What’s being presented at ASCO this year: I

So here are some links to some initial key papers to be presented at ASCO this year. These four papers all address important issues affecting the treatment of metastatic and later stages of prostate cancer.

  • We already knew that the presence of the androgen receptor splice variant-7 (AR-V7) was an indicator that patients would not respond well to treatment with enzalutamide. In another paper from Antonarakis et al. at Johns Hopkins (see abstract no. 5001), the research team now reports that the presence of AR-V7 appears to makes patients non-responsive to abiraterone acetate and to enzalutamide. The authors note that “AR-V7 status may be used as a biomarker to predict resistance to AR-targeting agents, facilitate treatment selection, and fuel the development AR N-terminal domain inhibitors.”
  • Halabi et al. (see abstract no. 5002) have used data from a meta-analysis of five large, randomized, Phase III clinical trials to confirm earlier reports from smaller studies indicating that the sites of metastasis among patients with metastatic, castration-resistant prostate cancer (mCRPC) are predictive for overall survival. Unsurprisingly, they confirm that mCRPC patients with liver metastases had the worst overall survival (12.1 months); men with with lung metastases had better overall survival (16.5 months) compared to the patients with liver metastases but significantly worse survival than men with non-visceral bone metastases (20 months).
  • Data from the CHAARTED study, comparing androgen deprivation therapy (ADT) alone to ADT + docetaxel-based chemotherapy in newly diagnosed patients with metastatic prostate cancer, will indeed be presented by Sweeney et al. on Sunday, June 1, but there will be no access to the abstract (abstract no. LBA2) until early that morning, so for the time being we are still limited to what we were told in the original media release issued late last year
  • Efstathiou et al. report data from a small (60-patient) study (see abstract no. 5000) showing that it is possible to give abiraterone acetate and enzalutamide simultaneously to selected patients with progressive mCRPC with metastasis to bone and a castrate serum testosterone level of ≤ 50 ng/dl. At the time of the submission of the abstract, the authors report PSA changes for 49 patients, with a maximum PSA decline ≥ 50 percent in 37/49 men (76 percent); a maximum PSA decline of ≥ 90 percent in 22/49 men (45 percent); and absolute PSA level ≤ 0.1 ng/ml  in 5/49 men (10 percent); and PSA progression  in 6/49 men (12 percent). The authors also report the following Grade 3 adverse events: elevated alanine transaminase (ALT) levels (n = 5), hypertension (n = 5), elevated alkaline phosphatase (ALP) levels (n = 4), arthralgia (n = 3), and bone pain (n = 2). There were no evident Grade 4 adverse events.

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