Patrick Piliè, MD, an assistant professor in the Department of Genitourinary Medical Oncology of the Division of Cancer Medicine at The University of Texas MD Anderson Cancer Center, discusses the benefit of second-generation androgen receptor (AR) inhibitors in patients with nonmetastatic castration-resistant prostate cancer (CRPC).

Currently, 3 large randomized, phase 3 trials examined the use of second-generation AR inhibitors in patients with nonmetastatic CRPC, according to Piliè. Specifically, the ARAMIS (NCT02200614), PROSPER (NCT02003924), and SPARTAN (NCT01946204) trials, examined darolutamide (Nubeqa), enzalutamide (Xtandi), and apalutamide (Erleada), respectively, Piliè says.

All 3 trials met their primary end point of metastasis-free survival and demonstrated an improvement in overall survival (OS), Piliè notes. In particular, the OS benefit achieved with darolutamide plus androgen deprivation therapy (ADT) translated to a 31% reduction in risk of death compared with ADT alone, Piliè concludes.

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Patrick Piliè, MD, discusses the benefit of second-generation androgen receptor inhibitors in patients with nonmetastatic castration-resistant prostate cancer.


Dr. Piliè on the Benefit of Second-Generation AR Inhibitors in Nonmetastatic CRPC

Patrick Pilie, MD, an assistant professor in the Department of Genitourinary Medical Oncology of the Division of Cancer Medicine at The University of Texas MD Anderson Cancer Center, discusses the impact of adiposity on response to androgen signaling inhibition in patients with metastatic castration-resistant prostate cancer (mCRPC).

Men with higher visceral adiposity, and subcutaneous adiposity, experience better responses to androgen ablative therapy, Pilie says. Additionally, although obesity and a body mass index of 26 or higher was predictive of better outcomes with this treatment, even patients who were not obese but had higher adiposity scores achieved better responses than those with lower adiposity scores, Pilie adds.

This was biologically consistent, even in the group that was not obese; thus these results demonstrate a more specific measurement of metabolic arrangements and adiposity using this imaging technique, Pilie concludes.

Patrick Pilie, MD, discusses the impact of adiposity on response to androgen signaling inhibition in patients with metastatic castration-resistant prostate cancer. 

Patrick Pilie, MD

Articles

Dr. Piliè on the Benefit of Second-Generation AR Inhibitors in Nonmetastatic CRPC

Dr. Piliè on Impact of Adiposity on Response to Androgen Signaling Inhibition in mCRPC