The population of the CARD-like cohort is also not a direct copy of the CARD population as the treatment landscape has changed since CARD enrolment to include PARP inhibitors (olaparib, and rucaparib) for patients with DNA repair abnormalities. Prostate cancer (PC) is one of the most commonly diagnosed cancers and a leading cause of death among men in the United States (US) [1, 2].Within 5 years of the PC diagnosis, an estimated 10-20% of patients develop castration-resistant prostate cancer (CRPC) [3, 4].Metastatic CRPC (mCRPC) represents the most aggressive form of PC disease and is associated with a poor prognosis []. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. Consensus on the Treatment and Follow-Up for Metastatic Castration Update on Systemic Prostate Cancer Therapies: Management of Metastatic Castration-resistant Prostate Cancer in the Era of Precision Oncology. A total of 12,140 patients received at least one line of active treatment for mCRPC between 2001 and 2019; Table1. This study was funded by Sanofi. National Library of Medicine The incidence of grade 3 adverse events was comparable between arms [19]. At present, for most patients, no clear predictors of response are available, which makes it difficult to determine the most suitable treatment for each patient to consider personalized treatment. That trial involved patients with mCRPC who had been previously treated with docetaxel and either abiraterone or enzalutamide who developed disease progression within 12 months of receiving these agents. Numerous phase II trials have shown that sequential administration of abiraterone and enzalutamide (regardless of the order and regardless of previous treatment with another chemotherapy agent) is associated with poor PSA response and minimal gains in PFS [50]. 2015;10:e0139440. Two trials have shown only a marginal survival benefit for patients remaining on LHRH analogues during second- and third-line therapies [8,9]. The Cochrane collaborations tool for assessing risk of bias in randomised trials. Another phase III trial was performed to assess the possibility of administering cabazitaxel at a lower dose (20 mg/m2 versus the standard dose of 25 mg/m2), as part of the PROSELICA study [15]. 2020;31:614MO. [Citado 23 de Diciembre de 2020] Available online: Valero J., Peleteiro P., Henriquez I., Conde A., Piquer T., Lozano A., Soler C.C., Muoz J., Llescas A., Jove J., et al. Cyclin-dependent kinase (CDK12) alterations are reported to occur in 411% of PCa [25] cases and are more common in the mCRPC setting. Systemic treatment for metastatic castrate resistant prostate cancer: does seqence matter? PubMed Targeting mTOR Complex 2 in Castration-Resistant Prostate Cancer with Acquired Docetaxel Resistance. Disclaimer. Despite those findings, we do not recommend hormonal therapy sequencing in most mCRPC patients. Treatment Outcome, Toxicity, and Predictive Factors for Radioligand Therapy with 177Lu-PSMA-I&T in metastatic castration-resistant prostate cancer. NCCN: National Comprehensive Cancer Network Prostate Cancer (version 2.2021) 2021. -. For this analysis, patients with mCRPC treated in France, Germany, Italy, Spain, United Kingdom, USA, Japan and Brazil were included. Although olaparib has recently been approved in the US for this population, there is growing evidence that these patients may benefit from the use of taxanes at some point during their course of treatment [2, 25]. 1 During the same period, the earnings estimates per share for 2024 have risen from $7.11 . Beer T.M., Armstrong A.J., Rathkopf D.E., Loriot Y., Sterberng C.N., Higano C.S., Iversen P., Bhattacharya S., Carles J., Chowdhury S., et al. Retrospective studies evaluating the sequential use of abiraterone and enzalutamide in patients with mCRPC after treatment with docetaxel have suggested cross-resistance between ARTAs, and two recent prospective studies demonstrate that patients who have progressed on an ARTA are unlikely to respond to a second alternative inhibitor [12,13,14,15,16]. Real-World Treatment Patterns and Overall Survival of Patients with Then we got MRIs and CT scans, and we still missed some things. ERA 223: A phase 3 trial of radium-223 (Ra-223) in combination with abiraterone acetate and prednisone/prednisolone for the treatment of asymptomatic or mildly symptomatic chemotherapy-nave patients with mCRPC; Proceedings of the ESMO Congress; Munich, Germany. Abiraterone alone or in combination with enzalutamide in metastatic castration-resistant prostate cancer with rising prostate-specific antigen during enzalutamide treatment. Treatment-related toxicity, mainly due to hyperstimulation of the mineralocorticoid axis, included arterial hypertension (10%; grade 34: 1%), hypokalemia (17%: grade 34: 3%), and water retention (33%; grade 34: 2%). 