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GU Cancers 2026 | EMBARK: long-term remissions with hormonal therapy in prostate cancer

Neal Shore, MD, FACS, Carolina Urologic Research Center, Myrtle Beach, SC, highlights a post hoc analysis of the EMBARK trial (NCT02319837) evaluating sustained prostate-specific antigen suppression after treatment suspension in men with high-risk biochemical recurrence. Patients received enzalutamide plus leuprolide, leuprolide alone, or enzalutamide monotherapy. Treatment was suspended after nine months if prostate-specific antigen was low. Results indicated that a small proportion of patients, particularly those receiving the combination therapy, maintained deep prostate-specific antigen responses despite testosterone recovery years later, suggesting potential long-term remissions with finite hormonal therapy. This interview took place at the 2026 ASCO GU Cancers Symposium in San Francisco, CA.

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Transcript

So we’re very proud of the results of the EMBARK analysis, a 10-plus year study looking at patients with high-risk BCR, post-RP, RRP, or both. And what we presented as a poster at ASCO GU this year was the patients who had PSAs of less than 0.2, and particularly those patients and the durability of how long they could remain off therapy. So a treatment interruption was what some folks would call a holiday...

So we’re very proud of the results of the EMBARK analysis, a 10-plus year study looking at patients with high-risk BCR, post-RP, RRP, or both. And what we presented as a poster at ASCO GU this year was the patients who had PSAs of less than 0.2, and particularly those patients and the durability of how long they could remain off therapy. So a treatment interruption was what some folks would call a holiday. And about 1 in 25 patients had greater than a two-year experience in the combination arm, which is not insignificant that patients can enjoy that level of a PSA declination and getting back to eugonadal levels of testosterone. So the added quality of life benefits that one would imagine with that. We saw lower percentages in the single-digit percentage with monotherapy ADT as well as with the monotherapy ARPI. But yet there were patients at one year, low single digit percentages, those become less. But we do find these patients who have sort of a super responder effect or outcome that can last not just one year, but sometimes two and three years. So it’s clearly a smaller subset of patients, but I think when you have those patients, it’s quite an impressive thing to observe.

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