Dr. Agarwal on Treatment for Newly Diagnosed Prostate Cancer

Neeraj Agarwal, MD, associate professor, Division of Oncology, Department of Medicine, University of Utah School of Medicine, Huntsman Cancer Institute, discusses treatment options for patients with newly diagnosed prostate cancer.

Until recently, men with newly diagnosed prostate cancer were treated with continuous androgen deprivation therapy (ADT), based on the data from SWOG 9346 trial, explains Agarwal. This trial showed that intermittent ADT was inferior to continuous ADT.

This was transformed by data from the CHAARTED trial, which tested chemotherapy with docetaxel upfront for 6 cycles and showed significantly improved overall survival benefit, says Agarwal. STAMPEDE trial data investigated the combination of ADT with docetaxel showing significantly improved survival outcomes compared to ADT alone.

At ASCO 2017, the STAMPEDE and LATITUDE trials both showed that the addition of abiraterone acetate (Zytiga) with prednisone or prednisone alone, improves outcomes in these patients. The hazard ratio was 0.62, favoring the combination arm, and there was a 40% reduction in the risk of death.