Current Therapies & Ongoing Research in the Prostate Cancer Space

Chad Tang, MD, The University of Texas MD Anderson Cancer Center, discusses currently available treatment options and recent research in the prostate cancer space.

Over the last decade, advancements have revolutionized the field of prostate cancer. Some of these advances include the development of new agents and technologies which have transformed the screening and treatment of patients with prostate cancer.

Tang highlights some of the current therapies, including apalutamide (Erleada), enzalutamide (Xtand), and darolutamide (Nubeqa), that are used for patients with prostate cancer, as well as the growing trend of radiation therapy. Then, he delves into new research in the space, including 2 phase 2, randomized trials titled STOMP (NCT01558427) and ORIOLE (NCT02680587). Both of these studies are being evaluated in the oligometastatic prostate cancer space.

Transcription:

0:08 | For metastatic castrate sensitive prostate cancer, for systemic therapy in the [United States] the most common regime is some sort of continuous hormone regime. Most likely, this is regeneration anti-androgens, such as apalutamide, enzalutamide, darolutamide, or abiraterone acetate [Zytiga] as a cemetery backbone. As a growing indication of its use, if you have many metastatic sites, radiation could also be an option to control those sites as well. For oligometastatic prostate cancer, there is a growing trend to do radiation therapy, in addition to potentially systemic therapy.

0:57 | There have been 2 randomized trials for oligometastatic prostate cancer, called STOMP and ORIOLE. They randomized patients to radiation in metastatic patients vs observation. What they showed was that radiation delayed the PSA progression that inevitably occurs in these patients when they were just observed. We know the radiation does, by itself, delay the progression.

1:32 | We also know from other trials that radiation therapy can combine synergistically with hormone therapy and from earlier trials, that upfront hormonal therapy for metastatic disease can result in [overall survival] benefit vs delaying hormone therapy.