Prostate Cancer

Three presentations during the 2018 American Urological Association Annual Meeting in San Francisco, California, together demonstrated the potential and utility of different assays to identify prostate cancer and guide treatment decisions for patients with prostate cancer. Each assay suggested a simpler and more cost-effective tool for guiding decision making in prostate cancer than immediate tissue biopsy.

Nicholas J. Vogelzang, MD, a medical oncologist at the Comprehensive Cancer Centers of Nevada, discusses the rationale behind conducting the PROSPECT trial in patients with relapsed prostate cancer. Patients enrolled in this study had prostate cancer return after hormonal ablation.

Maha H. Hussain, MB, ChB, professor of medicine and deputy director at Robert H. Lurie Comprehensive Cancer Center, discusses the current role of PARP inhibitors in clinical trials for treatment of patients with prostate cancer.

Duke researchers discussed findings from 2 studies at the 2018 ASCO Annual Meeting, which revealed chemotherapy and hormone-targeting treatment may be more beneficial to black men with metastatic castration-resistant prostate cancer compared with their white counterparts.

A new formulation of abiraterone acetate in combination with methylprednisolone has been approved by the FDA as a treatment for men with metastatic castration-resistant prostate cancer, according to Sun Pharma, the company commercializing the treatment.

According to results from the Annual Report to the Nation on the Status of Cancer, cancer incidence rates have declined in men while remaining stable in women. Additionally, there have been significant declines in cancer death rates, but differences between race and ethnic groups remain. 

According to results from a posthoc analysis of the phase III SPARTAN trial, apalutamide (Erleada) lowered the risk of PSA progression by 94% in patients with nonmetastatic castration-resistant prostate cancer.

Risk stratification to guide molecular testing and treatment is emphasized in the latest prostate cancer guidelines from the NCCN. Recommendations for germline testing, molecular testing, and initial therapy have been developed for each risk category, each of which has its own management page in the newest version of the NCCN guidelines.

Findings from the CHAARTED, LATITUDE, and STAMPEDE trials showed various results for adding docetaxel or abiraterone acetate to androgen deprivation therapy in prostate cancer, and this kicked off a challenging issue for clinicians: Is it better to add docetaxel, abiraterone acetate, both, or neither to their patient’s treatment plan?

Patients with prostate cancer and DNA damage repair defects could be candidates for therapy involving poly polymerase inhibitors, and there is strong justification for activating clinical trials in this space, according to Maha Hussain, MD, the Genevieve Teuton Professor of Medicine and deputy director of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University.

Updated results from the phase II LuPSMA study published in<em> The Lancet Oncology </em>showed radionuclide treatment with&nbsp;Lutetium-177 [¹⁷⁷Lu]-PSMA-617 nearly doubled median PSA progression-free survival in men with progressive metastatic castrate-resistant prostate cancer compared with previous results with another radiopharmaceutical, radium-223.

Molecular tumor profiling is rapidly driving personalized medicine within oncology. The value of identifying a targetable mutation using next-generation sequencing for available therapies or clinical trials cannot be underestimated.&nbsp;Herein, we review essential considerations in the initial assessment, specialty referral, and sequencing of treatment for advanced prostate cancer with an identified actionable mutation.

Reviewers Commentary: This article&nbsp;adds to the growing body of literature on the role of PARP inhibitors in tumors with DNA repair defects.

Several new indications were approved by the FDA in March, including blinatumomab (Blincyto)&nbsp;for MRD+ ALL, brentuximab vedotin (Adcetris) for Hodgkin lymphoma, and a 4-week nivolumab (Opdivo) dosing schedule across several indications. Here&rsquo;s a look back on the FDA happenings for the month of March 2018.

Prostate Cancer

Based on data from the phase III PROSPER trial, a supplemental new drug application for enzalutamide for the treatment of men with nonmetastatic castration-resistant prostate cancer has been granted a priority review by the FDA,&nbsp;according to Pfizer and Astellas, the companies developing the antiandrogen agent.