Triplet Therapy for HSPC

[treedown]

This article came over on the Prostate Cancer Newletter.

onclive.com/view/dr-sharma-...

I am unsure based on lack of detail and to a smaller extent a comment by TA if the use of Triplet Therapy in these trials applies only to newly diagnosed or also to those with recurrence.

The NCCN guideline seems to suggest both but I would not argue that in court.

[MoonRocket]

I feel bad that this post is being ignored....thanksTreedown.

[Tall_Allen in reply to MoonRocket]

Probably because it is already SOC for more than a year.

[MoonRocket in reply to Tall_Allen]

He's a little slow... 🐢

[Tall_Allen]

This article is only about the trials in those newly diagnosed (not recurrence) with distant metastases (PEACE1 and ARASENS).

Here's more detail:

prostatecancer.news/2022/10...

[treedown in reply to Tall_Allen]

Thanks, I suspect you made Moonrocket happy

[MoonRocket in reply to treedown]

I'm all 😊😊😊😊😊😊

[treedown in reply to Tall_Allen]

If you follow NCCN you'll see from page PROS-11 (RADIATION THERAPY RECURRENCE) flows to PROS-12 (SYSTEMIC THERAPY FOR CASTRATION-SENSITIVE PROSTATE CANCER) in which case it would be saying it is SOC for recurrence as well.

NCCN PROS-12

[Tall_Allen in reply to treedown]

Recurrence after RP is on PROS-10. Recurrence after RT is on PROS-11. The recommended therapies do NOT include triplet.

[Gatun]

I was just sent this article on using ivermectin for prostate cancer but haven't researched it further so might want to ask your doctor and follow up with more research. rwmalonemd.substack.com/cp/...

Very best.

.

[Purple-Bike]

It´s not prominently shown in ARASENS, but the trial does include recurrent mHSPCa.

Figure 1A above in the supplemental version shows that 117 patients are recurrent (58 in the Daralutamide + ADT + Docetaxel group, 59 in the placebo + ADT+ Docetaxel group). HR for adding Daralutamide is 0.695 in line with the much larger groups with de novo disease, however with a large confidence interval given the small number - it is suggestive that adding daralutamide is of benefit. .

From the main text: "The effect of darolutamide treatment on OS across prespecified subgroups, including de novo and recurrent disease, was favorable across all subgroups of patients with high-volume and almost all subgroups with low-volume disease"

I

117 recurrent patients HR 0.695 but large confidence interval

[treedown in reply to Purple-Bike]

Thank you! That's what I was looking for, but have never seen or searched for the actual trial data. I was just curious why it appears in the guidelines.