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Timothy A. Yap, MBBS, PhD, of The University of Texas MD Anderson Cancer Center, discusses results from the PETRA study, a first-in-class, first-in-human trial of the next-generation PARP1-selective inhibitor AZD5305 in patients with BRCA1/2, PALB2, or RAD51C/D mutations in advanced or metastatic ovarian cancer, HER2-negative breast cancer, pancreatic, or prostate cancer. Target engagement was demonstrated across all dose levels, and antitumor activity was observed in selected tumor and molecular subtypes.
In this video, Drs. Celestia (Tia) Higano, Julie Graff, and Neal Shore discuss the role of prostate-specific membrane antigen (PSMA)-targeted radioligand therapy in the treatment of metastatic castration-resistant prostate cancer. The patient is an 81-year-old man with 13-year history of prostate cancer who had received multiple prior lines of treatment for his metastatic disease, but no prior taxane. After his PSA rose again, he opted to travel abroad for lutetium (Lu-177) PSMA therapy, since he was not eligible for trials in the United States. The faculty discuss the VISION trial and the current and future role of PSMA-targeted radioligand therapy in prostate cancer. Editor’s Note: This video was filmed prior to the FDA approval of Lu-177 PSMA radioligand therapy on March 23, 2022.
This is Part 3 of Updates in Prostate Cancer, a four-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Celestia (Tia) Higano, Julie Graff, and Neal Shore discuss the first-line therapy for BRCA2-mutated metastatic castration-resistant prostate cancer. The patient is a 69-year-old man with new castration-resistant prostate cancer who was previously treated with androgen-deprivation therapy plus docetaxel for metastatic hormone-sensitive prostate cancer and has a known BRCA2 mutation. The faculty discuss their choices for first-line therapy for this patient, reviewing the current NCCN recommendations, the role of PARP inhibitors, and recent data from the PROpel and MAGNITUDE trials.
This is Part 2 of Updates in Prostate Cancer, a four-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Celestia (Tia) Higano, Julie Graff, and Neal Shore discuss doublet and triplet androgen-deprivation therapy options for metastatic prostate cancer. The patient is a 71-year-old man with metastatic prostate cancer, a PSA of 275, and a positive bone scan, who has begun to receive androgen-deprivation therapy. The faculty discuss what, if any, additional therapy they might add to this patient’s treatment regimen, weighing the current doublet and triplet combination options for metastatic hormone-sensitive prostate cancer. They review the results of the recent PEACE-1 and ARASENS trials and emphasize the importance of assessing bone mineral density and of encouraging genetic counseling for these patients.
This is Part 1 of Updates in Prostate Cancer, a four-part video roundtable series. Scroll down to watch the other videos from this Roundtable. �In this video, Drs. Celestia (Tia) Higano, Julie Graff, and Neal Shore discuss the management of metastatic hormone-sensitive prostate cancer in elderly patients. The patient is a fit 88-year-old man with a history of localized prostate cancer who was originally treated with stereotactic body radiation therapy and is reluctant to start androgen-deprivation therapy for his metastatic disease due to the potential side effects. The faculty discuss the importance of counseling patients about side effects of treatment and when to consider androgen-deprivation therapy rather than metastasis-directed therapy alone, reviewing the results of the phase III HERO trial.
As reported in The Lancet Oncology by Zapatero et al, 10-year results of the Spanish phase III DART 01/05 trial did not support the 5-year findings of significantly improved biochemical disease–free, metastasis-free, and overall survival with long-term vs short-term androgen deprivation plus...
Over the past 15 years, public health authorities have downgraded recommendations for the prostate-specific antigen (PSA) test as a screening tool to reduce the overdiagnosis and overtreatment of men with low-grade prostate cancer. Researchers from Weill Cornell Medicine have found that while these ...
As reported in The Lancet by Fizazi et al, the phase III PEACE-1 trial has shown that the addition of abiraterone and prednisone to androgen-deprivation therapy (ADT) and docetaxel improved radiographic progression-free survival and overall survival in patients with de novo metastatic...
