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, enzalutamide, apalutamide, or docetaxel, recent surveys have shown that the majority of men with this disease still receive ADT alone, according to Neal Shore, MD, FACS.

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 findings suggest that delay of RT constitutes an option in the setting of treatment during the COVID-19 pandemic.

As reported in Journal of Clinical Oncology by Abida et al, the phase II TRITON2 trial has shown that the PARP inhibitor rucaparib produces durable responses in patients with metastatic castration-resistant prostate cancer with deleterious BRCA1 or BRCA2 alterations. The trial supported the May 2020 accelerated approval of rucaparib in this setting.

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.

The phase III CALGB 90203/Alliance trial has shown no improvement in 3-year biochemical progression-free survival with the addition of neoadjuvant chemohormonal therapy to radical prostatectomy in patients with localized high-risk prostate cancer. These findings were published by Eastham et al in the Journal of Clinical Oncology.