulating that the OS data is maturing, with additional data expected later this year.

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