The accuracy of prostate-specific antigen (PSA) screening for prostate cancer could be improved by accounting for genetic factors that cause changes in PSA levels not associated with cancer, according to data presented by Kachuri et al during the American Association for Cancer Research (AACR)...
Julio M. Pow-Sang, MD, of Moffitt Cancer Center, discusses the treatment landscape for localized prostate cancer and its heterogeneity, the critical importance of stratifying risk to determining treatment options, and the continued improvement of therapy in the field.
Formal discussant of the ARASENS trial, Elisabeth I. Heath, MD, FACP, Professor of Oncology and Associate Center Director, Translational Sciences, at Karmanos Cancer Institute in Detroit, commented on the changing paradigm in prostate cancer treatment. “The narrative is changing to triplet therapy, ...
Enzalutamide is a common first-line choice for patients with metastatic castration-resistant prostate cancer, but response in some patients eventually wanes and then patients are switched to a different treatment. According to the phase IIIb PRESIDE trial, reported at the 2022 ASCO Genitourinary...
The PARP inhibitor olaparib in combination with abiraterone demonstrated a statistically significant and clinically meaningful improvement in radiographic progression-free survival vs current standard-of-care abiraterone as a first-line treatment for patients with metastatic castration-resistant...
Xin Gao, MD, of Massachusetts General Hospital, discusses phase I/II findings on bavdegalutamide, an androgen receptor protein degrader, which showed clinical activity in heavily pretreated patients with metastatic castration-resistant prostate cancer who received one to two prior novel hormonal agents.
Triplet therapy with the oral androgen receptor inhibitor darolutamide plus docetaxel plus androgen-deprivation therapy significantly improved overall survival in patients with metastatic hormone-sensitive prostate cancer vs docetaxel plus androgen-deprivation therapy, according to results of the...
As reported in The Lancet Oncology by David Dearnaley, FRCR, and colleagues, the phase III PROMPTS study has shown that a strategy of routine screening with spinal magnetic resonance imaging (MRI) and preemptive treatment to prevent clinical spinal cord compression is likely not warranted in...
On March 23, the U.S. Food and Drug Administration approved lutetium Lu-177 vipivotide tetraxetan (Pluvicto) for the treatment of adult patients with prostate-specific membrane antigen (PSMA)-positive metastatic castration-resistant prostate cancer who have been treated with androgen receptor...
Tanya B. Dorff, MD, of City of Hope National Medical Center, discusses the first-in-human phase I findings showing that prostate stem cell antigen (PSCA) CAR T-cell therapy is feasible in patients with metastatic castration-resistant prostate cancer, with preliminary antitumor activity exhibited.
Neil E. Fleshner, MD, MPH, of the Princess Margaret Cancer Centre, discusses phase II results from the ACDC-RP trial, which indicate a significant tumor response to neoadjuvant abiraterone acetate plus prednisone and leuprolide, with or without cabazitaxel, in patients with high-risk prostate cancer. Those who exhibited either a complete response or minimal residual disease experienced higher rates of progression-free survival. According to Dr. Fleshner, genomic efforts are underway to determine predictors of response.
In a study in a German cohort reported in the Journal of Clinical Oncology, Tilki et al found that adjuvant radiation therapy was associated with reduced all-cause mortality vs early salvage radiation therapy after radical prostatectomy among men with pN1 prostate cancer. The benefit increased with ...
The past year has witnessed tremendous advances in genitourinary oncology. I am pleased to review these findings in this year’s Genitourinary Oncology Almanac from The ASCO Post. I hope that you will find this roadmap helpful in highlighting a selection of these exciting developments. Checkpoint...
Enzalutamide is a common first-line choice for patients with metastatic castration-resistant prostate cancer, but response in some patients eventually wanes and then patients are switched to a different treatment. According to the phase IIIb PRESIDE trial, reported at the 2022 ASCO Genitourinary...
