Peer-influenced content. Sources you trust. No registration required. This is HCN.

Renal & Urology NewsIntensified Neoadjuvant Therapy Improves Outcomes in Very High-Risk Prostate Cancer

Patients receiving neoadjuvant abiraterone + ADT had the highest 3-year biochemical progression-free survival rate.

Intensifying neoadjuvant therapy with the addition of abiraterone or docetaxel to androgen deprivation therapy (ADT) may offer significant benefits in pathologic response for patients with very high-risk prostate cancer. The findings come from a pooled analysis of two phase 2 clinical trials and suggest a potential shift in treatment paradigms.

HCN Medical Memo
These findings offer a compelling case for considering intensified neoadjuvant therapy as part of a multimodal treatment approach. Although adverse events were more frequent in the combination therapy groups, the significant improvement in pathologic response and biochemical progression-free survival rates may outweigh these risks for certain patients.

Key Points:
  • Hongqian Guo, MD, and colleagues analyzed data from 137 patients, 132 of whom had very high-risk prostate cancer, including 78.8% with locally advanced disease.
  • The rate of complete pathologic response or minimal residual disease was significantly higher in groups receiving abiraterone plus ADT (31%) or docetaxel plus ADT (28%) compared to ADT alone (2%).
  • The 3-year biochemical progression-free survival rate was 61.2% for abiraterone plus ADT, 51.1% for docetaxel plus ADT, and 41.9% for ADT alone.
  • Adverse events were more frequent in the combination therapy groups, with grade 3 or higher events most common in the docetaxel plus ADT group.

Although non-surgical treatment remains the first-line strategy for men with high-risk prostate cancer, therapeutic advances have provided impetus for researchers to consider surgery as part of multimodal therapy.

Additional Points:
  • Pre-operative PSA levels of 0.1 ng/mL or less and Gleason score were also predictive to lesser degrees.
  • There is currently no consensus on the optimal treatment for men with high-risk prostate cancer, but these findings suggest that intensified neoadjuvant therapy may be beneficial.

More in Prostate Cancer

The Healthcare Communications Network is owned and operated by IQVIA Inc.

Click below to leave this site and continue to IQVIA’s Privacy Choices form