2019;381:250618. Abiraterone in metastatic prostate cancer without previous chemotherapy. Of the total patients, 452 were eligible for the CARD-like cohort. ADT androgen deprivation therapy, LHRH luteinizing hormone-releasing hormone, mCRPC metastatic castration-resistant prostate cancer. Here we present a cohort of patients with mCRPC who received cabazitaxel after an ARTA, the same as patients in the cabazitaxel arm of the CARD study. Prostate cancer and PARP inhibitors: progress and challenges MeSH and transmitted securely. The development of second-generation antiandrogens showed that a large percentage of prostate cancers remain dependent on androgen signaling, even at the low serum testosterone levels present after castration. Its common for hormone therapy, known as androgen deprivation therapy (ADT), to stop working after a few years. In patients with metastatic castration-nave and mCRPC, microsatellite instability (MSI-H) and mismatch repair-deficient (dMMR) should be included [29,30,31]. Sequential use of ARTA was frequent. Correspondence to In that trial, which included 775 patients with mCRPC who had received prior treatment with docetaxel, patients were randomized to cabazitaxel + prednisone (CP) or MP. Non-Metastatic Castration-Resistant Prostate Cancer: Symptoms, Causes The therapeutic arsenal for mCRPC is expected to change significantly in coming years as several new treatments and novel biomarkers are incorporated into routine clinical practice. 8600 Rockville Pike N Engl J Med. Treatments approved for metastatic castration-resistant prostate cancer (mCRPC) include taxanes (docetaxel, cabazitaxel), androgen-receptor-targeted agents (ARTAs; abiraterone, . Cabazitaxel versus abiraterone or enzalutamide in prostate cancer. Adding talazoparib to first-line treatment with enzalutamide improves radiographic progression-free survival (rPFS) in patients with metastatic castration-resistant prostate cancer (mCRPC) and . Kantoff P.W., Higano C.S., Shore N.D., Berger E.R., Small E.J., Penson D.F., Redfern C.H., Ferrari A.C., Dreicer R., Sims R.B., et al. Khalaf DJ, Annala M, Taavitsainen S, Finch DL, Oja C, Vergidis J, et al. Metastatic castration-resistant prostate cancer (mCRPC) encompasses a heterogeneous wide range of molecular tumor behavior and a high risk of progression. Secondary outcome measuresincluding PSA response rate, time to PSA progression, and radiographic PFSwere all better in the patients who received enzalutamide. As recommended by international guidelines, treatment with cabazitaxel should be the preferred choice in patients with mCRPC with progression of disease after treatment with docetaxel and an ARTA in lieu of treatment with a subsequent ARTA. PubMed The objective was to compare characteristics and treatment patterns of patients from a real-world dataset with the CARD population. doi: 10.1200/JCO.2015.64.2702. Ideally, your care team should possess expertise in distinct domains of cancer care, such as imaging, chemotherapy, radiation, and surgery, according to a study published in the Annals of Oncology in August 2015. However, there were no significant differences between the two treatment regimens [14]. Metastatic castration-resistant prostate cancer (mCRPC) encompasses a heterogeneous wide range of molecular tumor behavior and a high risk of progression. Talazoparib showed durable antitumor activity in these heavily pretreated patients with mCRPC and DDR-HHR gene alterations. In addition, secondary outcome measures (PSA response rate, time to PSA progression, and PFS) were all better in the abiraterone arm. Ipilimumab versus placebo after radiotherapy in patients with metastatic castration-resistant prostate cancer that had progressed after docetaxel chemotherapy (CA184043): A multicentre, randomized, double-blind, phase 3 trial. Cabazitaxel versus abiraterone or enzalutamide in metastatic prostate cancer. Based on these findings, abiraterone + prednisone became the new standard of care for mCRPC in patients with and without prior chemotherapy. This means that the same man who was non-metastatic before is now metastatic, because we have more sensitive scans [and can find incredibly small tumors], Tagawa says. Our scans are getting better, says Dr. Tagawa. CAS Bookshelf 2014;371:42433. Article In this study, analysis of treatment patterns suggests that in the recent past, sequential use of ARTAs was common in daily practice. Integrative clinical genomics of advanced prostate cancer. Key: N, number; AB, Abiraterone; CBZ, Cabazitaxel; ENZA, Enzalutamide; DOC, Docetaxel; MTX, Mitoxantrone; PRD, Prednisone; OS, Overall survival; SSE, Symptomatic skeletal event. In that same year, 449,761 new diagnoses were recorded in Europe, with more than 100,000 deaths [1,2]. https://doi.org/10.1038/s41391-021-00487-1, DOI: https://doi.org/10.1038/s41391-021-00487-1. In two large retrospective, international, observational studies, patients with mCRPC tested for germline DNA damage repair mutations had similar progression-free survival and response rate with docetaxel regardless of whether they did or did not have germline DNA damage repair mutations [26, 27]. aTreatment may include addition of denosumab. and O.A. RP is employed by Sanofi and AO is a former employee of Sanofi. In 2004, the results of two major phase 3 clinical trials established docetaxel as a primary chemotherapeutic option for patients with mCRPC [ 7, 8 ]. