Pobel Translates PEACE-1 Trial Results Into Clinical Practice for mCSPC
Cedric Pobel, MD, discusses how the results of the PEACE-1 trial support the use of radiotherapy plus standard of care and abiraterone in low-volume metastatic castration-sensitive prostate cancer.
Cedric Pobel, MD, medical oncologist, PhD student, Institut de Cancérologie, Gustave Roussy, Paris, France, discusses how the results of the PEACE-1 trial (NCT01957436) support the use of radiotherapy plus standard of care (SOC) and abiraterone for the treatment of patients with low-volume metastatic castration-sensitive prostate cancer (mCSPC).
The open-label, randomized, controlled, phase 3 PEACE-1 study was conducted across 77 hospitals in Europe and used a 2 × 2 factorial design. A total of 1173 male patients with de novo mCSPC were enrolled and randomly assigned to 1 of 4 treatment arms: SOC alone, SOC plus abiraterone, SOC plus radiotherapy, or SOC plus both radiotherapy and abiraterone.
The main findings from the trial revealed that in the SOC plus abiraterone and radiotherapy arm, there was a median rPFS of 7.5 years vs 4.4 years in the SOC and abiraterone alone arm (adjusted hazard ratio [HR] 0.65; P =.019). Radiotherapy did not lead to a significant benefit for rPFS in patients not receiving abiraterone.
Looking at overall survival (OS), there was no statistically significant improvement observed across the study population when radiotherapy was added. The median OS was similar between the SOC and SOC plus radiotherapy groups, with no substantial difference between patients who had low-volume metastatic disease (median OS 6.9 years vs 7.5 years, respectively; HR 0.98; P =.86).
“These findings do change the standard of care in clinical practice. For all patients meeting the criteria, they should now receive the triplet therapy, which includes the addition of abiraterone to castration and docetaxel,” explains Pobel.
He then provided some insight on what future studies are needed to build on these findings from PEACE-1.
