What’s in the news from ASCO this year?

So there is no “revolutionary news” in relation to prostate cancer being presented at the annual meeting of the American Society of Medical Oncology (ASCO) in Chicago this year: no results of major phase III trials and no other critical new data that is likely to change physicians’ current practices when they get back home to their clinics.

On the other hand, there is an enormous amount of new and evolving information that hold promise for the future. Here is a summary of just some of what we have learned over the past couple of days:

  • African-American patients being treated for metastatic prostate cancer often seem to do better, on average, than Caucasian and Hispanic patients. Why? We don’t yet know, but this does appear to be the case overall and specifically with respect to treatment with abiraterone. (This had previously been suggested in regard to response to sipuleucel-T as well.)
  • Promising data on the future potential of leutetium-177 PSMA in the treatment of advanced and late-stage prostate cancer continues to accumulate — but we are going to have to wait to find out how it performs in late stage trials.
  • The PD-1 inhibitors — products like pembrolizumab/Keytruda and nivolumab/Opdivo — don’t (at least as yet) seem to be showing the same levels of potential in the treatment of prostate cancer as they have been showing in the treatment of melanoma and lung cancer and some other types of cancer. However, there is an exception to that general rule which is that they do seem to be beneficial in men with what is known as MSI-H-positive prostate cancer. (MSI-H stands for microsatellite instability high.) It should be noted, however, that there are an enormous number of trials of the PD-1 inhibitors and the PD-L1 inhibitors ongoing.
  • We are continuing to accumulate data on how, when, and why some patients with castration-resistant prostate cancer (CRPC) will respond better to one type of drug therapy that another, depending on their specific genetic make-up and other clinical factors.
  • On a less positive front, we have heard little new information about the potential of CAR-T therapy in the treatment of late stage prostate cancer — and we had been hoping to hear some preliminary, promising data by now, but it isn’t forthcoming as yet.

Information presented at the annual meeting of the American Society for Clinical Oncology (ASCO) is obviously largely focused on later stages of prostate cancer that are treated by medical oncologists as opposed to urologists and radiation oncologists, so there is a lot of information about new and ongoing clinical trials, such as — for example — the Genentech-sponsored trial known as IPATential150, which is a randomized, multicenter, placebo-controlled, Phase III trial in which ipatasertib + abiraterone + prednisone or prednisolone is being compared to a placebo + abiraterone + prednisone or prednisolone in 850 men with metastatic castration-resistant prostate cancer (mCRPC). For more information about ipatasertib, please click here. This trial is currently scheduled to report primary results some time in 2020 or 2021 but may not report final results until 2023.

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