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Biomarkers, Combo Regimens Key to Mitigating AR-Resistance in mCRPC

Gina Columbus @ginacolumbusonc
Published: Monday, Nov 21, 2016

Dana E. Rathkopf, MD

Dana E. Rathkopf, MD

A number of clinical trials are seeking to identify beneficial therapeutic outcomes in patients with prostate cancer who are resistant to androgen receptor (AR)¬–targeted agents.

First, abiraterone acetate (Zytiga) is being tested in combination with the PARP inhibitor veliparib in a randomized phase II trial of patients with metastatic castration-resistant prostate cancer (mCRPC) who progress on androgen-deprivation therapy (ADT; NCT01576172).

Immunotherapy is also being explored here, too. Results of a phase II study, presented at the 2016 ESMO Congress, showed that the addition of the PD-L1 inhibitor pembrolizumab (Keytruda) to enzalutamide (Xtandi) in patients with mCRPC progressing on the AR-directed therapy may be associated with durable responses.1

Out of the 20 enrolled patients, 4 achieved a confirmed prostate-specific antigen (PSA) reduction ≥50% and remained progression-free after 16 to 61 weeks. Additionally, 2 of the 4 PSA responders had measurable disease in the liver and lymph nodes and are evaluable for objective response; both achieved a partial response.

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