Conference MDAngle offers personal perspectives from conference attendees, showcasing their anticipation, quick takeaways, and insights into how the presented research will affect their patients.
The 2024 American Society of Clinical Oncology (ASCO) Annual Meeting took place in Chicago, Illinois, from May 31 to June 3. In the setting of prostate cancer, key studies included investigations into combination therapies, the impact of metformin on low-risk prostate cancer progression, and cognitive-behavioral therapy for managing symptoms. Additionally, attention was directed at health-related quality-of-life studies and emerging treatments.
Sandy Srinivas, MD
Professor of Medicine/Oncology, Stanford University; Director, In-Patient Hematology/Oncology Service, Department of Medicine, Stanford Healthcare, Stanford, California
Preconference Considerations
ASCO 2024: Upcoming Treatment Innovations in Prostate Cancer
Dr Srinivas previews a range of compelling abstracts on prostate cancer for ASCO 2024, with a focus on late-breaking studies such as CHAARTED 2 comparing cabazitaxel plus abiraterone vs abiraterone alone, the MAST study evaluating the impact of metformin on low-risk prostate cancer progression, and the MANCAN2 trial investigating cognitive-behavioral therapy for managing hot flushes and night sweats. Attention is also drawn to health-related quality-of-life studies such as PSMAfore and EMBARK. Additionally, the negative findings of CYCLONE 2 regarding abemaciclib plus abiraterone, and emerging treatments such as ARV-766 and tarlatamab for neuroendocrine prostate cancer, are anticipated discussions.
Quick Clinical Takeaways
Key Insights on New Prostate Cancer Data From ASCO 2024
Dr Srinivas highlights new data from several prostate cancer trials. CHAARTED 2 revealed improved radiographic progression-free survival (rPFS) with abiraterone plus cabazitaxel but did not lead to significant changes in practice. CYCLONE 2 had disappointing results, showing no added benefits from abemaciclib in metastatic castration-resistant prostate cancer. Despite MAST's negative outcomes for metformin, emphasis on evaluating standard treatments persists, and the PSMAfore and EMBARK trials indicated quality-of-life enhancements with lutetium-177(177Lu)-PSMA-617 and enzalutamide.
How Will My Patients Benefit?
How New Data from ASCO 2024 Will Impact Prostate Cancer Care
Dr Srinivas highlights the findings of the PSMAfore trial, showing that 177Lu-PSMA-617 significantly improved rPFS and quality of life in patients with metastatic castration-resistant prostate cancer compared with alternate androgen receptor pathway inhibitors (ARPIs). The trial showed a doubling of rPFS from 5.5 to 12 months, and despite a significant crossover, a favorable overall survival hazard ratio was reported. Dr Srinivas describes the potential benefits of this new treatment option for patients who are too frail for chemotherapy.
Polling Question
Summary
Among a series of prostate cancer studies presented at ASCO 2024, positive results from the PSMAfore and EMBARK trials indicated quality-of-life improvements with 177Lu-PSMA-617 and enzalutamide, respectively. The CHAARTED 2 study showed improved rPFS with cabazitaxel plus abiraterone, though it did not lead to practice changes. The CYCLONE 2 trial found no benefits from adding abemaciclib to abiraterone. The MAST study's negative outcomes for metformin highlighted the ongoing need to evaluate standard treatments. In three videos, Dr Srinivas also emphasizes the potential of new treatments like ARV-766 and tarlatamab for neuroendocrine prostate cancer, and highlights the potential benefits of 177Lu-PSMA-617 for her patients with metastatic castrate-resistant prostate cancer.
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Cite this: Conference MDAngle: ASCO 2024Prostate Cancer - Medscape - May 23, 2024.
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