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Prostate Cancer Quick Takes
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Prostate Cancer Quick Takes ESMO 2024 - ARANOTE, PEACE-3, and SPLASH Trials
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Oliver Sartor, MD
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| Zachary Klaassen interviews Oliver Sartor about three significant prostate cancer trials presented at ESMO 2024. Dr. Sartor discusses the ARANOTE, PEACE-3, and the SPLASH trials.
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| ESMO 2024 Breakthroughs in Advanced Prostate Cancer |
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| The ARANOTE, PEACE-3, and SPLASH trials showcased new treatment options in advanced prostate cancer. ARANOTE confirmed darolutamide + ADT improves rPFS in mHSPC, while PEACE-3 demonstrated that combining radium-223 with enzalutamide improves rPFS and OS in mCRPC with bone metastases. SPLASH highlighted 177Lu-PNT2002 as a promising radioligand therapy option for chemotherapy-naïve mCRPC.
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| The Phase III EORTC-1333-GUCG/PEACE III Trial in Asymptomatic or Mildly Symptomatic CRPC Metastatic to Bone |
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| At ESMO 2024, the phase III PEACE-3 trial results were highlighted, showing that combining radium-223 with enzalutamide significantly improved radiographic progression-free survival and overall survival in patients with mCRPC with bone metastases. This combination therapy may now become a first-line treatment option for mCRPC, with the important stipulation that bone protective agents must be used to reduce fracture risk, as observed in both the ERA-223 and PEACE-3 trials.
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| The Phase III SPLASH Trial in PSMA-Positive mCRPC |
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| The phase III SPLASH trial, presented at ESMO 2024, evaluated 177Lu-PNT2002 in mCRPC patients who had progressed after an ARPI. The trial demonstrated a significant radiographic progression-free survival benefit with 177Lu-PNT2002, along with a favorable safety profile. While overall survival data are still inconclusive due to high crossover, the rPFS results suggest 177Lu-PNT2002 may provide a new radioligand therapy option in the pre-chemotherapy mCRPC setting.
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| The Phase III ARANOTE trial in mHSPC |
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| The phase III ARANOTE trial, presented at ESMO 2024, evaluated darolutamide + ADT versus placebo + ADT in mHSPC patients. Darolutamide + ADT significantly improved radiological progression-free survival and demonstrated a positive trend for overall survival, along with benefits across other secondary endpoints like time to CRPC and PSA progression. The trial supports darolutamide + ADT as a viable option for mHSPC patients, particularly those with low-volume disease, offering flexibility in treatment without chemotherapy.
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