Prostate cancer therapy is changing as new medications get approval.
Upfront taxane-based chemotherapy with docetaxel improved survival in patients with metastatic prostate cancer, according to phase III findings from the CHAARTED and STAMPEDE trials, but additional findings have shown strong potential with abiraterone acetate (Zytiga) as well, leading physicians to make varying therapy decisions for their patients.
In both studies, explains Edwin M. Posadas, MD, the use of first-line docetaxel in combination with hormonal treatment had a significant reduction in the risk for prostate cancer death. The field began to move quickly toward the use of docetaxel, but soon thereafter were 2 British studies—the STAMPEDE abiraterone arm and the LATITUDE study.
Both trials found that upfront use of abiraterone—an agent that was initially approved after use of docetaxel—in addition to prednisone and standard androgen-deprivation therapy (ADT), or standard initial therapy, resulted in a 38% and 37% reduction in the risk of death in LATITUDE and STAMPEDE, respectively.1,2
The only thing lacking, Posadas says, is a comparison between the studies.
“Should you give a man docetaxel or abiraterone?” he asks. “Many physicians will use their clinical judgement to make that decision. The answer probably lies in the molecular makeup of the tumor.”
As the field continues to hone in on targeted therapies in advanced prostate cancer, targeted agents like nonsteroidal antiandrogens are now being developed for patients with nonmetastatic prostate cancer, as well.
In an interview during the 2018 OncLive® State of the Science Summit™ on Genitourinary Cancers, Posadas discussed the evolution of prostate cancer therapy, including the earlier use of advanced-stage agents and the potential for immunotherapy in the field.
|Source: 2018 Ushers in New Era of Prostate Cancer Treatment|