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首页> 外文期刊>Journal of the advanced practitioner in oncology >Prostate Cancer: 2021 ASCO Annual Meeting Highlights for the Advanced Practitioner: The Advanced Practitioner Perspective: Prostate Cancer: Androgen-Deprivation Therapy With Orteronel or Bicalutamide, By The ASCO Post Staff
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Prostate Cancer: 2021 ASCO Annual Meeting Highlights for the Advanced Practitioner: The Advanced Practitioner Perspective: Prostate Cancer: Androgen-Deprivation Therapy With Orteronel or Bicalutamide, By The ASCO Post Staff

机译：Prostate Cancer: 2021 ASCO Annual Meeting Highlights for the Advanced Practitioner: The Advanced Practitioner Perspective: Prostate Cancer: Androgen-Deprivation Therapy With Orteronel or Bicalutamide, By The ASCO Post Staff

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Neeraj Agarwal, MD, of Huntsman Cancer Institute at the University of Utah, discusses phase III data from the SWOG S1216 trial, which evaluated the clinical benefit of using androgen-deprivation therapy with either orteronel (or TAK-700, a CYP17 inhibitor) or bicalutamide in patients with newly diagnosed metastatic hormone-sensitive prostate cancer. A transcript of his interview with The ASCO Post follows. The SWOG S1216 trial was a federally funded trial in men with metastatic hormone-sensitive prostate cancer. In this trial, the experimental agent was TAK-700, which is a drug with a similar mechanism of action as abiraterone, but doesn't require concurrent prednisone in the doses it was used in the trial because of its high specificity for CYP17-lyase enzyme inside the prostate tumor. The primary endpoint of the trial was overall survival, and the secondary endpoint was progression-free survival. Other secondary endpoints also included PSA at 7 months, which is a known intermediate validated surrogate for overall survival, and safety of the combination. The Advanced Practitioner Perspective The phase III SWOG S1216 trial evaluated orteronel (TAK-700) or bicalutamide in patients with newly diagnosed metastatic hormone-sensitive prostate cancer. Orteronel is a CYP17-lyase inhibitor, similar in mechanism of action to abiraterone without the need for concurrent prednisone due to high specificity for the CYP17-lyase enzyme. Median follow-up was 57 months. The median OS in patients receiving TAK-700 was 81 months compared with 70 months in the patients receiving bicalutamide. These results did not meet the predefined criteria for statistical significance. This lack of statistical significance could be related to a longer-than-estimated OS in the control arm. The secondary endpoint of PFS was significantly improved with TAK-700 as was the PSA at 7 months. There were more grade 3/4 adverse drug events (hypertension, fatigue) in the TAK-700 arm compared to the bicalutamide arm. The SWOG-9346 trial was published in 2013 and showed the median OS of patients with newly diagnosed metastatic hormone-sensitive prostate cancer was 46 months. In the time since that study was published, OS has improved in this patient population, and there are a number of drugs approved in this setting. The long-term role of TAK-700 in the treatment of metastatic hormone-sensitive prostate cancer will need to be clarified with further studies.

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