Mark Scholz, MD, medical director, Prostate Oncology Specialists, discusses the significance of the ARAMIS trial in the treatment of patients with nonmetastatic castration-resistant prostate cancer (CRPC).

This is an exciting time in terms of leveraging effective treatment options, Scholz says. In the ARAMIS study, results of which were presented at the 2019 Genitourinary Cancers Symposium, researchers were looking at a third androgen receptor (AR) inhibitor, darolutamide. The hope was that darolutamide would match the efficacy of apalutamide (Erleada) and enzalutamide (Xtandi) and be free of the toxicities these 2 drugs are associated with.

Scholz says that these studies consistently emphasize the importance of getting these patients on therapy earlier, such as at the first sign of rising prostate-specific antigen levels and hormone resistance. While the AR inhibitors have shown practice-changing benefit, he notes that only about 25% of patients start therapy with these agents in a timely fashion. In general, these drugs are tolerable and effective in delaying time to metastases by about 2 years. Trials like ARAMIS show that patients with nonmetastatic CRPC need to be treated more aggressively, Scholz concludes.

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Mark Scholz, MD, medical director, Prostate Oncology Specialists, discusses the significance of the ARAMIS trial in the treatment of patients with metastatic castration-resistant prostate cancer.

Dr. Scholz on Significance of ARAMIS Trial in CRPC

Mark Scholz, MD, medical director, Prostate Oncology Specialists, discusses the final analysis of the COU-AA-302 study, which compared abiraterone acetate to prednisone alone in patients with metastatic castration-resistant prostate cancer (mCRPC).

The COU-AA-302 study demonstrated an unequivocal survival advantage for abiraterone compared to placebo, Scholz says. This is a revolutionary development, he adds, because the standard of care for this disease has been docetaxel.

In comparing abiraterone and docetaxel, Scholz finds there is equal efficacy. However, a substantial reduction in toxicity and convenience of administration exists in using abiraterone.

Almost universally within Prostate Oncology Specialists, patients with mCRPC are being treated with abiraterone prior to docetaxel, in light of these findings.

View more from the 2015 GU Cancer Symposium

Mark Scholz, MD, medical director, Prostate Oncology Specialists, discusses the final analysis of the COU-AA-302 study, which compared abiraterone acetate to prednisone alone in patients with metastatic castration-resistant prostate cancer (mCRPC).


Mark Scholz, MD

Articles

Dr. Scholz on Significance of ARAMIS Trial in CRPC

Dr. Scholz on Using Abiraterone in mCRPC