Prostate Cancer

Treatment Recommendations Upon Metastasis in CRPC

I think one of the most important advancements in biomedical technology that has improved our understanding of the complexities of cancer is the ability to sequence the cancer genome for any individual patient, in a rapid and cost-effective manner, to help us make treatment decisions in the clinic.

Groundbreaking developments in cancer therapies can change lives, extending survival and sending patients who previously thought their chances were slim into remission. But these therapies come at a cost, and many patients reel at the prospect of heavy financial burdens. To help patients and programs meet the challenges of affording cancer treatments, community cancer centers are expanding the role of financial advocates in their organizations.

Thomas A. Gallo, MS, MDA, president of the Association of Community Cancer Centers, discusses his mission as president to “reflect, renew, and reignite” in order to create a more resilient oncology team for the community.

Among men in the ongoing phase II TRITON2 trial with BRCA1/2 alterations, 51% had a confirmed prostate-specific antigen response to rucaparib (Rubraca), according to preliminary data reported in a poster presentation by Wassim Abida, MD, PhD, and colleagues at the 2018 ESMO Congress.

Larotrectinib induced an objective response rate of 80% in patients with advanced solid tumors who harbored&nbsp;<em>NTRK&nbsp;</em>gene fusions, according to results pooled from 3 small trials of the TRK inhibitor. Results were presented during the 2018 ESMO Congress.

According to a presentation from the ERA 223 trial atthe 2018 ESMO Congress, no improvements in survival endpoints were seen with the addition of radium-223 dichloride to abiraterone acetate and prednisone in patients with metastatic castration-resistant prostate cancer.

Rising prescription drug prices continue to add to the burden of paying for quality healthcare. In an effort to confront such costs, the Centers for Medicare &amp; Medicaid Services has rescinded a prohibition on step therapy for Medicare Advantage plans. But some contend such a policy will reduce patient access to optimal medication.

Rucaparib (Rubraca) has received a breakthrough therapy designation from the FDA&nbsp;for single-agent use in adult patients with <em>BRCA1/2</em>-positive metastatic castration-resistant prostate cancer following at least 1 androgen receptor&ndash;directed therapy and taxane-based chemotherapy.

Patients with the localized form of CRPC still have no options that are proven to extend overall survival, but preliminary results from the PROSPER trial of enzalutamide and the SPARTAN trial of apalutamide offer them unprecedented hope.

Susan Halabi, PhD, discusses an analysis that found&nbsp;that the risk of death from&nbsp;metastatic castration-resistant prostate cancer was nearly 20% lower in African-American men than in Caucasian men.

Olaparib in combination with abiraterone acetate improved progression-free survival compared with the antiandrogen agent alone in patients with metastatic castration-resistant prostate cancer, according to findings from a phase II trial presented at the 2018 ASCO Annual Meeting.&nbsp;The results of the trial were also published the same day in Lancet Oncology.

According to Pfizer and Astellas, the codevelopers of&nbsp;enzalutamide (Xtandi), the agent has been approved by the FDA for treatment of patients with nonmetastatic castration-resistant prostate cancer.