Is the Triplet Regimen Standard of Care for Metastatic Castrate-Sensitive Prostate Cancer?
PracticeUpdate: The PEACE-1 trial has made a lot of news from this year's ASCO. How do you view the data that was presented?
Dr. Sartor: PEACE-1 is a potentially important trial that looks at the metastatic hormone-sensitive prostate cancer population and uses ADT, radiation to the prostate, and abiraterone. And there are four different arms. So what they've reported care is not a survival analysis, but Dr. Fizazi reported a radiographic progression-free survival. Now, one of the things about this particular regimen, as it turned out, the data started to be collected in the pre-taxane era, and subsequently the use of ADT-docetaxel was layered in. That being said, we look at ADT-docetaxel and no docetaxel in different subsets, and unequivocally the addition of abiraterone makes a huge difference. The data at this point with radiation to the prostate is not clear.
PracticeUpdate: The presented data did show a strong improvement in the risk of radiographic progression. How should that inform clinical practice?
Dr. Sartor: Even though PEACE-1 shows a strong RPFS benefit in patients with ADT-docetaxel treated with abiraterone, as opposed to no abiraterone. We do not have data to show that docetaxel adds further value to those patients being treated with ADT plus abiraterone. So abiraterone can add to the effects of ADT-docetaxel, but we don't know if docetaxel adds to the benefit of ADT plus abiraterone. For me, even though this is an important trial, I'm not ready to endorse the use of triplet therapy, triplets meaning ADT, abiraterone, and docetaxel, as a standard of care because we still have important questions to answer. And particularly the important question is, does docetaxel add value to those patients treated with ADT-abiraterone? We need more data.
Click on any of these tags to subscribe to Topic Alerts. Once subscribed, you can get a single, daily email any time PracticeUpdate publishes content on the topics that interest you.
Visit your Preferences and Settings section to Manage All Topic Alerts
Additional Info
Disclosure statements are available on the authors' profiles:
Advanced Prostate Cancer Center of Excellence
Visit our Advanced Prostate Cancer Center of Excellence for additional, in-depth coverage.