Thomas Flaig, MD
Among patients with metastatic prostate cancer who have a suboptimal response to initial androgen deprivation therapy (ADT), there is a small group who respond to hormone therapy, a recent study reports.
Flaig, associate professor, Division of Medical Oncology, associate dean for clinical research, University of Colorado School of Medicine, discussed the study of abiraterone acetate in metastatic prostate cancer after hormone induction failure and its impact on future research in this setting.
OncLive: Please provide an overview of your study.
This is a study of abiraterone acetate for metastatic prostate cancer in patients with suboptimal biochemical response to hormone induction. These are patients that have metastatic hormone sensitive disease that started on standard hormone therapy, much like we have been doing for several decades. But these are patients that have a poor initial response to the standard hormone therapy. So, the PSA, which we use to monitor disease response, is still above 4, and that is 6 to 9 months after they started that standard hormone therapy. We often tend to see patients, even if their PSA is very very high from the cancer, but they start standard hormone therapy, fall to a very low level. For any patient who is in the situation of being 6 to 9 months after starting, having a PSA of more than 4, they are in a very poor prognosis category.
In a broad way, this study looked at this very high-risk group of patients that had sort of failed with induction therapy, and we added in abiraterone, a next generation antihormonal agent, to see if we can salvage or get a response with additional, more intense hormone therapy.
What were the significance of the results?
There are a couple of important things about this trial. I think that the significant findings here are that there is group of patients that had very deep, near complete responses after adding in abiraterone. One looks at the waterfall plot for the findings here—there was a broad group of patients who had PSA decline.
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