|
|
|
|
|
|
|
PEER-TO-PEER CLINICAL CONVERSATIONS |
|
|
|
|
|
|
UpFrontPSMA Trial Results: Lutetium-177 PSMA-617 in Hormone-Sensitive Prostate Cancer, Journal Club
|
Phillip J. Koo, MD, FACS, and Zachary Klaassen, MD, MSc
Phillip Koo and Zachary Klaassen discuss the UpFrontPSMA study, a Phase 2 trial published in Lancet Oncology. The study evaluates lutetium-177 PSMA-617 followed by docetaxel versus docetaxel alone in patients with de novo high-volume metastatic hormone-sensitive prostate cancer.
|
|
|
|
|
|
|
|
|
|
|
|
STAMPEDE2 Trial Explores Combination Niraparib and Abiraterone in mHSPC
|
Sarah Howlett, MD, and Mahaz Kayani, MD
Zachary Klaassen hosts Sarah Howlett and Mahaz Kayani about the STAMPEDE2 platform trial, focusing on Arm N, which tests niraparib-abiraterone in metastatic hormone-sensitive prostate cancer patients with specific homologous recombination repair gene alterations.
|
|
|
|
|
|
|
|
|
|
|
|
Advancing mHSPC Treatment Options: ARANOTE Trial Analysis
|
Fred Saad, MD, FRCS, and Neal Shore, MD, FACS
Fred Saad and Neal Shore discuss the ARANOTE trial with Zach Klaassen, exploring the use of darolutamide plus ADT in metastatic hormone-sensitive prostate cancer. They highlight the trial's diverse patient population and impressive results, including a 46% reduction in radiographic progression-free survival risk. |
|
|
|
|
|
|
|
|
|
|
|
|
|
Advancing mHSPC Care: Bridging Research and Practice - A Letter from UroToday's mHSPC Center of Excellence Editor-in-Chief
|
|
Neeraj Agarwal, MD, FASCO
|
| In his editorial, Dr. Neeraj Agarwal highlights the evolving landscape of metastatic hormone-sensitive prostate cancer (mHSPC) treatment, emphasizing the shift towards combination therapies, including androgen receptor pathway inhibitors (ARPIs). Despite clinical advancements, real-world adoption of these treatments remains low, with many patients still receiving androgen deprivation therapy (ADT) alone.
|
|
|
|
|
|
|
|
|
|
| HARMONY: A Phase II Study of Niraparib/Abiraterone Acetate plus Prednisone for Hispanic/Latino and Non-Hispanic Black Patients with Metastatic Hormone-Sensitive Prostate Cancer and Deleterious Homologous Recombination Repair Alterations
|
| Qian Qin MD
|
| Qian Qin presents the HARMONY trial, a phase II study focused on evaluating the combination of niraparib, abiraterone acetate, and prednisone for Hispanic/Latino and non-Hispanic Black patients with metastatic hormone-sensitive prostate cancer (mHSPC) and homologous recombination repair (HRR) alterations.
|
|
|
|
|
|
| Ideal Sequence after ADT Alone or ADT plus ARPI for mHSPC |
| Ian Davis, MBBS(Hons), PhD, FRACP, FAChPM, FAHMS, GAICD |
| Ian Davis discusses the challenges in determining an ideal treatment sequence for mHSPC patients following androgen deprivation therapy alone or in combination with androgen receptor pathway inhibitors. He emphasized that no "ideal" sequence exists, but several key principles should guide treatment decisions, including the goal of maximizing patient benefit over the long term and considering the efficacy and timing of future treatment options. |
|
|
|
|
|
|
|
|
|
|
| mHSPC: Optimizing Combination Therapy |
| Paul Sieber, MD |
| Paul Sieber emphasized that doublet therapy with ADT plus an androgen receptor pathway inhibitor (ARPI) is the standard treatment for mHSPC, with PSMA-PET/CT playing an increasing role in staging. For high-volume and fit patients, triplet therapy (ADT + ARPI + docetaxel) may be appropriate, while radiation therapy can be considered for those with low-volume metastatic disease. |
|
|
|
|
|
| Adding Metformin to ADT for Patients with mHSPC: Overall Survival Results from the Multi-Arm, Multi-Stage Randomized Platform Trial STAMPEDE |
| Silke Gillessen, MD |
| Silke Gillessen presented results from the STAMPEDE trial, which investigated adding metformin to ADT in non-diabetic patients with mHSPC. The study found no clear evidence that metformin improved overall survival in unselected patients, although a potential benefit was observed in those with high-volume disease. Metformin significantly improved metabolic parameters like weight, fasting glucose, HbA1c, and cholesterol levels, suggesting possible long-term cardiovascular benefits. |
|
|
|
|
|
| Synchronous Low-Volume mHSPC – In Which Patients Do You Recommend Combination Systemic Therapy Plus Local Treatment of the Primary and in Which Patients is ADT Alone Plus Radiotherapy Enough?
|
| Robert Jones, MD, PhD
|
| Robert Jones discussed the treatment of patients with synchronous low-volume mHSPC, focusing on when to use combination systemic therapy plus local treatment and when ADT plus radiotherapy suffices. Data from STAMPEDE and PEACE-1 trials show that adding radiotherapy to ADT with ARPIs may not significantly improve overall survival, although it offers benefits like reduced genitourinary events.
|
|
|
|
|
|
|
|
|
|
|
