James L. Godwin, MD, physician, Sidney Kimmel Cancer Center, Thomas Jefferson Hospital, discusses immunotherapy efforts in prostate cancer.

Immunotherapy in prostate cancer is a complex topic, says Godwin. Of the genitourinary malignancies that physicians treat, prostate cancer has been the most resistant to immunotherapy compared with renal cell carcinoma and urothelial carcinoma. Strategies have been looked at in order to sensitive the local tumor microenvironment to figure out how to get T cells to better infiltrate that space.

These strategies include combination therapies, specifically using vaccines in combination with immunotherapy. Multiple NIH studies are looking at that approach, says Godwin. Other large studies are looking at the addition of immunotherapy to androgen-targeted agents. KEYNOTE-189 is evaluating the addition of pembrolizumab (Keytruda) to enzalutamide (Xtandi) in patients with metastatic castration-resistant prostate cancer.

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Dr. Godwin on Immunotherapy Efforts in Prostate Cancer

James L. Godwin, MD, physician, Sidney Kimmel Cancer Center, Thomas Jefferson Hospital, discusses ongoing trials for men with prostate cancer.

There are several ongoing trials looking at enzalutamide (Xtandi) in the frontline setting including ENZAMET and ARCHES. Additionally, the PEACE1 study is looking at a variety of combinations. Godwin says there will soon be head-to-head randomized data of docetaxel plus androgen-deprivation therapy (ADT) versus abiraterone acetate (Zytiga) plus ADT. The addition or absence of radiation therapy will depend on the patient population. These findings will add some extra data for physicians to consider when choosing therapy, states Godwin.

There are also trials looking at combinations of chemotherapy plus a next-generation androgen-targeting agent. An arm of the STAMPEDE trial is looking at the combination of upfront abiraterone and enzalutamide. There many ongoing phase III trials that will likely read out in the next few years and help inform the management of the disease, concludes Godwin.

James L. Godwin, MD

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Dr. Godwin on Immunotherapy Efforts in Prostate Cancer

Dr. Godwin on Ongoing Clinical Trials for Men With Prostate Cancer