Prostate Cancer — An Interview with Prof Karim Fizazi (Companion Faculty Lecture) Video
Research To Practice | Oncology VideosSummary
Recent findings from the ASCO 2026 meeting reveal significant advancements in the treatment of prostate cancer, particularly regarding high-risk localized cases and metastatic hormone-sensitive disease. A major focus was the presentation of a randomized phase 3 trial that evaluated the efficacy of combining androgen deprivation therapy with apalutamide, an androgen receptor pathway inhibitor, prior to and following surgery. While the trial demonstrated a 20% reduction in the risk of metastasis or death using advanced imaging techniques, results from conventional imaging did not show a statistically significant improvement, leading to ongoing debates about the trial's overall impact on treatment protocols.
In addition to this trial, the EMBARK trial established the standard of care for patients with biochemical failure after local treatment, showing improved overall survival with the use of enzalutamide alongside ADT. New data from the PSM edition trial indicated that adding lutetium PSMA to standard treatment also prolongs radiographic progression-free survival across various patient subgroups. Furthermore, the Talapro3 trial highlighted the benefits of using a PARP inhibitor in patients with specific genetic alterations, suggesting a move towards more personalized treatment approaches.
Emerging therapies such as the new PARP inhibitor Saruparib and the actinium PSMA treatment are under investigation, with early results showing promise in terms of efficacy and safety. The A-DREAM trial explored the potential of intermittent treatment strategies for exceptional responders, indicating that a significant percentage of patients could maintain treatment-free periods without disease progression. As research continues, the landscape of prostate cancer treatment is evolving, emphasizing the importance of genetic profiling and tailored therapies to enhance patient outcomes.
Show Notes
Featuring a slide presentation and related discussion from Prof Karim Fizazi, including the following topics: PROTEUS Phase III trial evaluating the addition of apalutamide to standard therapy in high-risk localized prostate cancer (0:00) Time to testosterone recovery during treatment suspension in the Phase III EMBARK trial of enzalutamide and leuprolide in nonmetastatic prostate cancer (5:05) Radiographic progression-free survival subgroup analysis in the PSMAddition Phase III trial of 177Lu-PSMA-617 in metastatic hormone-sensitive prostate cancer (6:58) TALAPRO-3: Efficacy of talazoparib and enzalutamide in metastatic hormone-sensitive prostate cancer harboring homologous recombination repair gene alterations (8:16) Phase I/II PETRANHA study of novel PARP inhibitor saruparib in metastatic hormone-sensitive prostate cancer (10:52) Phase II A-DREAM trial of androgen deprivation therapy interruption in patients with metastatic hormone-sensitive prostate cancer responding to androgen receptor pathway inhibitor (13:23) Overall survival by duration of enzalutamide treatment received in the Phase III ARCHES trial (15:21) Efficacy of capivasertib and abiraterone in the Phase III CAPItello-281 trial for patients with PTEN-deficient metastatic hormone-sensitive prostate cancer (16:24) Phase I AcTION study of 225Ac-PSMA-617 in patients with metastatic castration-resistant prostate cancer (mCRPC) with or without prior 177Lu-PSMA radioligand therapy (18:16) Phase III PSMAfore trial of 177Lu-PSMA-617 in progressive mCRPC; ongoing Phase III trials of radioligands in mCRPC (19:54) Ongoing Phase III OMAHA-004 trial of CYP11 inhibitor opevesostat versus next-generation hormonal agent switch in patients with mCRPC and 1 prior next-generation hormonal agent (23:14) CME information and select publications
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