ESMO 2021 | First-line treatments for patients with mHSPC and mCRPC

Richard Cathomas, MD, PhD, Hospital Graubünden, Chur, Switzerland, talks on treatment strategies for patients with hormone-sensitive metastatic prostate cancer (mHSPC) and castration-resistant metastatic prostate cancer (mCRPC). Recent data from the ARCHES trial (NCT02677896) has shown that the optimal strategy for patients with mHSPC is androgen deprivation therapy (ADT) plus a novel hormonal agent including abiraterone, enzalutamide and apalutamide. In addition, the PEACE-1 study (NCT01957436) demonstrated an overall survival (OS) benefit for patients treated with a triple combination therapy consisting of ADT, docetaxel and abiraterone. For patients with mCRPC, first-line treatment depends on pre-treatment in the hormone-sensitive setting. Patients carrying specific mutations such as BRCA mutations can benefit from PARP inhibitors. Other patients can be treated with chemotherapy. Lutetium-177 (177Lu)-PSMA-617 is a radioligand therapy that has shown promising results in this patient population but it is not yet used in the first-line setting. This interview took place at the European Society for Medical Oncology (ESMO) 2021 congress.