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. AO owns stock in Sanofi. Harris JD, Chang Y, Syahirah R, Lian XL, Deng Q, Bao X. J Immunol Regen Med. Androgen deprivation therapy is a stalwart therapy for the initial treatment of metastatic disease. Real-world evidence of patients with metastatic castration-resistant Lu-177-PSMA-617 and similar radiopharmaceuticals are in . The database contains patient characteristics, prescribing physician/institution information, and tumor and treatment information for patients who received at least one line of active treatment for mCRPC between 2001 and 2019. Cancer Treat Res Commun. The number of patients with available data for each line decreased with advancing lines of treatment (Fig. Prostate Cancer | Janssen Sequencing current therapies in the treatment of metastatic prostate cancer. Clipboard, Search History, and several other advanced features are temporarily unavailable. Epub 2015 Mar 4. EAU - ESTRO - ESUR - SIOG Guidelines on Prostate Cancer 2020. Nilsson S., Cislo P., Sartor O., Vogelzang N.J., Coleman R.E., OSullivam J.M., Reuning-Scherer J., Schan M., Zhan L., Parker C. Patient-reported quality-of-life analysis of radium-223 dichloride from the phase III ALSYMPCA study. Metastatic castration-resistant prostate cancer (mCRPC) remains a terminal diagnosis with an aggressive disease course despite currently approved therapeutics. Trial Design and Objectives for Castration-. doi: 10.3322/caac.21601. In that trial, 1195 patients who had progressed after treatment with docetaxel were randomized to abiraterone + prednisone or placebo + prednisone. Although the time to treatment switch was recorded in the database, this was not equivalent to time to progression as was recorded in the CARD study. In advanced prostate cancer patients at high fracture risk due to bone loss, clinicians should recommend preventative treatments with . wrote the manuscript. Mottet N, van den Bergh RCN, Briers E, Cornford P, De Santis M, Fanti S, et al. The primary outcome measure was OS, which was significantly better in the Radium-223 group (14.9 vs. 11.3 months, HR 0.7, p < 0.001). Radiopharmaceuticalsprimarily beta emitters, such as strontium or samariumhave long been prescribed, mainly for the palliative treatment of bone pain. Some studies have reported no impact, whereas other studies suggest that these patients do have worse outcomes [22, 25, 26]. Docetaxel and estramustine compared with mitoxantrone and prednisone for advanced refractory prostate cancer. de Wit, R., Freedland, S.J., Oudard, S. et al. Although metastatic castration-resistant prostate cancer (MCRPC) patients currently benefit from a wealth of effective treatment options, MCRPC remains incurable, and the prognosis of these patients is quite poor. There were 75 patients who received abiraterone in both first and second line. Cabazitaxel is another member of the taxane family that has proven effective even in docetaxel-resistant cancers. We conducted a randomized, open-label, phase 3 trial evaluating the PARP inhibitor olaparib in men with metastatic castration-resistant prostate cancer who had disease progression while. 2016;76:92736. We performed medical chart reviews and identified 261 patients with HRRm mCRPC that received therapy between 5/1/2020 to 1/24/2023. The main objective of this bibliometric study was to provide an overview of MCRPC, explore clusters and trends in research and investigate the future direction of MCRPC research. Treatment selection must also consider prior therapies and access to clinical trials. Historically, the median survival for men with mCRPC was less than two years, . Because it can be very stressful to have advanced prostate cancer, and tough to talk about what it all means for your future, the ASCO urges men to have an open and honest conversation with their care team. National Library of Medicine Radium-223 is a calcium mimetic alpha emitter that accumulates in the bone with a very low capacity to penetrate surrounding tissues, but greater cytotoxic capacity due to its higher linear energy transfer. The following data were collected: patient and disease characteristics, history of prostate cancer, baseline laboratory outcomes, details of previous therapies and treatment exposure. 