Axel Merseburger, MD, PhD, looked back on 2022 ASCO GU and the new data presented for the treatment of prostate cancer.
In an interview with CancerNetwork® during the 2022 Genitourinary Cancers Symposium, Axel Merseburger, MD, PhD, chairman of the Clinic of Urology at University Hospital Schleswig-Holstein in Lübeck, Germany, discussed presentations results that have the ability to impact treatment, and why how clinicians should being to transition can consider these data in their treatment planings.
I’m also interested in the presentation of the ARASENS trial [NCT02799602], which is just now simultaneously published in the New England Journal of Medicine, a large phase 3 trial looking at the combination of docetaxel and darolutamide [Nubeqa] compared with docetaxel and ADT [androgen deprivation therapy].1,2 This trial was positive with regards to overall survival and PFS [progression-free survival] and some secondary endpoints with therapy intensification in mHSPC, or metastatic hormone-sensitive prostate cancer, which makes sense. What we don’t know 100% yet, is the of about a missing third arm in this trial with the combination of darolutamide and ADT, and how these that would have competed against the triplet combination. When comparing with historic data from STAMPEDE [NCT00268476] and , SUMMITENZAMET [NCT02446405NCT03934866] trials from the took trial, they’re comparable results achieved with ADT and docetaxel compared with the doublet.
We’ve now seen a triplet is better than a doublet of docetaxel, but it’s hard to say if we can translate this and it’s always not advised to do so in the trial to trial comparisons. We need more data.
We have had a very good ASCO[annual meeting], especially with regards to the topic of prostate cancer, with very interesting discussions. It all goes into therapy intensification, maybe even treatment beyond progression, on a site that I think it It is important to communicate that what we discuss here is not general practice. Unfortunately, many men just receive ADT. My big take home message for my colleagues and my team is please don’t use just ADT, not in mHSPC and surely not in mCRPC [metastatic castration-resistant prostate cancer]. You may need to combine the treatment in order to achieve the an overall survival benefit. We’ve just learned what we can achieve when a triplet or doublet treatment is performed in those men with advanced disease.
1. Smith MR, Hussain MHA, Saad F, et al. Overall survival with darolutamide versus placebo in combination with androgen-deprivation therapy and docetaxel for metastatic hormone-sensitive prostate cancer in the phase 3 ARASENS trial. J Clin Oncol. 2022;40(suppl 6):abstr 13. doi: 10.1200/JCO.2022.40.6_suppl.013
2. Smith MR, Hussain M, Saad F, et al. Darolutamide and survival in metastatic, hormone-sensitive prostate cancer. Published Online February 17, 2022. N Engl J Med. 2022. doi:10.1056/NEJMoa2119115