Dr. Oh on Choosing AR-Targeted Therapy Versus Chemotherapy in mHSPC

William K. Oh, MD, chief, Division of Hematology and Medical Oncology, professor of medicine and urology, Mount Sinai Hospital, discusses factors to consider when choosing a treatment for patients with metastatic hormone-sensitive prostate cancer (mHSPC).

Abiraterone acetate (Zytiga) and apalutamide (Erleada) are approved for the treatment of men with mHSPC based on findings from the phase III LATITUDE and TITAN trials, respectively. Enzalutamide (Xtandi) is currently under review by the FDA for a supplemental new drug application in this indication based on data from the phase III ARCHES and ENZAMET trials.

Choosing the optimal agent is difficult without cross-study comparisons, explains Oh. Moreover, docetaxel is another option in this setting. As such, patient comorbidities, age, and personal preference should be taken into consideration, says Oh.

If patients opt for docetaxel, they can stop treatment after 6 cycles. Conversely, patients who receive AR-targeted therapy and androgen deprivation therapy, remain on treatment indefinitely, concludes Oh.