Given the superiority of ADT+enzalutamide over ADT alone demonstrated in the ARCHES and PROSPER trials, would you recommend it in the definitive setting for men with high-risk castrate-sensitive prostate cancer?

Topics: Radiation Oncology • Genitourinary Cancers

If so, would you give it concurrently with radiation and ADT or adjuvantly? Would you consider it in post-prostatectomy patients?

Answer from: Radiation Oncologist at Community Practice

The quick answer is: No.There is no level 1 evidence that next gen AR-signaling inhibitors (ASI) improve DMFS or OS in high risk localized prostate cancer. Multiple trials are ongoing or maturing in followup, nearly all in combination with RT.Given that most contemporary high risk studies show ~10% ...

Comments

Radiation Oncologist at Fort Belvoir Community Hospital
Dan, How would you define modest? ~30% absolu...

Radiation Oncologist at Case Western Reserve University/ University Hospitals Seidman Cancer Center
Jeremy- You need to remember that half of those p...

Radiation Oncologist at Fort Belvoir Community Hospital
Thanks Dan. Great info and insight. Although Id ...

Radiation Oncologist at Fort Belvoir Community Hospital
Oh, one additional point is that only about half o...

Answer from: Medical Oncologist at Community Practice

There is still some clinical heterogeneity in patients with high-risk prostate cancer, who are castration sensitive. Considering financial resource stewardship, it is imperative that we be circumspect with utilization of expensive therapies. This is especially true when there be whe...

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