David S. Morris, MD, FACS, presented “Advanced Prostate Cancer Clinical Trials Updates” during the 32nd Annual International Prostate Cancer Update (IPCU32) conference on March 8, 2022, in Snowbird, Utah.

How to cite: Morris, David S. “Advanced Prostate Cancer Clinical Trials Updates” March 8, 2022. Accessed Dec 2022. https://grandroundsinurology.com/advanced-prostate-cancer-updates/

Advanced Prostate Cancer Clinical Trials Updates – Summary

David S. Morris, MD, FACS, of Urology Associates, PC in Nashville, Tennessee discusses advanced prostate cancer updates, including those shared recently at medical conferences including the European Society for Medical Oncology (ESMO) and the American Society of Clinical Oncology’s Genitourinary Cancers Symposium (ASCO GU) as well as several studies, namely the STAMPEDE trial, PEACE-1, ARASENS, ENZAMET, PROpel, and MAGNITUDE. Dr. Morris reviews U.S. Food and Drug Administration (FDA) approvals for prostate cancer treatments over recent decades and discusses the STAMPEDE trial in relation to patients with non-metastatic, castration-sensitive prostate cancer (nmCSPC), displaying data that show the addition of abiraterone acetate plus prednisolone (AAP) with or without enzalutamide (ENZ), to androgen deprivation therapy (ADT) increased metastasis-free survival (MFS) as well as overall survival (OS). He points out that this should be considered a new standard of care for men with this particular disease and risk profile. Dr. Morris then moves to a patient profile with metastatic castration-sensitive prostate cancer (mCSPC) and poses the question as to whether triplet therapy is beneficial for these patients. He cites and reviews data from the PEACE-1 and ARASENS trials. He then displays a chart illustrating the median OS for various therapies for mCSPC, including ADT, ADT+docetaxel, ADT+abiraterone, ADT+docetaxel+abiraterone, ADT+docetaxel+darolutamide, and ADT+docetaxel+enzalutamide, with ADT+docetaxel+darolutamide resulting in the longest median OS at 63 months. Dr. Morris then compares PEACE-1, ARASENS, and ENZAMET data and points out that the addition of an androgen receptor (AR) agent does not add significant toxicity to docetaxel. He addresses two additional trialsPROpel and MAGNITUDE. Dr. Morris unpacks the takeaways, explaining that doctors should consider adding abiraterone to ADT for high-risk, non-metastatic disease; consider adding abiraterone or darolutamide for patients with mCSPC whose therapy will include using docetaxel; and consider adding poly-ADP-ribose polymerase inhibitors (PARPi) to abiraterone in patients with first-line mCRPC. 

About the 32nd Annual International Prostate Cancer Update (IPCU32):
Presented by Program Chair E. David Crawford, MD,  The International Prostate Cancer Update (IPCU), is a multi-day, CME-accredited conference focused on new developments in prostate cancer treatment, diagnosis, and prevention. IPCU 32 featured lectures, interactive discussions, panel roundtables, debates, and case reports. This conference was led by expert physicians and is designed for urologists, medical oncologists, radiation oncologists, and other healthcare professionals involved in the diagnosis and treatment of prostate cancer.