Formal discussant of the ARASENS trial, Elisabeth I. Heath, MD, FACP, Professor of Oncology and Associate Center Director, Translational Sciences, at Karmanos Cancer Institute in Detroit, commented on the changing paradigm in prostate cancer treatment. “The narrative is changing to triplet therapy, ...
Triplet therapy with the oral androgen receptor inhibitor darolutamide plus docetaxel plus androgen-deprivation therapy significantly improved overall survival in patients with metastatic hormone-sensitive prostate cancer vs docetaxel plus androgen-deprivation therapy, according to results of the...
MAGNITUDE is challenging from a statistical point of view,” said formal discussant Celestia S. Higano, MD, currently Adjunct Professor, Department of Urologic Sciences at the University of British Columbia, Vancouver, Canada, and formerly of Fred Hutchinson Cancer Research Center in Seattle....
The combination of the poly (ADP-ribose) polymerase (PARP) inhibitor niraparib plus abiraterone acetate and prednisone as first-line therapy significantly improved radiographic progression-free survival vs abiraterone and placebo alone in men with metastatic castration-resistant prostate cancer...
In a phase III trial (IPATential150) reported in The Lancet, Christopher Sweeney, MD, of Dana-Farber Cancer Institute, and colleagues, found that the addition of the AKT inhibitor ipatasertib to abiraterone and prednisolone produced a significant improvement in radiographic progression-free...
Hypofractionated radiotherapy to the prostate bed proved to be noninferior to conventionally fractionated radiotherapy after prostatectomy regarding gastrointestinal and genitourinary side effects, according to the results of the phase III NRG Oncology GU003 trial, presented at the 2021 American...
The addition of 2 years of abiraterone acetate plus prednisolone (AAP) to androgen-deprivation therapy improves metastasis-free survival and overall survival compared with androgen-deprivation therapy alone in men with nonmetastatic castration-sensitive prostate cancer, according to a primary...
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...
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...
As reported in the Journal of Clinical Oncology by Kim N. Chi, MD, of BC Cancer and Vancouver Prostate Centre, and colleagues, the final overall survival analysis of the phase III TITAN trial showed significant benefit of apalutamide plus androgen-deprivation therapy vs placebo plus...
Invited discussant of the VISION trial, Mary-Ellen Taplin, MD, of Dana-Farber Cancer Institute, Boston, commented on the study, noting that she was a co-investigator of the trial. “Patients with metastatic castration-resistant prostate cancer have a number of treatment options. There are 10...
Lutetium-177–PSMA-617 (LuPSMA)—an investigational radiolabeled small molecule—significantly improved radiographic progression-free survival and overall survival when added to the standard of care compared with the standard of care alone for men with metastatic castration-resistant prostate cancer...
The PARP inhibitor olaparib in combination with abiraterone demonstrated a statistically significant and clinically meaningful improvement in radiographic progression-free survival vs current standard-of-care abiraterone as a first-line treatment for patients with metastatic castration-resistant...
Sumanta K. Pal, MD, of City of Hope National Medical Center, discusses some key research developments in kidney cancer, including data on nivolumab and ipilimumab with or without CBM588 in metastatic renal cell carcinoma; intestinal microbiome associated with the development of grade 3 or 4 adverse events in patients with metastatic disease who have been treated with nivolumab plus ipilimumab and probiotic support; the link between TERT promoter mutations and clinical outcome with immune checkpoint inhibitor therapy for advanced urothelial cancer; mutations in the androgen receptor gene in patients with prostate cancer receiving novel androgen deprivation treatments; and findings on waning antibody titers in patients who have received COVID-19 vaccinations (Roundup of Abstracts 371, 561, 374, Posters 38 and 48).
A novel prostate cancer treatment—actinium Ac-225–PSMA-617 radioligand therapy—has been shown to increase the progression-free and overall survival of patients with metastatic castration-resistant prostate cancer, according to research published by Sathekge et al in the Journal of Nuclear Medicine. ...
