Amado J. Zurita-Saavedra, MD, assistant professor, associate professor, Department of Genitourinary Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, discusses the potential benefits of augmenting therapy earlier on in the treatment of patients with newly diagnosed metastatic prostate cancer.

Augmenting therapy for patients with prostate cancer should be strongly considered, according to Zurita-Saavedra. Earlier intensified therapy with androgen-signaling blockade or chemotherapy could benefit these patients, particularly those with high-volume or high-risk disease, Zurita-Saavedra explains.

Reservations exist with augmenting treatment earlier rather than later in patients with prostate cancer, Zurita-Saavedra adds, and this has led to a delay in community and private practices to apply this approach to care, Zurita-Saavedra adds. However, some studies have produced compelling data that have indicated that augmenting therapy early on has helped patients with prostate cancer, Zurita-Saavedra concludes. 

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Amado J. Zurita-Saavedra, MD, discusses the potential benefits of augmenting therapy earlier on in the treatment of patients with newly diagnosed metastatic prostate cancer.

Dr. Zurita-Saavedra on Augmenting Therapy Earlier in Prostate Cancer Treatment Journey

Amado J. Zurita-Saavedra, MD, associate professor, Department of Genitourinary Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, discusses emerging frontline therapies in metastatic hormone-sensitive prostate cancer (HSPC).

Ongoing clinical trials are evaluating PARP inhibitors, AKT inhibitors, and lutetium 177 (

Lu)–PSMA-617 as frontline therapies for men with metastatic HSPC, Zurita-Saavedra explains. Some emerging therapies may have utility in all-comers, whereas others will be reserved for molecularly defined subsets of patients.

Moreover, based on the data that emerged with antiandrogen agents like enzalutamide (Xtandi) and apalutamide (Erleada), it is likely that emerging agents will be combined with these agents to further improve outcomes for patients with metastatic HSPC, Zurita-Saavedra concludes.

Amado J. Zurita-Saavedra, MD, discusses emerging frontline therapies in metastatic hormone-sensitive prostate cancer. 



Dr. Zurita-Saavedra on Emerging Frontline Therapies in Metastatic HSPC 

Amado J. Zurita-Saavedra, MD, assistant professor, associate professor, Department of Genitourinary Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, discusses the utilization of the antiandrogen agents apalutamide (Erleada) and enzalutamide (Xtandi) in patients with metastatic hormone-sensitive prostate cancer (mHSPC). 

The phase 3 TITAN trial (NCT02489318) examined apalutamide vs androgen deprivation therapy (ADT) in patients with mHSPC. One of the primary end points of the trial was overall survival, and data confirmed that apalutamide extended survival vs ADT, according to Zurita-Saavedra. 

The implications of TITAN and the phase 3 ARCHES trial (NCT02677896), which evaluated enzalutamide vs ADT in the same patient population, are similar, Zurita-Saavedra adds. In both trials, the patients derived benefit from the antiandrogen agents, as patient-reported outcomes indicated that quality of life (QoL) did not decline with the agents, Zurita-Saavedra explains.

Adverse effects were found to be tolerable by most patients, Zurita-Saavedra says. Additionally, apalutamide and enzalutamide have proven to be useful in extending life and improving patient QoL beyond the point of symptomatic progression of prostate cancer and all the complications related to disease progression in select patients, Zurita-Saavedra concludes.

Amado J. Zurita-Saavedra, MD, discusses the utilization of the antiandrogen agents apalutamide and enzalutamide in patients with metastatic hormone-sensitive prostate cancer.

Dr. Zurita-Saavedra on Leveraging Antiandrogen Agents in Metastatic HSPC

Amado J. Zurita-Saavedra, MD, assistant professor, associate professor, Department of Genitourinary Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, discusses moving therapies utilized in metastatic castration-resistant prostate cancer (mCRPC) into the treatment of patients with metastatic hormone-sensitive prostate cancer (mHSPC).

Over time, many of the therapies approved for use in patients with mCRPC have been moved into the earlier setting of mHSPC, Zurita-Saavedra explains. These therapies include hormonal therapies and chemotherapies that were not available in mHSPC even 5 years ago.

Such shifts have resulted in significant improvements in progression-free survival and overall survival for patients with mHSPC, Zurita-Saavedra explains. Additionally, the agents have been well tolerated among patients with mHSPC, who have been able to maintain similar quality of life to that observed with the control regimens, Zurita-Saavedra concludes.

Amado J. Zurita-Saavedra, MD, discusses moving therapies utilized in metastatic castration-resistant prostate cancer into the treatment of patients with metastatic hormone-sensitive prostate cancer. 



Amado J. Zurita-Saavedra, MD

Articles

Dr. Zurita-Saavedra on Augmenting Therapy Earlier in Prostate Cancer Treatment Journey

Dr. Zurita-Saavedra on Emerging Frontline Therapies in Metastatic HSPC

Dr. Zurita-Saavedra on Leveraging Antiandrogen Agents in Metastatic HSPC

Dr. Zurita-Saavedra on Moving Therapies From mCRPC to mHSPC