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Combination Androgen Receptor Inhibition and Docetaxel in Metastatic Castration-sensitive Prostate Cancer: The Next Step in First-line Treatment?

      Abstract

      The addition of docetaxel and abiraterone to androgen deprivation therapy (ADT) heralded a new era in the first-line treatment of metastatic castration-sensitive prostate cancer (mCSPC). Following the success of these combination regimens, 3 new trials presented data on using enzalutamide or apalutamide in men with mCSPC, which showed similar success. These seminal trials collectively established the addition of docetaxel, enzalutamide, apalutamide, or abiraterone to ADT as standards in the upfront treatment of mCSPC. Notably, a subset of patients in these more recent trials were treated with a combination of docetaxel, ADT, and androgen receptor signaling inhibitors or maintenance androgen receptor signaling inhibitors after docetaxel and ADT that provided an initial glimpse into the efficacy of these triplet or maintenance strategies. We discuss the implications of these recent findings and place them in context of the current mCSPC treatment landscape.

      Keywords

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      References

        • Sweeney C.J.
        • Chen Y.H.
        • Carducci M.
        • et al.
        Chemohormonal therapy in metastatic hormone-sensitive prostate cancer.
        N Engl J Med. 2015; 373: 737-746
        • James N.D.
        • Sydes M.R.
        • Clarke N.W.
        • et al.
        • STAMPEDE investigators
        Addition of docetaxel, zoledronic acid, or both to first-line long-term hormone therapy in prostate cancer (STAMPEDE): survival results from an adaptive, multiarm, multistage, platform randomised controlled trial.
        Lancet. 2016; 387: 1163-1177
        • Mohler J.L.
        • Antonarakis E.S.
        • Armstrong A.J.
        • et al.
        Prostate cancer, version 2.2019, NCCN clinical practice guidelines in oncology.
        J Natl Compr Canc Netw. 2019; 17: 479-505
        • Fizazi K.
        • Tran N.
        • Fein L.
        • et al.
        • LATITUDE Investigators
        Abiraterone plus prednisone in metastatic, castration-sensitive prostate cancer.
        N Engl J Med. 2017; 377: 352-360
        • James N.D.
        • de Bono J.S.
        • Spears M.R.
        • et al.
        • STAMPEDE Investigators
        Abiraterone for prostate cancer not previously treated with hormone therapy.
        N Engl J Med. 2017; 377: 338-351
        • Kyriakopoulos C.E.
        • Chen Y.H.
        • Carducci M.A.
        • et al.
        Chemohormonal therapy in metastatic hormone-sensitive prostate cancer: long-term survival analysis of the randomized phase III E3805 CHAARTED trial.
        J Clin Oncol. 2018; 36: 1080-1087
        • Armstrong A.J.
        • Szmulewitz R.Z.
        • Petrylak D.P.
        • et al.
        ARCHES: a randomized, phase III study of androgen deprivation therapy with enzalutamide or placebo in men with metastatic hormone-sensitive prostate cancer.
        J Clin Oncol. 2019; 37: 2974-2986
        • Chi K.N.
        • Agarwal N.
        • Bjartell A.
        • et al.
        • TITAN Investigators
        Apalutamide for metastatic, castration-sensitive prostate cancer.
        N Engl J Med. 2019; 381: 13-24
        • Davis I.D.
        • Martin A.J.
        • Stockler M.R.
        • et al.
        • ENZAMET Trial Investigators and the Australian and New Zealand Urogenital and Prostate Cancer Trials Group
        Enzalutamide with standard first-line therapy in metastatic prostate cancer.
        N Engl J Med. 2019; 381: 121-131
        • Bevers T.B.
        • Helvie M.
        • Bonaccio E.
        • et al.
        Breast cancer screening and diagnosis, Version 3.2018, NCCN Clinical Practice Guidelines in Oncology.
        J Natl Compr Canc Netw. 2018; 16: 1362-1389
        • Pritchard K.I.
        Combining endocrine agents with chemotherapy: which patients and what sequence?.
        Cancer. 2008; 112: 718-722
        • Sutherland S.
        • Miles D.
        • Makris A.
        Use of maintenance endocrine therapy after chemotherapy in metastatic breast cancer.
        Eur J Cancer. 2016; 69: 216-222
        • Parker C.C.
        • James N.D.
        • Brawley C.D.
        • et al.
        • Systemic Therapy for Advanced or Metastatic Prostate cancer: Evaluation of Drug Efficacy (STAMPEDE) investigators
        Radiotherapy to the primary tumour for newly diagnosed, metastatic prostate cancer (STAMPEDE): a randomised controlled phase 3 trial.
        Lancet. 2018; 392: 2353-2366