Dr. Aggarwal on ADT Intensification in Biochemically Relapsed Prostate Cancer

Rahul Aggarwal, MD, developmental therapeutics specialist, genitourinary oncologist, the University of California Health (UCSF), UCSF Helen Diller Family Comprehensive Cancer Center, discusses the rationale for investigating androgen deprivation therapy (ADT) intensification in biochemically relapsed prostate cancer.

The phase 3 PRESTO study (NCT03009981) evaluated ADT alone vs ADT plus apalutamide (Erleada) vs ADT plus apalutamide, abiraterone acetate (Zytiga), and prednisone in men with biochemically recurrent prostate cancer and a prostate specific antigen (PSA) doubling time less than 9 months following radical prostatectomy.

Investigators evaluated intensified therapy on the backbone of ADT over a 52-week period in an effort to suppress PSA and enable longer treatment-free intervals, Aggarwal explains.

The top line interim analysis results for the primary end point of PSA progression-free survival (PFS) were presented at the 2022 ESMO Congress, Aggarwal continues. Patients treated in the 2 experimental arms featuring ADT plus apalutamide and ADT plus apalutamide, abiraterone, and prednisone experienced improved PSA PFS compared with patients who received ADT alone, Aggarwal concludes.