Embark Phase 3 clinical trial

[chefjlu]

Came across this today --- health.harvard.edu/blog/aft...

[Researcher50]

Think Maxone had posted this also, but my question now would be whether apalutamide would be better than enzalutamide in this setting as it has been shown to have greater efficiency?

[MoonRocket in reply to Researcher50]

Hmmm can you clarify what you mean by greater efficiency? I think the 2nd generation "mides" all perform equally. There hasn't been, and probably won't be, a head to head but looking at study results of the approving trials indicates results would be similar. Enzalutimide, being the oldest of the three has been studied more and will be coming off patent before the other two. I'm very interested in the EPI-7386 trials with enzalutimide. So far, looks very promising and is moving to Stage 2.

[Researcher50 in reply to MoonRocket]

I googled a comparison between the two and this is what came up. pubmed.ncbi.nlm.nih.gov/370...

[MoonRocket in reply to Researcher50]

Interesting retrospective Study. Based on the conclusion, was the PSA90 the focus of the study? It also suffers from selection bias, while, it stats it attempted to adjust, there is still a bias based on the pool to select from.

[billfenley2 in reply to Researcher50]

Sorry if this is not appropriate here, but the Embark 3 study was with non-metastatic patients (supposedly) and this comparison is with metastatic patients.

[Researcher50 in reply to billfenley2]

The devil is in the details! Thank you! I was trying to extrapolate a bit. The Embark study says "The investigators already knew from earlier studies that enzalutamide delays further progression and lengthens survival for men with metastatic prostate cancer", which is what lead them to try it earlier in a BCR setting. So my thought was if enzalutamide worked well in this setting, then perhaps apalutamide might be even more effective based on the comparison of the two. No studies, just wondering if that might make sense.

[billfenley2 in reply to Researcher50]

Good thoughts, Researcher. A couple of months ago I was talking about this with my MO, Andy Armstrong (Duke). Xtandi hadn't been FDA approved for this use yet (it was so approved in November) so I asked him about Erleada, but he was dismissive of it for this use, at least in terms of its credentials compared to the gold-plated Embark trial endorsing Xtandi.

[Survivor86]

Thanks Chef! The Embark 3 study offers great hope for many of us who follow this forum—the perfect gift this holiday season. Wishing you all the best in the New Year!