The Lynx Group

Prostate Cancer

Treatment with the androgen receptor inhibitor darolutamide (Nubeqa), in combination with androgen-deprivation therapy (ADT) and docetaxel, significantly improved overall survival (OS) compared with ADT and docetaxel alone in patients with metastatic hormone-sensitive prostate cancer (mHSPC), according to recent results from the phase 3 ARASENS clinical trial, which were simultaneously published in the New England Journal of Medicine.
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The use of a polygenic score (PGS) based on noncancer genetic variations in prostate-specific antigen (PSA) values helped to refine PSA screening in a large group of men without prostate cancer at baseline. The use of the PGS to adjust PSA allows identification of aggressive versus low-risk prostate cancer and can potentially reduce unnecessary biopsies, said the lead investigator of a large genome-wide association study (GWAS) presented at the 2022 American Association for Cancer Research annual meeting.
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Two years of abiraterone acetate (Zytiga) plus prednisone added to androgen-deprivation therapy (ADT) improved metastasis-free survival and overall survival compared with ADT alone in men with nonmetastatic castration-sensitive prostate cancer, whereas the addition of enzalutamide (Xtandi) to ADT had no benefit, and much greater toxicity.
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The addition of 177Lu-PSMA-617, a radionuclide therapy that targets prostate-specific membrane antigen (PSMA), to standard-of-care treatment resulted in a 38% reduction in the risk for death versus standard of care alone in men with progressive PSMA-positive metastatic castration-resistant prostate cancer (mCRPC), according to findings from the phase 3 VISION clinical trial, which were presented during a plenary session at the ASCO 2021 virtual annual meeting.
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On December 18, 2020, the FDA approved relugolix (Orgovyx; Myovant Sciences), an oral gonadotropin-releasing hormone (GnRH) receptor antagonist, for the treatment of adults with advanced prostate cancer. Relugolix is the first oral androgen-deprivation therapy (ADT) and the first oral GnRH receptor antagonist approved for patients with advanced prostate cancer. The FDA granted relugolix priority review for this indication.
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On December 1, 2020, the FDA approved Gallium 68 PSMA-11 (Ga 68 PSMA-11; University of California), the first drug for positron emission tomography (PET) imaging of prostate-specific membrane antigen (PSMA)-positive lesions in men with prostate cancer. Ga 68 PSMA-11 is indicated for men with suspected metastatic prostate cancer that may be curable by surgery or by radiation, and for suspected recurrent prostate cancer based on elevated serum prostate-specific antigen (PSA) levels.
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Oral relugolix given daily is superior to standard androgen-­deprivation therapy (ADT) with leuprolide (Lupron) in men with advanced prostate cancer, according to the results of the phase 3 HERO study, which were reported at the ASCO 2020 virtual annual meeting and published online before the meeting.
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The combination of cabozantinib (Cabometyx), a kinase inhibitor, and atezolizumab (Tecentriq), a PD-L1 inhibitor, achieved clinically meaningful activity in patients with metastatic castration-resistant prostate cancer (CRPC), including those with high-risk clinical features, according to the results of the phase 1b COSMIC-021 trial presented at the ASCO 2020 virtual annual meeting.
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Early results from the phase 2 TheraP clinical trial show that the targeted radiation therapy Lutetium-177 PSMA-617 (Lu-PSMA) significantly improved prostate-specific antigen (PSA) response compared with standard cabazitaxel in men with metastatic castration-resistant prostate cancer (CRPC) that progressed after docetaxel therapy.
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No improvement in survival or in any key secondary end point was observed when the checkpoint inhibitor atezolizumab (Tecentriq) was added to enzalutamide (Xtandi) for the treatment of metastatic castration-resistant prostate cancer (CRPC) in the phase 3 IMbassador250 trial. The study results were presented at the 2020 American Association for Cancer Research virtual annual meeting.
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