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HIGHLIGHTS FROM THE 2024 AMERICAN SOCIETY OF CLINICAL ONCOLOGY ANNUAL MEETING
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| CYCLONE 2: A Phase 3 Study of Abemaciclib with Abiraterone in Patients with mCRPC
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| Matthew Smith, MD, Ph.D.
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| Matthew Smith presented results from the CYCLONE 2 trial, which evaluated abemaciclib plus abiraterone versus abiraterone alone in patients with mCRPC. The study found no significant improvement in radiographic progression-free survival with the addition of abemaciclib, although it did show consistent safety profiles for the treatments.
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| The MAST (Metformin Active Surveillance Trial) Study: A Randomized, Double-blind, Placebo-controlled Trial of Metformin for Reducing Progression Among Men on Expectant Management for Low-risk Prostate Cancer
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| Anthony Joshua, MBBS (Hons), PhD, BSc (Med) (Hons), FRACP
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| Anthony Joshua presented results from the MAST study, a randomized, double-blind, placebo-controlled trial assessing metformin's impact on disease progression in men with low-risk prostate cancer under active surveillance. The study found no significant difference in progression-free survival between the metformin and placebo groups, though there was a potential detriment for patients with high BMI.
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| Cabazitaxel with Abiraterone versus Abiraterone Alone - Randomized Trial for Extensive Disease Following Docetaxel: The CHAARTED2 Trial of the ECOG-ACRIN Cancer Research Group (EA8153)
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| Christos Kyriakopoulos, MD
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| Christos Kyriakopoulos presents the results from the CHAARTED2 trial, which investigated cabazitaxel combined with abiraterone versus abiraterone alone in patients with extensive mCRPC previously treated with docetaxel. The trial demonstrated that the combination significantly improved progression-free survival and delayed PSA progression compared to abiraterone alone, although no overall survival benefit was observed.
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| Discussion: Something Old, Something New, Something Borrowed |
| Shahneen Sandhu, MBBS, FRACP |
| Shahneen Sandhu reviewed three prostate cancer studies. The CHAARTED2 trial showed that cabazitaxel with abiraterone improved progression-free survival in mCRPC but did not extend overall survival. The CYCLONE 2 trial found no significant benefit from adding abemaciclib to abiraterone, and the MAST trial indicated that metformin did not reduce progression in low-risk prostate cancer on active surveillance, with worse outcomes observed in patients with higher BMI. |
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| PSMAfore: HRQoL and Pain in a Phase 3 Study of 177Lu-PSMA-617 in Taxane-Naïve Patients with mCRPC |
| Karim Fizazi, MD, Ph.D. |
| Karim Fizazi presented the PSMAfore trial's interim results, highlighting the benefits of 177Lu-PSMA-617 in taxane-naïve mCRPC patients. The treatment delayed radiographic progression, improved health-related quality of life, and reduced pain compared to an androgen receptor pathway inhibitor change. |
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| MANCAN2: A Multicenter Randomized Controlled Trial of Self-Help Cognitive Behavioral Therapy to Manage Hot Flush and Night Sweat Symptoms in Patients with Prostate Cancer Receiving ADT |
| Simon Crabb, MD |
| Simon Crabb presents the MANCAN2 trial results, which investigated self-help cognitive behavioral therapy (CBT) for managing hot flushes and night sweats in prostate cancer patients on androgen deprivation therapy. The study found that CBT significantly reduced hot flushes, night sweats, anxiety, and depression at 6 weeks, though these benefits did not persist at 6 months. |
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| EMBARK Post Hoc Analysis of Impact of Treatment Suspension on HRQoL |
| Stephen J. Freedland, MD |
| Stephen Freedland presented a post hoc analysis of EMBARK, examining the impact of treatment suspension on health-related quality of life (HRQoL) in high-risk prostate cancer patients. The analysis revealed that after treatment suspension, hormonal treatment-related symptoms quickly improved in all arms but began to worsen after week 97. |
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| HRQoL Results from PRESTO (AFT-19), a Phase 3 Randomized Trial of Intensification of Androgen Blockade in Patients with High-Risk Biochemically Relapsed Castration Sensitive Prostate Cancer |
| Ronald Chen, MD, MPH |
| Ronald Chen presented health-related quality of life results from the PRESTO trial, focusing on patients with high-risk biochemically relapsed castration-sensitive prostate cancer. The trial compared intensified androgen blockade (ADT plus apalutamide, or ADT plus apalutamide and abiraterone acetate plus prednisone) to ADT alone. |
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| Living Your Best Life on Treatment |
| Channing Paller, MD |
| Channing Paller discussed four abstracts on prostate cancer treatment and quality of life at ASCO 2024. In "MANCAN2," cognitive behavioral therapy (CBT) reduced hot flashes and night sweats at 6 weeks, but benefits were not sustained at 6 months. The EMBARK trial showed enzalutamide's feasibility without major impacts on quality of life but highlighted distinct side effects. |
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| A Clinical-Genetic ctDNA-Based Prognostic Model for Predicting OS in Men with mCRPC Treated with Potent Androgen Receptor Inhibition (Alliance) |
| Susan Halabi, Ph.D. |
| Susan Halabi presents a clinical-genetic circulating tumor DNA (ctDNA)-based prognostic model for predicting overall survival in men with metastatic castrate-resistant prostate cancer treated with potent androgen receptor inhibition. The model incorporated clinical variables and selected genetic factors, including ctDNA pathogenic genetic alterations. |
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| Baseline ctDNA Analyses and Associations with Outcomes in Taxane-Naive Patients with mCRPC Treated with 177Lu-PSMA-617 Versus Change of ARPI in PSMAfore |
| Johann De Bono, MD, MSc, Ph.D., FRCP, FMedSci |
| Johann De Bono presented findings on baseline ctDNA analyses and their associations with outcomes in taxane-naive patients with metastatic castration-resistant prostate cancer treated with 177Lu-PSMA-617 versus a change of androgen receptor pathway inhibition in PSMAfore. The analysis included assessments of radiographic progression-free survival, PSA response, and RECIST response based on ctDNA fraction and genetic alterations. |
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| Discussion: Prognosis is in the Blood |
| Gerhardt Attard, MD, Ph.D. |
| Gerhardt Attard discussed the clinical significance of ctDNA in prostate cancer, highlighting its potential for prognostication, treatment prediction, and response assessment. He reviewed studies by Dr. Susan Halabi and Dr. Johann De Bono, which identified ctDNA genetic factors predictive of overall survival in mCRPC patients treated with potent androgen receptor inhibition or 177Lu-PSMA-617, respectively, emphasizing the need for external validation and prospective trials to incorporate ctDNA biomarkers into clinical practice. |
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