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Regulatory Decisions Propel Nonmetastatic CRPC Paradigm Forward

Caroline Seymour
Published: Wednesday, Jul 25, 2018

Mehmood Hashmi, MD

Mehmood Hashmi, MD

Recent approvals in the setting of nonmetastatic castration-resistant prostate cancer (CRPC) continue to advance the field, explained Mehmood Hashmi, MD.

State of the Science Summit™, A Summer of Progress: Updates from ASCO 2018, Hashmi, an assistant professor of Medicine at University of Kansas Medical Center, discussed the newly defined landscape of nometastatic CRPC, the potential with immunotherapy, and emerging imaging modalities.

OncLive: What key updates in prostate cancer were reported from the 2018 ASCO Annual Meeting?

Hashmi: Prostate cancer is the most common cancer in men and the second-leading cause of cancer death. In the last 10 years, we saw major improvements in cancer survival, specifically due to [improvements in the treatment of patients with] prostate cancer. 2018 has been a very fruitful year, as well. Several studies were presented, specifically the SPARTAN and PROSPER trials. These trials were [conducted] in patients with nonmetastatic CRPC, which is a group of patients whose needs had never been met before.

Apalutamide, which is one of the newer androgen receptor¬–signaling inhibitors, showed improvement in MFS. Similarly, enzalutamide showed benefit in multiple outcomes in the PROSPER trial. Apalutamide has changed the standard of care. There are several other ongoing studies that were presented at the 2018 ASCO Annual Meeting that addressed treatment intensification, early-stage prostate cancer, combinations, the role of immunotherapy, and some of the new PARP inhibitors that might have a role in prostate cancer.

What were some promising studies presented this year?

The SPARTAN study was a very exciting 2-arm trial. The trial [tested] standard ADT plus apalutamide versus placebo with ADT, and investigators looked at MFS. There was a difference of about 24 months between arms. Metastasis can lead to significant morbidity and [impair] quality of life. This trial was very promising and has changed our practices.
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