Dr. Hussain on the Need for Effective Treatment in Nonmetastatic CRPC

Maha Hussain, MD, FACP, FASCO, Genevieve E. Teuton Professor of Medicine in the Division of Hematology and Oncology, Department of Medicine, and Deputy Director of the Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, discusses the need for treatment that elicits an overall survival benefit in patients with nonmetastatic castration-resistant prostate cancer (CRPC).

Men with nonmetastatic CRPC are a distinct group of patients. These patients have micrometastases that may not be visible on conventional imaging, says Hussain. 

Over time, these patients will develop metastatic disease. Notably, patients with micrometastatic disease are more likely to develop metastatic disease if the cancer is associated with a short prostate-specific antigen doubling time, Hussain explains.

Until 2018, limited treatment options​ were available to these patients, ​says Hussain. Such agents included antiandrogens and steroids.

However, these options were not associated with prolonged survival. The phase 3 PROSPER trial evaluated the efficacy of enzalutamide (Xtandi) in patients with nonmetastatic CRPC. 

Enzalutamide was approved in July 2018 for the treatment of men with nonmetastatic CRPC based on findings from the PROSPER study.