Therapy for Non-metastatic Castration-Resistant Prostate Cancer

William K. Oh, MD

Disclosures

June 26, 2020

Non-metastatic castration-resistant prostate cancer (nmCRPC) is seen in only about 4%-7% of prostate cancer patients but has been the subject of much research activity over the past few years.

In this ReCAP, Dr William K. Oh reports on three pivotal trials — SPARTAN, PROSPER and ARAMIS — that use metastasis-free survival (MFS) as their novel primary endpoint. All three trials compared a nonsteroidal antiandrogen (NSAA) agent with placebo. Their results showed consistent and significant improvement in MFS.

At the 2020 ASCO Virtual Meeting, updates were presented on all three trials. Data across the studies showed a statistically significant reduction, ranging from 22% to 31%, in the risk for death, which translated to a 10- to 15-month improvement in survival.

Imaging advances in the form of prostate-specific membrane antigen (PSMA) PET scans are also changing the nmCRPC space. These images can detect small volumes of disease, which will clarify our understanding of "non-metastatic."

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