Dr. Kohli on Drugs That Have Been Evaluated in mCRPC

Manish Kohli, MD, vice chair, Department of Genitourinary Oncology, Moffitt Cancer Center, discusses drugs that have been evaluated in metastatic castration-resistant prostate cancer (mCRPC).

Several single agents have been shown to have an overall survival benefit in patients with mCRPC; however, combination approaches have yet to show the same benefit, says Kohli.

For example, radium-223 dichloride (Xofigo) was combined with abiraterone acetate (Zytiga) and prednisone in the phase III ERA 223 trial. However, the combination failed to demonstrate a delay in skeletal-related complications versus abiraterone acetate/prednisone and placebo. As such, radiotherapy remains the current standard of care for pain palliation in the presence of a fracture or spinal cord compression, explains Kohli.

Additionally, data from the phase III ALLIANCE A031201 trial were presented at the 2019 ASCO Annual Meeting. Patients with progressive mCRPC were randomized to receive either the combination of enzalutamide (Xtandi) and abiraterone or enzalutamide alone. However, the combination failed to show synergistic activity, concludes Kohli.