2022 Dec 14;10:1078342. doi: 10.3389/fbioe.2022.1078342. Please enable it to take advantage of the complete set of features! Transl. Eliasson L, de Freitas HM, Dearden L, Calimlim B, Lloyd AJ. N Engl J Med. Cancer Treat Rev. There was also a higher incidence of arterial hypertension (6% vs. 3%), asthenia (34% vs. 29%), and hot flushes (20% vs. 10%) in the treatment arm. PubMed Central At some point over the course of their treatment, 2546 (21%) patients received cabazitaxel, predominantly in third and fourth lines of therapy (Fig. Since the year 2004, several clinical trials have been conducted to evaluate the efficacy of docetaxel, a cytotoxic agent of the taxane family, in mCRPC. Abiraterone is an androgen biosynthesis inhibitor that functions by inhibiting two of the main enzymes (17-alpha-hydroxylase and 17,20-lyase) involved in PCa. Prostate cancer tropism towards the bone explains high incidence rate (90%) of bone metastases in the castration-resistant phase. Article Increased survival with enzalutamide in prostate cancer after chemotherapy. Olaparib for metastatic castration-resistant prostate cancer. That trial was performed to evaluate enzalutamide administered before docetaxel versus placebo, in a study design that was similar to the COU-AA-302 trial with abiraterone. You are using a browser version with limited support for CSS. Therefore, the five-weekly DP regimen can be considered a valid treatment option, especially in frail patients given the important need to limit the toxicity in these patients. Alternatively, it may be that a new line was recorded as treatment was continued despite indicators of disease progression. Subsequently, olaparib was approved by the United States Food and Drug Administration (FDA). Lutetium-177 [Lu]Lu-PSMA-617 is a radiolabeled small molecule that delivers radiation to cells expressing PSMA. Results of the Uroncor Group (Uro-Oncological Tumors) of the Spanish Society of Radiation Oncology (SEOR) Clin. These mutations are often associated with germline mutations. Data analysis was performed on patients with documented treatment durations. Several clinical trials reported improved outcomes with the intensification of androgen deprivation therapy by the addition of docetaxel chemotherapy or novel hormonal agents (abiraterone, enzalutamide, or apalutamide) in the . The results showed a clear benefit for abiraterone in terms of both rPFS (16.5 vs. 8.3 months, HR 0.53, p < 0.001) and OS (34.7 vs. 30.3 months; HR 0.81; p = 0.0033). Calcium phosphate-based nanomedicine mediated CRISPR/Cas9 delivery for prostate cancer therapy. Age, Gleason and PSA are important prognostic factors for survival in metasttico castration-resistant prostate cancer. eCollection 2022. Real-world studies offer the possibility of validating the results of randomized clinical trials by including patient populations reflective of those in routine clinical practice and characterizing trends in healthcare service utilization. Lutetium-177-PSMA-617 for Metastatic Castration-Resistant Prostate Cancer. De Wit R., De Bono J.S., Sternberg C.N., Fizazi K., Tombal B., Wlfing C., Kramer G., Eymard J.C., Bamias A., Carles J., et al. Since multiple treatment options are available for patients with mCRPC, and the optimal sequence of these treatments remains unknown, it is critical to better understand patients and physicians preferences and how treatment choices may be influenced by patient characteristics, and treatment access [9, 17]. Increasing prevalence of metastatic castration-resistant prostate All patients provided written informed consent. Olaparib is now included in both the NCCN and APCCC guidelines [33,34], and germline and somatic testing for relevant alterations are now considered standard of care for these patients. Emerging evidence suggests that the status of the DNA damage-repair pathway influences sensitivity to platinum-based chemotherapy. Aldea M, Lam L, Llacer Perez C, Saint-Ghislain M, Mescam GG, Flchon A, et al. Talazoparib monotherapy in metastatic castration-resistant prostate cancer with DNA repair alterations (TALAPRO-1): An open-label, phase 2 trial. First, the data available were provided by the clinician and no data audit was performed. However, these data suggest that, in the future, PTEN status may play an important role in selecting potential candidates for this therapeutic strategy. The images or other third party material in this article are included in the articles Creative Commons license, unless indicated otherwise in a credit line to the material. Elevated labile iron in castration-resistant prostate cancer is targetable with ferrous iron-activatable antiandrogen therapy. The results of the phase III