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PROSCA 2021 Case 1 - ASCO GU (Merseburger)

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What would Axel Merseburger do?


 

RT to the primary tumour has proven clinical benefit in oligometastatic disease. ADT monotherapy is not enough. I would see docetaxel predominantly in second line sequence post ARTA progression. ADT and ARTA combination is a good option in this situation. I would be in favour of apalutamide due to the all-comer indication regardless of volume/risk/onset of disease. No need to combine with prednisone nor strict laboratory controls.

References:
  • Chi KN. Final analysis results from TITAN: a phase III study of apalutamide versus placebo in patients with metastatic castration-sensitive prostate cancer receiving androgen deprivation therapy. J Clin Oncol 2021;39(Suppl 6):4(abs.11)
 

What would Axel Merseburger do?

RT to the primary tumour has proven clinical benefit in oligometastatic disease. ADT monotherapy is not enough. I would see docetaxel predominantly in second line sequence post ARTA progression. ADT and ARTA combination is a good option in this situation. I would be in favour of apalutamide due to the all-comer indication regardless of volume/risk/onset of disease. No need to combine with prednisone nor strict laboratory controls.

References:
  • Chi KN. Final analysis results from TITAN: a phase III study of apalutamide versus placebo in patients with metastatic castration-sensitive prostate cancer receiving androgen deprivation therapy. J Clin Oncol 2021;39(Suppl 6):4(abs.11)
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