Prostate cancer: Timing of ARSI and taxanes in mCSPC

Dr. Tanya Dorff, a Medical Oncologist from the City of Hope Comprehensive Cancer Center and Dr. Neal Shore, Uro-Oncologist and Chief Medical Officer for Genesis Care and Urology and Surgical Oncology in the United States discuss ‘Timing of ARSI and taxanes for mCSPC’ in this GU CONNECT podcast. In this podcast, the experts reflect on how the treatment landscape for mCSPC has evolved over the past 7 years resulting in treatment intensification with ADT plus docetaxel following the CHAARTED and STAMPEDE studies and then more recently the use of ADT and androgen receptor inhibitors including abiraterone (LATITUDE, STAMPEDE), apalutamide (TITAN), and enzalutamide (ARCHES, ENZAMET).  This has further evolved with the recent reporting of the PEACE 1 and ARASENS trials which demonstrated a survival benefit with triplet therapy with abiraterone and darolutamide respectively, being used in combination with ADT and docetaxel. The experts discuss the importance of balancing benefit against risk for their mCSPC patients but state that the triplet therapies appear to be well tolerated in both the PEACE 1 and ARASENS trials. They provide their views, Neal as a urologist and Tanya as a medical oncologist, on the things to consider when making treatment decisions for these patients such as comorbidities, age, performance status, de novo versus recurrent disease, amongst others. They finish by concluding that treatment intensification should be implemented as standard of care for mCSPC patients to enable patients to have as many treatments with different mechanisms of action as early as possible in their treatment journey. 

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