Expert Point of View: Eleni Efstathiou, MD
Invited discussant of the PEACE-1 trial, Eleni Efstathiou, MD, of the Houston Methodist Cancer Center and Athens Medical Center, Greece, reminded listeners: “Androgen signaling inhibition is the prevailing therapeutic strategy in advanced prostate cancer, with reproducible outcomes. Many studies have shown that earlier is better, and more may end up being less.”
She congratulated the PEACE-1 investigators for “an impressive track record and research contribution. The study design is adapted to the evolving paradigm and is close to clinical practice.”
Dr. Efstathiou continued: “The PEACE-1 trial showed us that regardless of the standard of care, abiraterone acetate plus prednisone has a clinically meaningful overall survival impact.1 The timing of abiraterone acetate plus prednisone is of essence. In the study, 80% of men receiving androgen-deprivation therapy plus docetaxel received an enhanced androgen signaling receptor inhibitor later,” she continued.
Eleni Efstathiou, MD
Dr. Efstathiou emphasized that 14 clinical trials have reported positive results for enhanced androgen signaling (7 in castration-sensitive prostate cancer and 7 in castration-resistant prostate cancer). “All supported earlier treatment,” she added. “The lack of a marker-driven therapeutic strategy remains our biggest impediment.”
“The main take-home message [of PEACE-1] is that earlier combinatorial treatment with ‘enhanced’ androgen signaling inhibition is a requirement for men with advanced castration-sensitive prostate cancer,” she concluded.
DISCLOSURE: Dr. Efstathiou has received research support from Janssen, Sanofi-Genzyme, Astellas/Medivation, and ORIC Pharmaceuticals; and has served on scientific advisory boards and received honoraria from Janssen, Sanofi-Genzyme, Tomar, Takeda, Bayer, ORIC Pharmaceuticals, Merck, Astellas, Pfizer, Myovant Sciences, and AstraZeneca.
1. Fizazi K, Carles-Galceran J, Foulon S, et al: A phase III trial with a 2x2 factorial design in men with de novo metastatic castration-sensitive prostate cancer: Overall survival with abiraterone acetate plus prednisone in PEACE-1. ESMO Congress 2021. Abstract LBA5_PR. Presented September 19. 2021.
PEACE-1: Abiraterone Plus Androgen-Deprivation Therapy and Docetaxel Boosts Survival in Metastatic Castration-Sensitive Prostate Cancer
The addition of abiraterone acetate plus prednisone on top of androgen-deprivation therapy plus docetaxel improved survival in patients with de novo metastatic castration-sensitive prostate cancer vs androgen-deprivation therapy plus docetaxel alone. These results were from the phase III PEACE-1...