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Daniel E. Spratt, MD, of the University of Michigan Rogel Cancer Center, discusses a pooled analysis of two phase III trials showing adjuvant androgen-deprivation therapy (ADT) improves biochemical control and reduces distant metastasis when compared with a neoadjuvant approach, with no difference in late gastrointestinal or genitourinary toxicities. The analysis also showed that delaying radiotherapy to deliver neoadjuvant ADT did not benefit most patients (Abstract 32).
Cynthia Menard, MD, of the University of Montreal, discusses a study on the use of prostate-specific membrane antigen PET and CT to guide treatment. The scans led to high rates of new lesion detection and therefore intensification of radiotherapy for patients with prostate cancer, without an increase in side effects (Abstract 34).
Paul Sargos, MD, of the Institut Bergonié, discusses phase III findings from the GETUG-AFU 17 study, which compared adjuvant vs early salvage radiotherapy, both combined with short-term androgen-deprivation therapy after radical prostatectomy for localized prostate cancer. Although lacking statistical power, the study showed no benefit in event-free survival for adjuvant compared to salvage radiotherapy (Abstract 33).
Neha Vapiwala, MD, of the University of Pennsylvania, who served as a discussant for LBA1, summarizes her review of this study of patients with prostate cancer who had biochemical recurrence in the post-prostatectomy setting, who were candidates for salvage radiotherapy, and who received either conventional imaging or PET scans to help determine the course of treatment.
On October 27, the U.S. Food and Drug Administration (FDA) approved the FoundationOne Liquid CDx test for three new companion diagnostic indications to help match patients who may benefit from treatment with specific FDA-approved targeted therapies. The new indications are for alpelisib (Piqray) in ...
The addition of the radiotracer fluciclovine to positron-emission tomography (PET) imaging for treatment planning led to superior failure-free survival compared with conventional imaging in men with prostate cancer who had undergone radical prostatectomy and were experiencing biologic recurrence of ...
Ipatasertib plus abiraterone plus prednisone achieved significantly superior radiographic progression–free survival and antitumor activity compared with placebo plus abiraterone plus prednisonein patients with metastatic castration-resistant prostate cancer and PTEN loss, according to the results...
The PARP inhibitor olaparib reduced the risk of death by 31% compared with a second hormonal treatment (enzalutamide or abiraterone) in men with metastatic castration-resistant prostate cancer characterized by BRCA1, BRCA2, or ATM mutations, in the final analysis of the phase III PROfound trial...
Recently, the U.S. Food and Drug Administration (FDA) granted Priority Review to treatments for EGFR-mutant lung cancer and advanced renal cell carcinoma; granted Fast Track designation to agents in chronic lymphocytic leukemia (CLL) and locally advanced or metastatic solid tumors; and more....
As reported in The Lancet Oncology by Sargos et al, the French phase III GETUG-AFU 17 trial has shown no event-free survival benefit for adjuvant radiotherapy vs salvage radiotherapy—both with short-term androgen-deprivation therapy (ADT)—after radical prostatectomy in men with localized prostate...
In a phase III noninferiority trial (RAVES) reported in The Lancet Oncology, Kneebone et al found that salvage radiotherapy did not meet noninferiority criteria for biochemical progression vs adjuvant radiotherapy, but was associated with nearly identical biochemical control rates and reduced...
As reported in The Lancet by Christopher C. Parker, MD, and colleagues, initial findings in the phase III RADICALS-RT trial have shown no biochemical progression-free survival benefit and no difference in freedom from nonprotocol hormone therapy with adjuvant radiotherapy vs salvage radiotherapy...
A report published by Hu et al in JNCCN—Journal of the National Comprehensive Cancer Network found the rate of bone mineral density testing in people with prostate cancer undergoing androgen-deprivation therapy (ADT) has improved in recent years, but remains low. ADT is considered a cornerstone of...
As reported in the Journal of Clinical Oncology by Wassim Abida, MD, PhD, of Memorial Sloan Kettering Cancer Center, and colleagues, the phase II TRITON2 trial has shown that the poly (ADP-ribose) polymerase (PARP) inhibitor rucaparib produced durable responses in patients with previously treated...
In a systematic review and meta-analysis reported in The Lancet, Claire L. Vale, PhD, and colleagues found that immediate adjuvant radiotherapy did not improve event-free survival vs early salvage radiotherapy in men with intermediate-risk or high-risk localized or locally advanced prostate cancer...
In an analysis of long-term data from NRG Oncology’s RTOG 9408 trial reported in JAMA Network Open, Zumsteg et al found that patients with favorable vs unfavorable intermediate-risk prostate cancer had improved overall survival, and that androgen-deprivation therapy (ADT) vs no ADT was associated...
