Click on the link below:
massgeneral.org/news/press-...
Published by Massachusetts General Hospital on Feb. 18, 2022.
Thanks.
Click on the link below:
massgeneral.org/news/press-...
Published by Massachusetts General Hospital on Feb. 18, 2022.
Thanks.
Once again it is proven that more treatments earlier are far superior to sequential treatments. Schwah.
Another triplet combo: ADT, Docetaxel chemotherapy plus Zytiga has also proven to extend life in the PEACE 1 trial.
They did not check if ADT+Daroluamide works just as well as ADT+Chemo+Darolutamide. I believe it is likely that you can omit the chemo.
Emit chemo when fully metastasized ?I think you meant under certain circumstances depending on Gleason, spread, etc. no ?
I am not against chemo! However, the triplet therapy is based on the PEACE-1 and Arasens trials which included de-novo metastatic hormone-sensitive patients. So it just applies to de-novo hormone-sensitive patients. Both trials did not test what results the "triplet therapy" without chemo would have. And I assume the added benefit of the chemo component is very small.
Dr. Eleni Efstathiou made a video presentation raising the question: is docetaxel still needed for hormone sensitive metastatic PCa? She expresses doubts that the chemo is beneficial in this situation.
high5oncology.tv/fileadmin/...
"Both trials did not test what results the "triplet therapy" without chemo would have."
That's true, but you can compare other trials and see the differences.
For example, CHAARTED showed a 57.6 month median overall survival for ADT plus Docetaxel. LATITUDE showed an median OS for ADT plus Zytiga of 53.3 months. ADT plus Docetaxel plus Zytiga in PEACE 1 showed a 5.7 year median overall survival. That's a significant improvement over any other combination so far.
onclive.com/view/adt-based-...
One should not compare different trials because the cohorts are different. However, it is often done.
I just expressed doubts that chemo is really needed in the "triplet therapy". There are a lot of reports now advertising the triplet therapy. However, Prof. Sator expressed doubts too. practiceupdate.com/content/...
Also, in the Enzamet trial ADT+Xtandi had better results regarding OS than ADT+chemo+Xtandi.
nejm.org/doi/full/10.1056/n...
nejm.org/doi/suppl/10.1056/...
So I still have my doubts.
I had cited Prof. Sator regarding the PEACE-1 trial. He also questions the chemo component in the Arasens trial. He mentions that the STAMPEDE trial showed very similar results for ADT+Abiraterone compared with the Arasens trial with ADT+chemo+Darolutamide.
practiceupdate.com/C/133110...
I think LATITUDE VS PEACE 1 is a better "apples to apples" comparison. It's the same drugs with or without chemotherapy.
I thought the literature said that Daroluamide was only for NON-METASTASIZED PC. Thoughts?
Recently the Arasens trial was published which tested Darolutamide+chemo+ADT in metastatic hormone sensitive patients.
If my addled brain is correct, the result can be restated as:
At 3.5 years, 49% of controls (318) had died & 33% of triplet-therapy men (215) had died.
Schwah says "far superior".
I wonder how many other drugs must be added to the trio before most men survive 3.5 years?
-Patrick
Ask the 103 men that would have been dead (318-215=103) if it was far superior. It’s an ugly disease and improvements are incremental. But if that were the treatment protocol (vs the placebo) for say 300,000 men, an extra 100,000 men would be alive at 3.5 years. In the stampede and Latitude trials the difference was 40% more alive for those that did the Zytega and ADT bs ADT alone. The point being that many oncologists had been going by the theory that you use one treatment until it failed and then on to the next. The idea being to “save treatments”for the future and not use them up to quickly. Numerous studies now have proven that approach leaves more PC Patients dead sooner. Do you not agree with that?
Schwah
The sequential approach is mathematical nonsense, of course, but I think it goes back to the time when one was on ADT for 18-24 months, with lackluster Taxotere in reserve. No triplet option. Then Casodex happened, of course, but still not a lot of interest in throwing everything at it, with nothing at all left after the inevitable failure.
In a study such as this, results have to be published before all of the men in the study are dead - I understand why. But we don't know how the survival curves look for those who survived the first 3.5 years.
An extra 16% of the cohort made it past 3.5 years - the glass half full (you).
33% of the cohort were dead within 3.5 years - the glass half empty (me).
-Patrick
Lol. Interesting points. Think positive my friend.