Articles related to PROSTATE CANCER

To date, FDA has approved three next-generation AR inhibitors for nonmetastatic CRPC: apalutamide, enzalutamide, and darolutamide. All three agents improve metastasis-free survival and overall survival. Selection of treatment can be guided by factors such as the patient’s overall health and frailty, potential drug-drug interactions, and the safety profile associated with each agent. This review summarizes the data from the practice-changing SPARTAN, PROSPER, and ARAMIS trials and provides insights on implementation in practice and promotes early intervention with AR inhibitors as standard of care for patients with high-risk nonmetastatic CRPC.

RhoVac AB’s RV001 (onilcamotide) was granted Fast Track designation by FDA based on positive performance in its phase I/II trial. Unfortunately, in the follow-on Phase IIb BRaVac trial, the drug failed to demonstrate superiority over the placebo.

This editorial comments on Tilki and colleagues’ “Adjuvant Versus Early Salvage Radiation Therapy After Radical Prostatectomy for pN1 Prostate Cancer and the Risk of Death.” Those researchers found that adjuvant radiotherapy (RT) was associated with a lower all-cause mortality risk compared with early salvage RT. Yet in today’s practice environment, early salvage radiotherapy (sRT) is being broadly embraced over aRT despite a continuous lack of randomized data for certain high-risk groups. The editorialist recommends that “all patients with pN1 prostate cancer—and particularly those with increasing node positivity— should be counseled on the potential survival benefits of upfront adjuvant RT demonstrated in this study and the risk that early salvage RT may not be early enough.”

The recent 2022 ASCO GU Cancers Symposium provided important new data for the management of advanced prostate cancer. Presentations covered in this review of symposia highlights include androgen receptor (AR) inhibitors in patients with metastatic hormone-sensitive prostate cancer, combinations of PARP inhibitors with abiraterone acetate in metastatic castration-resistant prostate cancer, 177Lu-PSMA-617 in metastatic CRPC, some novel therapies, and even a look at an artificial intelligence pathology predictive biomarker.

Illucix is a preparation kit for gallium-68 PSMA-11 injection, an agent indicated for PET PSMA position tumors in patients with suspected prostate cancer metastasis who are eligible for initial definitive therapy and have suspected cancer recurrence based on elevated PSA levels.

From JAMA Network Open comes this conclusion: “In this study, the benefit associated with olaparib was reduced, eliminated, or inferior in specific subgroups of patients when treatment outcomes were compared with a more active standard of care, ie, cabazitaxel. While treatment with olaparib was associated with superior rPFS in patients with BRCA1/2 variants, those with other HRR variants may have worse outcomes with this approach, which should be reassessed by national guidelines. Numerous active studies…will add to the data regarding the role of PARP inhibitors in mCRPC.”