Clinical Advances in Hematology & OncologyMore Highlights in Prostate Cancer From the 2023 American Society of Clinical Oncology Annual Meeting

The ICECaP trial, BRCA status research, and the LuPARP study are highlighted.

The 2023 American Society of Clinical Oncology Annual Meeting presented significant research in prostate cancer, including the ICECaP study, BRCA status research, and the LuPARP study. These findings provide valuable insights into survival outcomes, genetic mutations, and promising treatments, shaping the future of prostate cancer management.

Key Points:

• PSA Level After Radiation Therapy:
  • PSA level of 0.1 ng/mL or greater within 6 months of completing radiation therapy linked to worse survival outcomes.
  • Analysis included 10,415 patients from 16 randomized trials.
  • Higher PSA levels associated with poorer PCSS, MFS, and OS.
• BRCA1/2 Mutations in Metastatic Castration-Resistant Prostate Cancer:
  • Germline and somatic BRCA1/2 mutations linked to worse outcomes.
  • 13.2% of 729 patients had a BRCA1/2 mutation.
  • Outcomes significantly worse in the BRCA group.
• 177Lu-PSMA-617 Plus Olaparib in mCRPC:
  • Combination shows promising activity and is well tolerated.
  • 66% of patients experienced a PSA response rate of at least 50%.
  • Recommended dose for phase 2 is 177Lu-PSMA-617 at 7.4 GBq plus olaparib at 300 mg twice a day.

Additional Points:

• ICECaP Study:
  • 98% of patients in the RT group had a PSA nadir of 0.1 ng/mL or higher within 6 months.
  • Hazard ratios varied between groups.
• CAPTURE Trial:
  • PFS, PFS2, and OS significantly worse in the BRCA group.
• LuPARP Study:
  • No dose-limiting toxicities seen.
  • Common grade 1/2 TRAEs included xerostomia, nausea, fatigue.

Conclusion:

• The findings from these studies provide essential insights into the prognostic value of PSA levels, the impact of BRCA mutations, and the potential of novel combinations in treatment, guiding future clinical decisions in prostate cancer management.

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