From the Editor

From the Desk of the Editor: Non-Metastatic Metastases and Other Confusing Findings from the PROSPER and SPARTAN Trials

Daniel George
July 24, 2018

Last month we saw the final published data from the PROSPER study1, and coupled with the earlier published SPARTAN study2, we now have two complete and large phase III studies detailing the clinical activity of androgen-receptor inhibitors, enzalutamide and apalutamide in so-called “non-metastatic” castrate-resistant prostate cancer (nmCRPC) patients. I am impressed with the results of these two studies; both demonstrated a robust clinical effect in delaying or preventing the development of metastases in this patient population that I believe is clinically beneficial in patients who are likely to live long enough to die from metastatic prostate cancer.  While I appreciate the FDA approval of these agents to treat this patient population, I don’t like this term non-metastatic CRPC.


Daniel George

Daniel George, MD

Daniel George is Professor of Medicine and Surgery, Divisions of Medical Oncology and Urology in the Duke University School of Medicine. He also has appointments in the Duke Clinical Research Institute and the Duke Cancer Institute where he is the Director of Genitourinary (GU) Oncology. He is an internationally recognized clinical researcher and thought leader in GU malignancies, with over 150 peer-reviewed publications. His areas of research include new drug development and biomarkers of GU cancers with an emphasis on signal transduction pathways and angiogenesis. Daniel George has led the Duke site for the Department of Defense (DOD) Prostate Cancer Clinical Trials Consortium since 2006, specializing in Phase I and II studies in prostate cancer. He is also the PI of the MaRCC registry in advanced renal cell carcinoma and Co-PI of IRONMAN, an international, multi-sponsor supported registry in advanced prostate cancer. Daniel George serves on the ASCO scientific committee for non-prostate cancer, the Alliance GU scientific committee, NCI GU Steering Committee and the NCI Renal Task Force. He will lead the newly launches Duke Prostate and Urologic Cancer Center.

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