IPATential150 trial were recently presented at the annual congress of the European Society of Medical Oncology [48]. Tannock I.F., De Wit R., Berry W.R., Berry W.R., Horti J., Pluzanska A., Chi K.N., Oudard S., Thodore C., James N.D., et al. Lastly, in the PLATO study, median duration of first-line enzalutamide in chemo-nave mCRPC patients was 9.1 months [14]. Eur Urol. RdW has received honoraria and/or research funding from Sanofi, Merck Sharp & Dohme and Bayer. OSullivan J.M., Carles J., Cathomas R., Gomez-Iturriaga A., Heinrich D., Kramer G., Ost P., van Oort I., Tombal B. Radium-223 Within the Evolving Treatment Options for Metastatic Castration-resistant Prostate Cancer: Recommendations from a European Expert Working Group. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (, mCRPC, prostate cancer, androgen deprivation therapy, novel therapies. AKT is part of the PI3K-AKT-mTOR pathway, acting as a regulator of cellular metabolism. Nuhn P, De Bono JS, Fizazi K, Freedland SJ, Grilli M, Kantoff PW, Sonpavde G, Sternberg CN, Yegnasubramanian S, Antonarakis ES. 28 September 2018. Treatments approved for metastatic castration-resistant prostate cancer (mCRPC) include taxanes (docetaxel, cabazitaxel), androgen-receptor-targeted agents (ARTAs; abiraterone, enzalutamide), radioisotopes (radium-223), poly-ADP ribose polymerase inhibitors (olaparib and rucaparib), and immunotherapy (sipuleucel-t and pembrolizumab for microsatellite instability high/deficient mismatch repair tumors) [2, 3]. Epub 2018 Apr 16. Treatment outcomes for metastatic castration-resistant prostate cancer (mCRPC) following progression on upfront androgen deprivation therapy (ADT) with androgen receptor pathway inhibitors (ARPI) for metastatic castration-sensitive prostate cancer (mCSPC). Freedland SJ, De Hoedt AM, DerSarkissian M, Chang R, Satija A, Nguyen C, et al. 2020;21:151325. Bethesda, MD 20894, Web Policies and transmitted securely. Learn About Advanced Prostate Cancer (mCRPC) - PROVENGE Age, Gleason and PSA are important prognostic factors for survival in metasttico castration-resistant prostate cancer. Drug Des Devel Ther. New data from researchers at Memorial Sloan Kettering Cancer Center (MSK) featured in the 2021 ASCO Annual Meeting press program highlights a promising new treatment option for individuals previously treated for metastatic castration-resistant prostate cancer (mCRPC). Consensus on management of castration-resistant prostate cancer on behalf of the Urological Tumours working Group (URONCOR) of the Spanish society of radiation oncology. 2018;68:394424. Thats why its important to assemble a team of doctors and specialists to keep your treatment and you on track. Data sharing not applicable. Early detection and treatment are therefore crucial in these patients. Prostate cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. HHS Vulnerability Disclosure, Help 2020;70:145164. Unfortunately, most men in this situation will go on to develop metastatic castration-resistant prostate cancer (mCRPC) and require secondary systemic therapy. There was also less toxicity in the twice-monthly arm, with a decrease in both hematologic and digestive toxicity (diarrhea, nausea). The authors received editorial support from Danielle Walsh and Amber Wood of MediTech Media, funded by Sanofi. Randomized clinical trials are needed to further clarify the place of cabazitaxel in such patients. An important consideration is whether or not this is reflective of daily clinical practice. Consequently, the aim of the present narrative review is to review the currently available evidence on novel and emerging therapies for the treatment of mCRPC. When advanced prostate cancer spreads to your bones, it can result in pain. Google Scholar. the contents by NLM or the National Institutes of Health. This study assessed prevalence trends for mCRPC over eight years in a large managed care population. The lower dose may have been used as the starting dose in the CARD-like cohort, while the starting dose in the CARD trials was 25mg/m2 for all patients. Clin Ther. 1). government site. MacroGenics Announces Preliminary Clinical Results from - GlobeNewswire government site. Inclusion in an NLM database does not imply endorsement of, or agreement with, The results of the phase III PREVAIL trial were reported in 2014 [19]. We also assessed the characteristics of patients receiving cabazitaxel after docetaxel and one ARTA to compare patient characteristics and the treatment duration of cabazitaxel with the CARD clinical study population. 