Dr Gallardo on Final PEACE-3 OS Data in Metastatic CRPC

“The community [oncologist] and patients should be informed about this [overall survival] benefit, with the caution of that probably not every patient should be a good candidate to receive this [combination]. We have to balance benefits/risks and patient preferences [to] seek the best [treatment] sequence for them.”

Enrique Gallardo, MD, of Parc Tauli Hospital Universitari, discussed the clinical significance of final overall survival (OS) data from the phase 3 EORTC 1333/PEACE-3 trial (NCT02194842) of radium-223 (Xofigo) with/without enzalutamide (Xtandi) in patients with metastatic castration-resistant prostate cancer (mCRPC).

Findings from the study, which were presented during the 2026 Genitourinary (GU) Cancers Symposium, revealed that patients with mCRPC with bone metastases who received the combination (n = 222) achieved a median OS of 38.21 months (95% CI, 33.08-44.75) compared with 32.62 months (95% CI, 29.31-38.24) among patients who received enzalutamide monotherapy (n = 224), translating to a 24% reduction in the risk of death (HR, 0.76; 95% CI, 0.60-0.96). The 36-month OS rates were 54.2% (95% CI, 47.1%-60.6%) and 47.4% (95% CI, 40.6%-54.0%) in the combination and monotherapy arms, respectively.

Gallardo noted that community oncologists and patients should be informed of these results; however the OS benefit with the combination does not make it the right treatment for every patient. Individual patient treatment goals should be considered in order to properly sequence therapy in this population, he added. Safety and quality of life considerations also need to be properly weighed during treatment selection, he concluded.

Disclosures: Gallardo received honoraria from Advanced Accelerator Applications, AstraZeneca Spain, Bayer, Bristol-Myers Squibb, Eisai, GlaxoSmithKline, Ipsen, LEO Pharma, Pfizer, Recordati, Rovi, and Sanofi. He also holds consulting or advisory roles with Advanced Accelerator Applications, Bayer, Bristol-Myers Squibb, EUSA Pharma, GlaxoSmithKline, Ipsen, MSD Oncology, Pfizer, and Recordati. He is on the speakers’ bureau of Advanced Accelerator Applications, Bristol-Myers Squibb, Eisai, GlaxoSmithKline, LEO Pharma, MSD Oncology, Rovi, and Sanofi/Aventis. He received travel, accommodations, and/or expenses from AstraZeneca Spain, Bayer, Ipsen, MSD Oncology, and Recordati.