Yung Lyou, MD, PhD, assistant clinical professor, Department of Medical Oncology and Therapeutics Research, City of Hope, discusses the key takeaways from the phase 3 ENZAMET trial (NCT02446405) in metastatic prostate cancer.

ENZAMET examined whether the addition of an antiandrogen agent that was already approved for metastatic castration-resistant prostate cancer would be beneficial for use in the metastatic hormone-sensitive setting, as well, Lyou says. Ultimately, results from the trial indicated that androgen deprivation therapy (ADT) plus enzalutamide (Xtandi) yielded an overall survival (OS) benefit vs ADT plus nonsteroidal antiandrogens, such as bicalutamide (Casodex) or flutamide (Eulexin), Lyou explains. The estimated 3-year OS rates experienced with enzalutamide vs standard antiandrogen treatment were 80% and 72%, respectively, Lyou concludes.

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Yung Lyou, MD, PhD, discusses the key takeaways from the phase 3 ENZAMET trial in metastatic prostate cancer.

Dr. Lyou on Key Takeaways from the ENZAMET Trial in Metastatic Prostate Cancer

Yung Lyou, MD, PhD, assistant clinical professor, Department of Medical Oncology and Therapeutics Research, City of Hope, discusses the efficacy of androgen-deprivation therapy (ADT) plus docetaxel in patients with metastatic hormone-sensitive prostate cancer (mHSPC).

Results from the phase 3 CHAARTED trial (NCT00309985), which examined ADT with or without docetaxel in this patient population, demonstrated that the combination improved overall survival (OS) compared with ADT alone, according to Lyou. Additionally, for patients with high-volume disease, defined as those with at least 4 metastatic lesions in the bones or more than 1 visceral metastasis, the median OS was 51.2 months with the combination vs 34.4 months with ADT alone, demonstrating a clear benefit to adding docetaxel, Lyou explains.

However, docetaxel has been associated with adverse effects, such as peripheral neuropathy and myelosuppression, Lyou adds. Overall, the study found that the combination was most beneficial for patients with high-volume disease, with no significant difference in OS observed in those with low-volume disease, Lyou concludes.

Yung Lyou, MD, PhD, discusses the efficacy of androgen-deprivation therapy plus docetaxel in patients with metastatic hormone-sensitive prostate cancer.

Dr. Lyou on the Efficacy of ADT Plus Docetaxel in High-Volume mHSPC

Yung Lyou, MD, PhD, assistant clinical professor, Department of Medical Oncology and Therapeutics Research, City of Hope, discusses emerging biomarkers in prostate cancer.

One advancement being made with regard to biomarkers is the uptake of liquid biopsies for men with prostate cancer, Lyou says. Rather than relying solely on invasive, tumor-based tissue testing, liquid biopsy offers a less invasive, blood-based option for genomic assessment, Lyou explains. 

Additionally, biomarkers such as soluble PD-L1 and FGFR3 are being evaluated for use with blood-based biopsies, Lyou says. Regarding tissue-based testing, stromal signature TFG-ß could offer a potentially actionable target in prostate cancer, concludes Lyou.

Yung Lyou, MD, PhD, discusses emerging biomarkers in prostate cancer. 

Dr. Lyou on Emerging Biomarkers in Prostate Cancer 

Yung Lyou, MD, PhD, assistant clinical professor, Department of Medical Oncology and Therapeutics Research, City of Hope, discusses optimal sequencing with apalutamide (Erleada) in prostate cancer.

In recent years, many options have become available for the first-line treatment of men with prostate cancer, says Lyou. However, these options have made treatment sequencing more challenging, Lyou explains.

Apalutamide is currently FDA approved to treat men with metastatic castration-sensitive prostate cancer (mCSPC), as well as nonmetastatic castration-resistant prostate cancer (mCRPC), says Lyou. As such, using apalutamide as frontline treatment for patients with castration-sensitive disease leaves the greatest number of treatment options available for patients who progress to metastatic castration-resistant prostate cancer (mCRPC), says Lyou. In mCRPC, apalutamide is not FDA approved and treatment options include docetaxel, abiraterone acetate (Zytiga) plus prednisone, or enzalutamide (Xtandi), concludes Lyou. 

Yung Lyou, MD, PhD, discusses optimal sequencing with apalutamide in prostate cancer.  



Yung Lyou, MD, PhD

Articles

Dr. Lyou on Key Takeaways from the ENZAMET Trial in Metastatic Prostate Cancer

Dr. Lyou on the Efficacy of ADT Plus Docetaxel in High-Volume mHSPC

Dr. Lyou on Emerging Biomarkers in Prostate Cancer

Dr. Lyou on Sequencing Apalutamide in Prostate Cancer