2015;41:197215. Wei Y., Wu J., Gu W., Wang J., Lin G., Qin X., Dai B., Gan H., Ye D., Zhu Y. Prognostic Value of Germline DNA Repair Gene Mutations in De Novo Metastatic and Castration-Sensitive Prostate Cancer. The recent successful development of poly ADP-ribose polymerase (PARP) inhibitors for patients with mCRPC and mutations in DNA damage repair genes has added to the treatment armamentarium and improved personalized treatments for . In a second step, we restricted the population to patients satisfying the main inclusion criteria of the CARD study to define the CARD-like cohort. The authors declare no conflict of interest. We searched for relevant articles published in those databases between January 2010 and December 2020 using the following search terms: advanced prostate cancer; metastatic castration resistant prostate cancer; randomized studies; chemotherapy; androgen deprivation therapy; immunotherapy; second-generation antiandrogens; radiopharmaceuticals; PARP inhibitors; radioisotopes; AKT inhibitors; and bone-targeted therapy. eCollection 2022. Metastatic castration-resistant prostate cancer (mCRPC) and its precursor, metastatic hormone sensitive prostate cancer (mHSPC), are advanced forms of the condition that don't respond to initial treatments, such as surgery and hormone therapy, and have started to spread beyond the prostate. Sequencing of taxanes and new androgen-targeted therapies in metastatic castration-resistant prostate cancer: results of the International Multicentre Retrospective CATS database. European Medicines Agency (EMA) EMA restricts use of prostate cancer medicine Xofigo; Proceedings of the EMA Restricts Use of Prostate Cancer Medicine Xofigo; London, UK. Provided by the Springer Nature SharedIt content-sharing initiative, Prostate Cancer and Prostatic Diseases (Prostate Cancer Prostatic Dis) Patients preferences for the treatment of metastatic castrate-resistant prostate cancer: a discrete choice experiment. Patients had previously received docetaxel or were not eligible to receive it. Antiproliferative mechanism of action of the novel taxane cabazitaxel as compared with the parent compound docetaxel in MCF7 breast cancer cells. In the year 2020, an estimated 191,000 new cases of PCa were diagnosed in the United States (USA) with more than 33,000 deaths. Of the patients who received an ARTA in first line (n=5118), 42% received the same or an alternative inhibitor in the second line. Treatment outcomes for metastatic castration-resistant prostate cancer Wei CG, Zhang R, Wei LY, Pan P, Zu H, Liu YZ, Wang Y, Shen JK. As a library, NLM provides access to scientific literature. You should also ask your care team about options for palliative care. Publishers Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Advanced prostate cancer: AUA/ASTRO/SUO Guideline 2020. 4,5 The authors would like to thank Henry Gazay for the creation of the LiveTracker and assistance in the data collection. The https:// ensures that you are connecting to the Eisenberger M., Hardy-Bessard A.C., Kim C.S., Gczi L., Ford D., Mourey L., Carles J., Parente P., Font A., Kacso G., et al. Since many physicians do not regularly image their patients at this stage of the disease, ARTAs may be discontinued when severe pain develops rather than at first radiographic progression, a point at which patients frequently experience deterioration of performance status. The phase III FIRSTANA trial was performed to evaluate whether cabazitaxel 20 mg/m2 (C20) or 25 mg/m2 (C25) was superior to docetaxel (75 mg/m2) in terms of OS as a first-line treatment of mCRPC. Oncologist. Cheng H.H., Sokolova A.O., Schaeffer E.M., Small E.J., Higano C.S. In the first phase III trial, TAX327 [10], a total of 1006 patients with mCRPC were randomized to receive docetaxel + prednisone (DP) in two different regimens (three times weekly at 75 mg/m2, or weekly at 30 mg/m2) or mitoxantrone + prednisone (MP). As a result, patients in routine clinical practice may be older, have more advanced or aggressive disease or comorbidities, any of which could subsequently affect the efficacy and tolerability of treatment [22]. The https:// ensures that you are connecting to the Treatment has improved drastically in recent years and many novel therapeutic agents are currently under investigation. 2020. https://www.auanet.org/guidelines/advanced-prostate-cancer. PubMed Central Based on those findings, CP became the standard treatment option for patients with progression after prior DP. SO received honoraria from Pfizer, Bayer, Novartis, BMS, Merck, Janssen and Astellas, and received travel/accommodation/expenses from Pfizer, Bayer, Novartis, BMS, Merck, Janssen, Astellas and Sanofi. Since then, all clinical trials conducted at CRPC include ADT as part of baseline treatment (Table 1). Funding acquisition: RP, AO. The median break between lines of abiraterone was 30 days (range 0577 days). 2017;39:72337. Median age of the CARD-like cohort was comparable to CARD (73 vs 70 years).
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