Dr Agarwal on the Rationale for ​Novel Combination​ ​Therapies in ​mCRPC

Neeraj Agarwal, MD, professor of medicine, and director of the Genitourinary Oncology Program, Huntsman Cancer Institute, discusses the rationale for novel combination therapies in metastatic castration-resistant prostate cancer​ (mCRPC).

Oftentimes, patients with mCRPC experience disease progression on hormonal therapies, such as abiraterone acetate (Zytiga) or enzalutamide (Xtandi), says Agarw​al.

At the 2020 ASCO Virtual Scientific Program, findings from a large, real-world study of over 1000 patients were presented, which was obtained from Flatiron Health, Agarwal explains. Although these data were not surprising, they confirm that noveltreatment options need to be available for this patient population, Agarwal adds.

The overall survival ​(OS) after first-line abiraterone was 15​.7 months with enzalutamide ​compared with 9.4 months with docetaxel. The OS after first-line enzalutamide was 13.3 months with abiraterone versus 9.7 months with docetaxel. These data show that this is an area of high unmet need.

To that end, the​ phase 1b COSMIC-021 trial is evaluating the combination of cabozantinib (Cabometyx) and atezolizumab (Tecentriq) in patients with mCRPC, Agarwal concludes.