In a study reported in JAMA Oncology, Michael S. Leapman, MD, and colleagues found that sociodemographic factors (like geographic area of residence) as well as manifestations of structural racism (like poverty and racial segregation) accounted for the majority of differences in the use of magnetic...
MAGNITUDE is challenging from a statistical point of view,” said formal discussant Celestia S. Higano, MD, currently Adjunct Professor, Department of Urologic Sciences at the University of British Columbia, Vancouver, Canada, and formerly of Fred Hutchinson Cancer Research Center in Seattle....
Alicia K. Morgans, MD, MPH, of Dana-Farber Cancer Institute, discusses findings from the largest digital survey conducted in patients with prostate cancer, allowing identification of unmet needs in the patient journey. Preliminary data suggest that lower rates of screening may correlate with higher rates of symptoms at diagnosis and potentially later-stage diagnosis.
In the prospective paired-cohort CADMUS study reported in The Lancet Oncology, Grey et al found that patients at risk of prostate cancer had a similar likelihood of being diagnosed with clinically significant cancer with the use of multiparametric ultrasound vs multiparametric magnetic resonance...
Kim Nguyen Chi, MD, of the University of British Columbia, BC Cancer-Vancouver Center, discusses first phase III results from the MAGNITUDE study, which explored the use of the PARP inhibitor niraparib with abiraterone acetate and prednisone as first-line therapy in patients with metastatic castration-resistant prostate cancer with and without homologous recombination repair gene alterations (Abstract 12).
Karim Fizazi, PhD, MD, of Gustave Roussy and University of Paris-Saclay, discusses results from a first-in-human phase I/II trial, which showed that administering ODM-208—an oral, nonsteroidal inhibitor of the enzyme CYP11A1—to men with metastatic castration-resistant prostate cancer who were pretreated with abiraterone/enzalutamide and taxanes was effective in blocking the production of steroid hormones. It also showed antitumor activity, especially in men with AR mutation–positive cancers.
Karen E. Knudsen, PhD, MBA, Chief Executive Officer of the American Cancer Society, discusses ways to address the inequities in genitourinary screening, treatment, and outcomes. Her suggestions focus on increasing awareness of screening, identifying risk factors, the dramatic rise in incidence among Hispanic individuals, and the basis for increased mortality in Black men.
In a single-institution study reported in JCO Oncology Practice, Ruppert et al found that nonmalignant etiologies contribute to back pain in many men with metastatic prostate cancer who experience pain in areas where spinal metastases are known to occur. Study Details The study consisted of...
In a study reported in the Journal of Clinical Oncology, Owens-Walton et al found that minority populations are underrepresented in phase II and III trials targeting prostate, kidney, and bladder cancers taking place in the United States. Study Details In the analysis, the ClinicalTrials.gov...
Axel S. Merseburger, MD, of the University Hospital Schleswig-Holstein, discusses results from a phase IIIb study of chemotherapy-naive patients with metastatic castration-resistant prostate cancer who have been treated with docetaxel plus prednisolone and experienced disease progression on enzalutamide. The data suggest that continued enzalutamide plus docetaxel improved progression-free survival compared with placebo plus docetaxel (Abstract 15).
Fred Saad, MD, of the University of Montreal Health Centre, discusses phase III findings demonstrating for the first time the clinical benefits of olaparib plus abiraterone in patients with metastatic castration-resistant prostate cancer, irrespective of their homologous recombination repair mutation status. This regimen led to significantly longer radiographic progression-free survival than placebo plus abiraterone (Abstract 11).
In an analysis from the phase III PROfound trial reported in The Lancet Oncology, Thiery-Vuillemin et al found that olaparib was associated with better pain outcomes and preservation of health-related quality of life (QOL) vs enzalutamide or abiraterone plus prednisone in a cohort of men with...
In a phase III trial (VIABLE) reported in JAMA Oncology, Nicholas J. Vogelzang, MD, and colleagues found that the addition of an autologous dendritic cell–based immunotherapy directed against prostate cancer (DCVAC/PCa) to chemotherapy did not improve overall survival in metastatic...