We know that men with metastatic castration-resistant prostate cancer (mCRPC) and visceral metastases have a worse prognosis than those with non-visceral metastases. The important question we need to understand is what, of our currently available treatments, might be effective for this more aggressive and deadly type of prostate cancer? Results of the phase 3 AFFIRM clinical trial have demonstrated that treatment with the androgen receptor inhibitor enzalutamide (Xtandi) resulted in significant improvements in outcomes for men with mCRPC. This blog post discusses the efficacy of enzalutamide among men from the AFFIRM trial who had visceral disease. Men who were in [...]
Early Hormone Therapy In Men With A Rising PSA Live Longer Then Men Who Delay Therapy – A Phase 3 Trial
The standard of care is to offer androgen deprivation therapy (ADT) to men with prostate cancer who have a rising prostate specific antigen (PSA) after an attempt to cure their cancer with primary therapy that has failed (PSA relapse) or in men who are considered not suitable for curative treatment. The question is what is the optimal timing to begin ADT. Researchers asked if immediate ADT improves overall survival compared with delayed therapy. They created a randomized, multi-center, phase 3, non-blinded trial; recruiting men from 29 oncology centers in Australia, New Zealand, and Canada. Eligibility included men with prostate cancer [...]
Radioligand Therapy With 177Lu-PSMA-617 – A Novel Therapeutic Possibility on the Horizon in Men With Metastatic Castration Resistant Prostate Cancer.
We are seeing more and more novel therapies being developed to treat castrate resistant metastatic prostate cancer (mCRPC). One such therapy involves theranostic (individualized therapies for various diseases, and to combine diagnostic and therapeutic capabilities into a single agent) concepts using radiolabeled ligands of the prostate-specific membrane antigen (PSMA). In a recent study, designed to evaluate tumor response, adverse effects, and survival in men with castrate resistant prostate cancer who had exhausted all other potential approved therapies, evaluated the novel radioligand therapy with Lu-PSMA-617. Fifty therapies using Lu-PSMA-617 were performed in 28 consecutive men with mCRPC. Data were retrospectively analyzed [...]
Prostate cancer treatment will change as we incorporate new studies into our clinical practice. One of the major emerging new trends is the earlier use of chemotherapy with androgen therapy (ADT) in men, including men who are still hormone responsive. This changing trend comes from the results from there pivotal randomized phase III trials: GETUG15, CHAARTED and STAMPEDE. All three of these studies demonstrated a benefit in progression-free survival with the use of ADT along with docetaxel chemotherapy. However, only two of the studies demonstrated a clinically meaningful overall survival benefit (CHAARTED and STAMPEDE), whereas the GETUG15 study did not [...]