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Expert Talks Optimizing ADT in Prostate Cancer

Angelica Welch
Published: Thursday, Sep 21, 2017

Prostate Cancer
Recent results from the phase III CHAARTED, STAMPEDE, and LATITUDE trials have highlighted various strategies for optimizing androgen-deprivation therapy (ADT) in patients with advanced or metastatic prostate cancer.

State of the Science SummitTM on Genitourinary Cancers, Aggarwal, assistant professor, director of the STAND Clinic, Helen Diller Family Comprehensive Cancer Center at University of California, San Francisco (UCSF), discussed maximizing ADT in prostate cancer. In his presentation during the meeting, he also highlighted the success of recent studies of ADT, as well as its future utilization in various stages of disease.

OncLive: Can you provide an overview of your lecture on ADT?

Aggarwal: I spoke about ADT for patients with prostate cancer, and, in particular, I focused on some of the recent data that have come out with the use of abiraterone acetate (Zytiga) and some of the new potent androgen receptor (AR)-targeting therapies and how they have really changed practice patterns—especially for patients with metastatic prostate cancer. I focused on those studies and how to apply them in practice.

I did discuss the difference between the LHRH antagonists versus the agonists, the choice of ADT, and what the current data and practice patterns are. I also shed light on the emerging clinical trials looking at earlier use of even more potent therapies—not just in the metastatic setting, but in the earlier disease settings by a chemical recurrence—and localized prostate cancer.

What are some of the most significant data that we have now?

There have been 2 hallmark studies that were presented earlier this year looking at the use of abiraterone in conjunction with standard ADT for patients with metastatic prostate cancer. One trial is the LATITUDE study, which is a Janssen-sponsored, randomized, phase III study that looked at abiraterone plus ADT versus ADT in patients who have metastatic prostate cancer with high-risk features—3 or more metastases or higher Gleason grade. It showed a pretty convincing overall survival benefit with the combination compared with standard ADT. 
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