Dr. Quinn on Novel Hormonal Therapies in Prostate Cancer

David I. Quinn, MD, MBBS, PhD, FRACP, FACP
Published: Thursday, Jun 20, 2019



David I. Quinn, MD, MBBS, PhD, FRACP, FACP, associate professor of medicine, section head, Genitourinary Oncology, Division of Cancer Medicine and Blood Diseases, Department of Medicine, Keck School of Medicine, discusses the rise of novel hormonal therapies in prostate cancer.

Many of the novel hormonal therapies in prostate cancer are being moved earlier into treatment with a notable improvement in survival, says Quinn. For example, there has been a lot of interest in bringing the agents that were previously FDA approved in castration-resistant prostate cancer (CRPC) to patients with hormone-sensitive disease. In the phase III LATITUDE study, abiraterone acetate (Zytiga) showed an improvement in survival that rivaled giving docetaxel to patients with high-risk hormone-sensitive disease. As such, that became a new option for those patients, says Quinn.

In the phase III STAMPEDE study, abiraterone was tested in a broader group of patients and also showed a benefit, particularly in high-risk patients. Despite the benefit that was observed across the entire study population, the risk-benefit ratio was not as impressive in low-risk patients, adds Quinn. Because these patients have an excess risk of complications—particularly cardiovascular, from being on abiraterone—clinicians should be cautious about prescribing abiraterone to patients with low-risk disease. Notably, abiraterone is going to become generic in the United States, which may increase patient access, he concludes.
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David I. Quinn, MD, MBBS, PhD, FRACP, FACP, associate professor of medicine, section head, Genitourinary Oncology, Division of Cancer Medicine and Blood Diseases, Department of Medicine, Keck School of Medicine, discusses the rise of novel hormonal therapies in prostate cancer.

Many of the novel hormonal therapies in prostate cancer are being moved earlier into treatment with a notable improvement in survival, says Quinn. For example, there has been a lot of interest in bringing the agents that were previously FDA approved in castration-resistant prostate cancer (CRPC) to patients with hormone-sensitive disease. In the phase III LATITUDE study, abiraterone acetate (Zytiga) showed an improvement in survival that rivaled giving docetaxel to patients with high-risk hormone-sensitive disease. As such, that became a new option for those patients, says Quinn.

In the phase III STAMPEDE study, abiraterone was tested in a broader group of patients and also showed a benefit, particularly in high-risk patients. Despite the benefit that was observed across the entire study population, the risk-benefit ratio was not as impressive in low-risk patients, adds Quinn. Because these patients have an excess risk of complications—particularly cardiovascular, from being on abiraterone—clinicians should be cautious about prescribing abiraterone to patients with low-risk disease. Notably, abiraterone is going to become generic in the United States, which may increase patient access, he concludes.

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