In a quality-of-life analysis from the phase IV CARD trial reported in The Lancet Oncology, Karim Fizazi, MD, and colleagues found that cabazitaxel was associated with improved pain response, time to pain progression, and time to symptomatic skeletal events vs abiraterone or enzalutamide in...
As reported in European Urology by Matthew R. Smith, MD, and colleagues, the final analysis of phase III SPARTAN trial has shown significant prolongation of overall survival with apalutamide vs placebo in patients with nonmetastatic castration-resistant prostate cancer and prostate-specific antigen ...
Nicholas D. James, PhD, MBBS, of The Institute of Cancer Research, London, discusses long-term STAMPEDE trial results that showed patients with metastatic, hormone-naive prostate cancer benefited from abiraterone acetate plus prednisolone in terms of overall and failure-free survival, as well as skeletal-related events (Abstract 611O).
As reported in The New England Journal of Medicine and during the ESMO Virtual Congress 2020 (Abstract 610O) by Maha Hussain, MD, FACP, FASCO, and colleagues, an overall survival analysis from the phase III PROfound trial has shown a significant benefit with olaparib vs physician’s choice of...
Recently, the U.S. Food and Drug Administration (FDA) granted designations to agents for metastatic castration-resistant prostate cancer, recurrent glioblastoma, and pediatric acute myeloid leukemia. Fast Track Designation for EPI-7386 in Metastatic Castration-Resistant Prostate Cancer The FDA...
In a phase II study reported in the Journal of Clinical Oncology, Kyriakopoulos et al found that use of quantitative total bone imaging with fluorine-18 (F-18)–sodium fluoride (NaF) positron-emission tomography/computed tomography (PET/CT) helped identify heterogeneity of response in bone lesions...
As reported in The New England Journal of Medicine by Karim Fizazi, MD, and colleagues, the phase III ARAMIS trial has shown significantly prolonged overall survival with darolutamide vs placebo in men with nonmetastatic castration-resistant prostate cancer. The previously reported primary analysis ...
Results from a phase II trial led by researchers at The University of Texas MD Anderson Cancer Center suggest that a combination of ipilimumab (anti–CTLA-4) plus nivolumab (anti–PD-1) can generate durable responses in a subset of patients with metastatic castration-resistant prostate cancer, an...
In a letter to the editor published in The New England Journal of Medicine, Brandon A. Mahal, MD, and colleagues described genomic differences in prostate cancer in Black, White, and Asian men. Study Details The study involved next-generation sequencing data from patients who had been treated for...
For some patients with prostate cancer, surgery and/or radiation are considered standard treatments. However, these procedures may cause side effects, including urinary incontinence or impotency. A recent study published by Abreu et al in the Journal of Urology demonstrated that high-intensity...
In a phase III trial (PROfound) reported in The New England Journal of Medicine, Johann de Bono, MB, ChB, PhD, of the Institute of Cancer Research and Royal Marsden Hospital, London, and colleagues found that olaparib significantly improved progression-free survival vs hormonal therapy in patients...
The message still needs to get out that metastatic castration-sensitive prostate cancer should be treated with both androgen-deprivation therapy (ADT) and either docetaxel or an androgen receptor pathway inhibitor. In spite of “overwhelming” support for ADT plus abiraterone/prednisone,...
In a study reported in JAMA Oncology, Dee et al found that radiotherapy (RT) initiated at up to 6 months after the start of androgen-deprivation therapy (ADT) was not associated with poorer overall survival vs initiation before ADT in men with prostate cancer. The investigators observed that these...
Uriya, age 49, visits Israel’s Rabin Medical Center for a cancer screening. On the surface, he shows no signs of disease. However, results from a study by David Margel, MD, PhD, revealed Uriya is living with prostate cancer at an early yet curable stage. Uriya carries the BRCA gene. Rabin Medical...
As reported in the Journal of Clinical Oncology by Abida and colleagues, the phase II TRITON2 trial has shown that rucaparib produces durable responses in patients with metastatic castration-resistant prostate cancer with deleterious BRCA1 or BRCA2 alterations. The trial supported the May 2020...
In a study reported in the Journal of Urology, Wang et al found that tests for small noncoding RNAs isolated from urinary exosomes accurately distinguished patients with vs without prostate cancer and patients with low- vs intermediate- or high-risk disease. Study Details The investigators...
Androgen-deprivation therapy has been, and remains, the standard of care for patients with metastatic prostate cancer. Patients are often surprised to learn that was all we would do to control their disease and sometimes asked why they would not receive chemotherapy, as for other cancers. I would...
