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Prostate Cancer

The addition of the PARP inhibitor niraparib (Zejula) to abiraterone acetate (Zytiga) plus prednisone (AAP) led to a significant improvement in radiographic progression-free survival (PFS) versus AAP alone in men with metastatic castration-resistant prostate cancer (mCRPC) harboring homologous recombination repair (HRR) gene alterations, according to the final analysis of the primary end point of a phase 3 trial.
Treatment with the androgen receptor inhibitor darolutamide (Nubeqa), in combination with androgen-deprivation therapy (ADT) and docetaxel, significantly improved overall survival (OS) compared with ADT and docetaxel alone in patients with metastatic hormone-sensitive prostate cancer (mHSPC), according to recent results from the phase 3 ARASENS clinical trial, which were simultaneously published in the New England Journal of Medicine.
The use of a polygenic score (PGS) based on noncancer genetic variations in prostate-specific antigen (PSA) values helped to refine PSA screening in a large group of men without prostate cancer at baseline.
Two years of abiraterone acetate (Zytiga) plus prednisone added to androgen-deprivation therapy (ADT) improved metastasis-free survival and overall survival compared with ADT alone in men with nonmetastatic castration-sensitive prostate cancer, whereas the addition of enzalutamide (Xtandi) to ADT had no benefit, and much greater toxicity.
Preliminary results from the first prospective study of a genomic classifier for African-American men suggest that both disparities in access to care and biological factors may be responsible for the increased incidence and mortality in this patient population.
The addition of 177Lu-PSMA-­­ 617, a radionuclide therapy that targets prostate-specific membrane antigen (PSMA), to standard-of-care treatment resulted in a 38% reduction in the risk for death versus standard of care alone in men with progressive PSMA-­positive metastatic castration-­resistant prostate cancer (mCRPC), according to findings from the phase 3 VISION clinical trial, which were presented during a plenary session at the American Society of Clinical Oncology (ASCO) 2021 virtual annual meeting.
Oral relugolix given daily is superior to standard androgen-deprivation therapy (ADT) with leuprolide in men with advanced prostate cancer, according to the results of the phase 3 HERO study. In June, the FDA granted a priority review for relugolix, an oral gonadotropin-releasing hormone (GnRH) antagonist, for the treatment of advanced prostate cancer.
No improvement in survival or in any key secondary end point was observed when the checkpoint inhibitor atezolizumab (Tecentriq) was added to enzalutamide (Xtandi) for the treatment of metastatic castration-resistant prostate cancer (CRPC) in the phase 3 IMbassador250 trial.
San Francisco, CA—Today, patients who receive stereotactic body radiation therapy (SBRT) for intermediate- or high-risk localized prostate cancer are not receiving concurrent androgen-deprivation therapy (ADT), despite national guideline recommendations that support the concurrent use of ADT with radiation therapy.
On May 19, 2020, the FDA approved a new indication for olaparib (Lynparza; AstraZeneca), a PARP inhibitor, for the treatment of men with metastatic castration-resistant prostate cancer and deleterious or suspected deleterious germline or somatic HRR mutation, as determined by an FDA-approved test, whose disease progressed after enzalutamide (Xtandi) or abiraterone acetate (Zytiga) therapy. Olaparib is the first FDA-approved PARP inhibitor for prostate cancer.
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