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HIGHLIGHTS FROM THE 2023 EUROPEAN SOCIETY FOR MEDICAL ONCOLOGY ANNUAL MEETING
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Mini Oral Session - Prostate
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| MAGNITUDE Three-Year Update and Final Analysis: Niraparib with Abiraterone Acetate plus Prednisone as First-Line Therapy in Patients with Metastatic Castration-Resistant Prostate Cancer and Homologous Recombination Repair Gene Alteration
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| Kim Chi, MD, FRCP
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| The final analysis of the MAGNITUDE trial evaluated the use of niraparib in combination with abiraterone acetate and prednisone as first-line therapy in patients with mCRPC who had homologous recombination repair gene alterations, with a particular focus on patients with BRCA1/2 alterations. The study found that the combination of niraparib with abiraterone acetate and prednisone significantly improved overall survival in BRCA+ mCRPC patients.
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| ProBio, a Randomized, Outcome-Adaptive, Biomarker-Driven Platform Trial: AR Pathway Inhibitors or Taxanes for Patients with Metastatic Castration-Resistant Prostate Cancer: A Direct Comparison
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| Henrik Grönberg, MD
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| ProBio is an outcome-adaptive, biomarker-driven trial that aims to compare androgen receptor pathway inhibitors with taxanes for patients with mCRPC. Patients were randomized based on genomic alterations in circulating tumor DNA in five different biomarker signatures, and the trial found that AR pathway inhibitors are favored over taxanes in patients with detectable ctDNA, particularly those with AR wild type and TP53 wild type, and TMPRSS2-ERG fusion-positive disease.
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| KEYNOTE-641 Phase 3: Pembrolizumab plus Enzalutamide for Patients with Metastatic Castration-Resistant Prostate Cancer
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| Julie N. Graff, MD
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| Julie Graff presents the results of the phase 3 KEYNOTE-641 trial, which assessed the combination of pembrolizumab and enzalutamide for patients with metastatic castration-resistant prostate cancer (mCRPC). The study aimed to evaluate the efficacy of pembrolizumab in combination with enzalutamide compared to enzalutamide alone in patients with chemotherapy-naïve mCRPC, with or without prior abiraterone therapy.
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| KEYNOTE-991 Pembrolizumab plus Enzalutamide and Androgen Deprivation Therapy or Patients with Metastatic Hormone-Sensitive Prostate Cancer
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| Christian J. Gratzke, MD
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| Christian Gratzke presents the phase 3 KEYNOTE-991 trial that assessed the combination of pembrolizumab with enzalutamide and androgen deprivation therapy in patients with metastatic hormone-sensitive prostate cancer who were naïve to next-generation hormonal agents. The study aimed to evaluate radiographic progression-free survival and overall survival as primary endpoints.
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| Invited Discussant: KEYNOTE-641, KEYNOTE-991, MAGNITUDE & ProBio
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| Himisha Beltran, MD
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| Himisha Beltran presents a discussion on four abstracts related to prostate cancer. She highlights the challenges and nuances in prostate cancer immunotherapy, emphasizing the need for better biomarkers and ongoing research in combination therapies and novel immune targets. Dr. Beltran also discusses the results of various trials, including those involving pembrolizumab and enzalutamide, as well as the MAGNITUDE trial involving niraparib and abiraterone.
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| EMBARK: Health-Related Quality of Life in nmHSPC Patients with High-Risk BCR
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| Stephen Freedland, MD
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| Stephen Freedland presents findings from the EMBARK study, focusing on health-related quality of life in nonmetastatic HSPC patients with high-risk biochemical recurrence. The EMBARK study evaluated enzalutamide treatments in these patients. The primary objective was to assess treatment effects on time to first deterioration and clinically meaningful deterioration in patient-reported outcomes, including quality of life measures.
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| Healthcare Data from the STAMPEDE Docetaxel and Zoledronic Acid Comparisons: Incidence of Fracture Related Hospitalisations in Men with De Novo High Risk and Metastatic Hormone Sensitive Prostate Cancer
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| Craig Jones, MD
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| Craig Jones presents a study focusing on the incidence of fracture-related hospitalizations in men with de novo high-risk localized and metastatic hormone-sensitive prostate cancer. The research analyzed healthcare data from the STAMPEDE trial to evaluate fracture risk in patients receiving androgen deprivation therapy alone or in combination with zoledronic acid and docetaxel.