Based on the recently published ENZAMET, ARCHES, and TITAN trials,1-3 we now have several choices of systemic combination therapies for men with metastatic hormone-sensitive prostate cancer. Today, men are faced with decisions of androgen-deprivation therapy alone or combinations with abiraterone,...
As reported inThe New England Journal of Medicine by Ian D. Davis, MBBS, PhD, FRACP, FAChPM, of Monash University and Eastern Health in Melbourne, and colleagues, the phase III ENZAMET trial has shown that the androgen receptor inhibitor enzalutamide improved progression-free and overall survival...
As reported in The New England Journal of Medicine by Kim N. Chi, MD, of BC Cancer and Vancouver Prostate Centre, and colleagues, the first analysis of the phase III TITAN trial has shown that the addition of apalutamide to androgen-deprivation therapy improved radiographic progression-free and...
Nonmetastatic castration-resistant prostate cancer arises in the subset of men with biochemically recurrent disease (ie, rising prostate-specific antigen [PSA] level after definitive therapy in the absence of metastases) who develop PSA progression after chronic exposure to androgen-deprivation...
In the phase III ARAMIS trial reported in The New England Journal of Medicine,1 Karim Fizazi, MD, PhD, of the Institut Gustave Roussy, Universite Paris-Sud, Villejuif, France, and colleagues found that the androgen-receptor (AR) antagonist darolutamide significantly prolonged metastasis-free...
The past year has witnessed the U.S. Food and Drug Administration (FDA) approval of a number of drugs for treatment of patients with metastatic castrate-resistant prostate cancer or castrate-sensitive prostate cancer. Castrate-Resistant Prostate Cancer Olaparib: On May 19, 2020, olaparib...
The single-arm TRITON2 study demonstrated the efficacy of the poly (ADP-ribose) polymerase (PARP) inhibitor rucaparib in patients with metastatic castration-resistant prostate cancer.1,2 Results from the study (ClinicalTrials.gov identifier NCT02952534) led to the approval of rucaparib in this...
A year ago, initial results from the double-blind, multicenter, randomized phase III ARAMIS clinical trial evaluating the efficacy and safety of darolutamide, a structurally unique androgen-receptor antagonist, in men with nonmetastatic castration-resistant prostate cancer, were published in The...
In the final overall survival analysis of the phase III PROSPER trial reported at the ASCO20 Virtual Scientific Program1 and published in The New England Journal of Medicine,2 Cora N. Sternberg, MD, and colleagues found that enzalutamide plus androgen-deprivation therapy (ADT) significantly...
As reported at the ASCO20 Virtual Scientific Program1 and in The New England Journal of Medicine2 by Neal D. Shore, MD, FACS, of Carolina Urologic Research Center, Myrtle Beach, South Carolina, and colleagues, the phase III HERO trial showed sustained castrate testosterone levels and lower risk of...
Positron-emission tomography/computed tomography (PET/CT) imaging with the prostate-specific membrane antigen (PSMA)-targeted radiotracer fluorine F-18 DCFPyL (PyL) successfully identified areas of occult metastasis in men with biochemically recurrent metastatic castration-resistant prostate...
Initial results of the randomized phase II TheraP trial showed that therapy directed to prostate-specific membrane antigen (PSMA) with lutetium-177–labeled PSMA-617 (LuPSMA) significantly improved prostate-specific antigen (PSA) response compared with cabazitaxel in men with metastatic...
Over the past year, we have seen significant advances in the treatment of prostate, kidney, and urothelial cancers that will benefit patients now and in the future. We have learned about the final results of important clinical trials across multiple genitourinary cancers disease states leading to...
As reported in the Journal of Clinical Oncology by Eastham et al, the phase III CALGB 90203/Alliance trial has shown no improvement in 3-year biochemical progression-free survival (BPFS) with the addition of neoadjuvant chemohormonal therapy to radical prostatectomy in patients with localized...
A new multi-institution, dose-determining clinical trial of a compound for patients with metastatic, castration-resistant prostate cancer showed the combination “demonstrated acceptable tolerability and potential efficacy,” reported Aggarwal et al in Clinical Cancer Research. The phase Ib/IIa study ...
The American Urological Association (AUA), American Society for Radiation Oncology (ASTRO), and Society of Urologic Oncology (SUO) recently announced a new clinical practice guideline for the diagnosis and treatment of advanced prostate cancer. Prostate cancer is one of the most commonly diagnosed...
Findings from the first international prostate cancer quality-of-life study showed that significant numbers of men treated for the disease are struggling with continence and sexual problems after treatment. Results suggest that any treatment apart from active surveillance may negatively affect...