GU ASCO Symposium 2022 Summary
Ulka Vaishampayan, MD, Professor of Medicine and Genitourinary (GU) Oncology at the University of Michigan’s Rogel Cancer Center in Ann Arbor, Michigan, discusses highlights from the 2022 GU ASCO Symposium, focusing on advanced prostate cancer treatment research. She begins by discussing the phase 3 ARASENS trial, which looked at overall survival with darolutamide versus placebo in combination with androgen deprivation therapy (ADT) and docetaxel for metastatic hormone-sensitive prostate cancer (mHSPC). Dr. Vaishampayan explains that the investigators found that darolutamide significantly reduced the risk of death by 32.5%, and that this means that an overall survival benefit has now been seen with treatment intensification in 2 separate trials: PEACE-1 (docetaxel plus abiraterone) and ARASENS (docetaxel plus darolutamide). She argues that these results indicate that a triplet regimen with ADT, docetaxel, and darolutamide is the new standard of care in men with mHSPC. Dr. Vaishampayan then moves on to discuss the phase 3 PROpel trial of olaparib and abiraterone versus placebo and abiraterone as first-line therapy for patients with metastatic castration-resistant prostate cancer (mCRPC). She notes that PROpel found 34% risk reduction of progression or death with olaparib plus abiraterone, and that while overall survival data is fairly immature, the trend seems to favor olaparib plus abiraterone over placebo plus abiraterone. She also highlights that the safety profile of olaparib plus abiraterone was consistent with the safety profile for the individual drugs and there was no detriment to quality of life. Finally, Dr. Vaishampayan considers first results from the phase 3 MAGNITUDE study of niraparib with abiraterone acetate and prednisone as first-line therapy in patients with mCRPC with and without homologous recombination repair (HRR) gene alterations. She explains that MAGNITUDE showed a benefit to niraparib in the HRR arm, but no benefit in the non-HRR arm. Dr. Vaishampayan concludes that MAGNITUDE demonstrates the importance of testing for HRR gene alterations in patients with mCRPC to identify who will optimally benefit from the combination of niraparib and prednisone and also supports niraparib plus prednisone as a new first-line treatment option for patients with mCRPC and alterations in genes associated with HRR.
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