With apologies to HopingForTheBest1 who started the thread:
STAMPEDE Will 'Change Practice' in High-Risk Prostate Cancer— Trial showed adding abi to ADT improved metastasis-free and overall survival
here is an excellent presentation by Nick James, who headed-up the study. I post this separately because it may have broader appeal:
youtube.com/watch?v=uU5yACT...
-Patrick
Nice. I looked at the research and biology and when I did estrogen patch ADT in 2019 I convinced my MO to prescribe AA/P.
My MO prescribed this in July 2019 when my RP failed. Im getting don the 2 years zytiga and 27 months of ADT Oct 14th.
I think, based on postings on this site, this enhance treatment is already accepted in the US.
US patients should understand that this will seldom apply to them. It is very rare in the US for patients to initially present with these risk characteristics, and only 3% were recurrent patients.
I posted this separately because James talks about the other intervention studies that are in the pipeline.
Well, say someone is recurrent and found to be N1 (pelvic lymph nodes only) andM0 ( no other mets on scans. The N1 makes them high risk by these criteria. So if they are to undergo salvage RT including
PLN fields together with two years of ADT. Then it would appear To be a very good idea to do two years of AbI/p along with it. Even before such time that this might be separately tested in recurrent patients. Why would one not especially with limited additional toxicity as was found.
Only 3% of their trial was recurrent. You can't use it to guide therapy decisions one way or another. There are other clinical trials you can use, just not STAMPEDE.
But presumably a much higher percentage of patients pass through MO before getting metastases. If they can be diagnosed early enough and treated as per STAMPEDE, then much misery could be prevented.
It's not just M0. The STAMPEDE population is a risk class seldom seen in actual practice in the US.
Could you explain why this would be rare in the US? I am trying to understand the difference in treatments between countries. Thanks.
In the UK, men are not screened with PSA as often as in the US. It is very rare in the US to see initial presentation with no distant metastases but with either pelvic lymph node metastases (N1) or with two of: Stage T3/4 (physician detected), PSA≥40, GS8-10
This might be the risk characteristics for the trial, but are there any reasons why this treatment would not benefit other patients. Why not patients with PSA less than 40? By the time their PSA reaches 40. They might well have metastases. Is it to reduce costs?
The trial ONLY applies to the kind of patients in the trial. You can always conjecture about other patient populations, but that is just pure conjecture until proved in a clinical trial In fact, there are certainly other clinical trials that show the benefit of abi in other patient populations.
If you want comments, please start a new thread rather than hijack this one.
Will do , thanks for the heads up
My hubby was on this in December 2015 sadly I lost him in January 2019
Sad news regarding the passing of Nick Lozano-Aquino (Nicnatno).
Interesting PSA progression on STAMPEDE Zytiga (Abiraterone) trial.
Shawty got low, low, low, & the Beat goes On. PSA update!
Dutasteride increases PSA Doubling Time after PSA Recurrence
Raising PSA with 6 months of RALP