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| External Validation of a Digital Pathology-Based Multimodal Artificial Intelligence (MMAI)-Derived Model in High-Risk M0/M1 Prostate Cancer Starting ADT in the Docetaxel or Abiraterone Phase 3 STAMPEDE Trials
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| Charles Parker, Ph.D.
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| Charles Parker presents findings regarding the external validation of a digital pathology-based multimodal artificial intelligence (AI) model for high-risk M0/M1 prostate cancer patients starting Androgen Deprivation Therapy (ADT) in the STAMPEDE trials. The AI model, known as ArteraAI, uses various parameters, including pathology data from prostate biopsies, Gleason scores, tumor stage, age, and pre-ADT PSA levels to make prognostic predictions.
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| Invited Discussant: More Than Therapy Alone
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| Boris Hadaschik, MD
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| Boris Hadaschik presents a discussant presentation on several key abstracts in the field of prostate cancer. He highlights the importance of advanced diagnostic methods, such as PSMA PET/CT, in patient management and emphasizes the need for personalized treatment approaches. Dr. Hadaschik also discusses the results of the EMBARK trial, which showed that enzalutamide in combination with ADT improved metastasis-free survival in patients with nonmetastatic hormone-sensitive prostate cancer.
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| Health-Related Quality of Life Deterioration-Free Survival by PSA Decline in Darolutamide-Treated Patients with Nonmetastatic Castration-Resistant Prostate Cancer from ARAMIS
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| Alicia Morgans, MD, MPH
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| A recent ad-hoc analysis presented by Alicia Morgans focused on darolutamide-treated patients with nonmetastatic castration-resistant prostate cancer (nmCRPC). The analysis assessed the impact of darolutamide on health-related quality of life (HRQoL) deterioration-free survival by prostate-specific antigen (PSA) decline.
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| PSA Outcomes with Darolutamide, ADT, and Docetaxel in Patients with High- and Low-Volume Metastatic Hormone-Sensitive Prostate Cancer in ARASENS
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| Fred Saad, MD, FRCS
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| Fred Saad presents the results of a secondary analysis of the ARASENS trial, focusing on prostate-specific antigen outcomes with darolutamide, docetaxel, and androgen deprivation therapy in patients with high- and low-volume metastatic hormone-sensitive prostate cancer.
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| Low- and High-Volume Disease in Metastatic Hormone Sensitive Prostate Cancer (mHSPC): From CHAARTED to PSMA PET
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| Lena Unterrainer, MD
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| Lena Unterrainer presents a study evaluating the impact of PSMA PET scans on the classification of patients with metastatic hormone-sensitive prostate cancer as low or high volume, using the CHAARTED criteria. The CHAARTED criteria define disease volume based on conventional imaging, which is used to guide treatment decisions and is associated with survival outcomes in mHSPC patients.
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| Utilization Rates of Treatment Intensification for Metastatic Hormone Sensitive Prostate Cancer (mHSPC) in England, UK
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| Joanna Dodkins, MBChB, MRCP |
| Joanna Dodkins presents an analysis that examined the utilization rates of treatment intensification for patients with metastatic hormone-sensitive prostate cancer (mHSPC) in England. The study found that, between 2018 and 2021, 39% of men diagnosed with mHSPC received treatment intensification, with docetaxel being the most commonly used agent.
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| Effects of Enzalutamide on Overall Survival +/- Early Docetaxel in Participants Aged Less than 70 Yrs vs Greater than or Equal to 70 Yrs in ENZAMET (ANZUP 1304)
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| Lisa Horvath, MBBS, FRACP, Ph.D.
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| A secondary analysis of the ENZAMET (ANZUP 1304) study was presented by Lisa Horvath. This analysis evaluated the effects of enzalutamide with or without early docetaxel on overall survival (OS) in participants aged under 70 years versus those aged 70 years and above. The study found that the benefits of enzalutamide on OS observed in the overall cohort were maintained in patients aged 70 years and older, regardless of the planned use of early docetaxel.
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| Efficacy of Olaparib + Abiraterone vs Placebo + Abiraterone in the Non-BRCA Mutation Subgroup of Patients with mCRPC in the PROpel Trial
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| Niven Mehra, MD, Ph.D.
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| Niven Mehra presents findings on the efficacy of olaparib in combination with abiraterone compared to placebo with abiraterone in patients with mCRPC, specifically focusing on the non-BRCA mutation subgroup. While the primary endpoint of radiographic progression-free survival was met with a significant benefit in the overall population, the analysis in the non-BRCA mutation subgroup revealed that olaparib with abiraterone showed a clinically meaningful benefit for rPFS but not for overall survival. |
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