ASCO GU 2022 | A Phase II trial investigating neoadjuvant abiraterone and cabazitaxel in high-risk prostate cancer
Neil Fleshner, MD, MPH, Princess Margaret Cancer Centre, Toronto, Canada, provides an overview of the Phase II trial investigating neoadjuvant abiraterone, an androgen antagonist, and the chemotherapeutic agent, cabazitaxel, in high-risk prostate cancer. The preliminary results were presented at the American Society of Clinical Oncology (ASCO) Genitourinary Cancers (GU) Symposium 2022. Approximately 80 men were randomized to receive either 6 months of abiraterone or abiraterone plus cabazitaxel. 44% of patients achieved a complete response (CR) or near CR, significantly higher than previously observed. No benefit was demonstrated with the addition of chemotherapy. Additionally, patients’ tumors are being gnomically profiled during this trial to interrogate mechanisms of resistance and sensitivity and aid in the personalization of treatment for this patient population. This interview took place at the American Society of Clinical Oncology (ASCO) Genitourinary Cancers Symposium 2022 in San Francisco, CA.
Transcript (edited for clarity)
What we aim to do is that, historically men with high risk prostate cancer typically are not treated with surgery. What we aim to do here was take the advantages gained from novel therapies and more advanced prostate cancer and apply those to men with non-metastatic disease, high risk men. We took the novel antigen receptor antagonist, abiraterone, which is not that novel anymore, but it was then as well as cabazitaxel, which a chemotherapeutic agent...
What we aim to do is that, historically men with high risk prostate cancer typically are not treated with surgery. What we aim to do here was take the advantages gained from novel therapies and more advanced prostate cancer and apply those to men with non-metastatic disease, high risk men. We took the novel antigen receptor antagonist, abiraterone, which is not that novel anymore, but it was then as well as cabazitaxel, which a chemotherapeutic agent.
What we did is we took extremely high risk men, roughly 80 men, and we did a randomized phase two study. Half of them got six months of the regular hormone therapy plus Abiraterone and the others got the hormone therapy plus the abiraterone plus the cabazitaxel. We then went and operated on them afterwards. Today we’re going to be presenting our results in terms of the preliminary results, our pathologic results. We achieved a complete response or near complete response in 44% of patients, which traditionally much higher than has been noted before.
We did not really show a benefit to adding the chemotherapy to the two regiment option. The other thing we also noticed was that patients who achieve this complete response or near complete response tended to stay free of their cancers later. We’re excited to see this. Really what I think it does is build for the future, because I think we have this tissue now available to interrogate both mechanisms of sensitivity as well as resistance to these drugs. Also, can build upon this, just ushering this era of personalizing medicine. Perhaps, genomically profiling these tumors in the future and that’s what we’re doing, just starting that study now and having a personalized treatment for each individual patient so we’re excited about that.
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