Evaluation of Trends in Treatment of Metastatic Hormone Sensitive Prostate Cancer (mHSPC) Across Canada During the COVID-19 Pandemic

Stecca, Carlos; Jiang, Di Maria; Veitch, Zachary; Hotte, Sébastien J.; Alimohamed, Nimira; Wood, Lori; Sridhar, Srikala S.

doi:10.1016/j.clgc.2022.11.020

Cited by 3 publications

(2 citation statements)

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“…Enzalutamide should be avoided in patients with a previous history of seizures and can cause neurological side effects including fatigue and a higher risk of falls. Overall, ADT + ARPI is the most commonly used regimen for mCSPC, given its tolerability compared to chemotherapy [ 26 , 27 , 28 ].…”

Section: Evolution Of Systemic Therapy Of Mcspc Prior To Triplet Therapymentioning

confidence: 99%

“…Although level I evidence supports triplet therapy in mCSPC with the addition of ARPI to a backbone of ADT + docetaxel, the most controversial question surrounds the magnitude of survival benefit gained by adding docetaxel to a backbone of ADT + ARPI [ 26 , 27 , 28 ]. Until a trial is completed on a backbone of ADT + ARPI and randomizing patients to docetaxel, clinicians will need to decide whether they offer triplet therapy instead of ADT + ARPI without level I evidence of benefit, and to which patients.…”

Section: Putting the Evidence Into Perspectivementioning

confidence: 99%

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Triplet Therapy in Metastatic Castrate Sensitive Prostate Cancer (mCSPC)—A Potential New Standard of Care

et al. 2023

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The treatment paradigm for metastatic castrate-sensitive prostate cancer (mCSPC) has evolved rapidly in the past decade with the approval of several life-prolonging therapies including docetaxel chemotherapy and multiple androgen receptor pathway inhibitors (ARPI) in combination with androgen deprivation therapy (ADT). Recently reported phase-three trials have demonstrated a survival benefit of upfront triplet therapy with ADT, docetaxel plus either abiraterone acetate or darolutamide when compared to ADT plus docetaxel alone. However, multiple questions including the incremental benefit of docetaxel to a combination of ADT and ARPI, the timing of ARPI, optimal patient selection for triplet therapy and clinical and genomic biomarkers still remain to be answered. Moreover, real-world data suggest suboptimal treatment intensification with many patients treated with ADT alone highlighting challenges in implementation. In this article, we review the phase-three data associated with triplet therapy in mCSPC. We also discuss the knowledge gaps that exist despite the completion of these studies and how ongoing studies are likely to change the paradigm in the near future. Finally, we provide a simple algorithm based on current data that clinicians can use in daily practice to select patients for appropriate treatment strategies.

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Section: Evolution Of Systemic Therapy Of Mcspc Prior To Triplet Therapymentioning

confidence: 99%