ASCO GU 2018: Case-Based Debate: Abiraterone Versus Docetaxel

San Francisco, CA ( As part of the ASCO GU moderated debates on controversial topics in prostate cancer, Dr. Nicholas Van As moderated a debate of abiraterone versus docetaxel for patients with metastatic hormone sensitive prostate cancer (mHSPC). Dr. Van As started with a case presentation of a 62-year-old lawyer diagnosed with metastatic prostate cancer, previously fit with a performance status (PS) of 0. His presenting symptom was back pain and he was found to have a PSA of 150 ng/mL. A prostate biopsy demonstrated Gleason 4+4 in 8 of 12 cores and his bone scan demonstrated widespread metastatic disease; however, MRI spine showed no spinal cord compression. On CT imaging there was pelvic nodal disease, but no visceral metastases. Dr. Van As then polled the audience as to whether they would treat this patient with either docetaxel or abiraterone, with 75% of respondents selecting docetaxel. 

ASCO GU 2018: Metformin and statin together may delay prostate cancer metastasis

San Francisco, CA ( Metformin and statin together may delay prostate cancer (CaP) metastasis. However, the synergistic effects on CaP mortality remain unknown. The aim of this study was to quantify individual and synergistic effects of post diagnostic statin and metformin use on CaP mortality in high risk CaP survivors.

ASCO GU 2018: Proportion of Biochemically-recurrent Prostate Cancer Patients with Durable Undetectable PSA After Short-course Androgen Deprivation Therapy

San Francisco, CA ( Optimal utilization of novel therapies for advanced prostate cancer (PC) is challenging without a validated surrogate efficacy endpoint. Ongoing trials are using durable undetectable prostate specific antigen (PSA) levels as a marker of efficacy. The proportion of patients and clinical relevance of those with a prolonged undetectable PSA after a short course of androgen deprivation therapy (ADT) is uncertain.

ASCO GU 2018: First Interim Analysis Of REASSURE, An Observational Study To Assess The Safety Of Radium-223 In Men With Metastatic Castration-resistant Prostate Cancer

San Francisco, CA ( Radium-223 is a targeted alpha emitter that has previously been demonstrated to extend survival in patients with metastatic castration-resistant prostate cancer (mCRPC). In the phase III ALSYMPCA study, in the final updated analysis of 921 patients, Ra-223 provided an overall survival benefit (median, 14.9 months vs. 11.3 months; hazard ratio, 0.70; 95% CI, 0.58 to 0.83; P<0.001). Assessments of all main secondary efficacy end points also showed a benefit of Ra-223 compared with placebo, and its safety profile was favorable at 3 years’ follow-up.1

ASCO GU 2018: Abiraterone Acetate in Patients Aged 75 or More with mCRPC in Both Pre-chemotherapy or Post-chemotherapy Settings

San Francisco, CA ( Prostate cancer (PC) affects a significant proportion of elderly patients, harboring a substantial burden of additional comorbidities. Abiraterone acetate (AA) is a selective androgen synthesis inhibitor that showed efficacy in both chemotherapy (CT) naive pts and those pretreated with docetaxel. The overall good tolerability of this treatment make it an attractive choice for elderly metastatic castrate resistant prostate cancer (Mcrpc) patients. The authors assessed and reported the utilization of this treatment among elderly PC patients, older than 75.

ASCO GU 2018: Immunotherapy for Biochemically Recurrent Prostate Cancer

San Francisco, CA ( Annually about 30-50,000 men are diagnosed with biochemically recurrent prostate cancer (BCRpc), defined by a rising PSA after radical prostatectomy (RP) or definitive radiation therapy (RT) with negative conventional imaging (CT and bone scan). Standard available treatments include salvage therapies, androgen deprivation or surveillance. The role of immunotherapy in this setting is undefined.

ASCO GU 2018: Cabozantinib for metastatic castration-resistant prostate cancer (mCRPC) following docetaxel: Combined analysis of two phase III trials.

San Francisco, CA ( Two phase III trials, COMET-1 and COMET-2, have reported that cabozantinib had not extended overall survival (OS) outcomes when compared to prednisone and prednisone plus mitoxantrone respectively, in unselected post-docetaxel patients with metastatic castrate resistant prostate cancer (mCRPC).

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