post-ASCO 2018 · PROSTVAC-V/F (PRO) in men with asymptomatic or minimally symptomatic metastatic, castration-resistant prostate cancer. Presented Monday, June 4, 2018 Abstract ...

post-ASCO 2018

Prostata Kræft- Nyheder fra ASCO 2018

Dag Stormoen Junior Speaker

H-Læge Onkologi

Gedske Daugaard Senior Speaker

Professor Onkologi

Abstracts

#5000 SPCG-13 Adjuverende Docetaxel ved strålebehandling

#5001 ADT +/- Abiraterone Abiraterone med eller uden LHRH til patienter PSA recidiv med M0HSPC

#5002 Prospect Prostvac til mCRPC

#5006 PSMA PET/CT 68Ga-PSMA11 PET/CT

A randomized phase III trial between adjuvant docetaxel

and surveillance after radical radiotherapy for intermediate

and high risk prostate cancer: Results of SPCG-13 trial. Presented Monday, June 4, 2018

Abstract #: 5000

Biokemisk progression PSA >2.0ng/ml

SPCG 13 - Data presented ASCO 2018

SPCG 13 - Data presented ASCO 2018

INGEN FORSKEL PÅ PSA PROGRESSIONSFRI OVERLEVELSE

Tendens tyder på effekt hos højrisiko pt.

KONKLUSION SPCG - 13

- Adjuvant docetaxel øger ikke PSA fri overlevelse efter radikal RT for

intermediær eller højrisiko prostata kræft.

- Biokemisk progressionsrate var lavere end forventet i begge arme i studiet

- Studiet støtter SPCG -12

A randomized study of finite abiraterone acetate (AA) plus

leuprolide (LHRHa) versus LHRHa in biochemically

recurrent non metastatic hormone naïve prostate cancer

(M0HNPC). Presented Monday, June 4, 2018

Abstract #: 5002

LHRH agonist +/- Abiraterone for biokemisk recidiv

af M0, hormon naïve PCa (Efstathiou et al):

28.3 mnd (24.2-35.4)

21.1 mnd (19.1-27.2)

HR 0.62 (95% CI 0.44-0.88; p0.007)

AA+LHRH vs LHRH in M0HNPC med HR 0.62

- Den eksperimentelle arm kom favorabelt ud til fordel for AA + LHRH med en

HR på 0.62.

- Tillæg af Abiraterone Acetat forlænger ikke tid til Testosteron recovery

hvilket er essentielt for QOL og langtidsbivirkninger.

Results of PROSPECT: A randomized phase 3 trial of

PROSTVAC-V/F (PRO) in men with asymptomatic or

minimally symptomatic metastatic, castration-resistant

prostate cancer. Presented Monday, June 4, 2018

Abstract #: 5006

FASE 2 i 2010 - Prostvac 8.5mnd OS benefit

PROSTVAC - Data presented ASCO 2018

Overall survival - ITT

Accuracy of 68Ga-PSMA11 PET/CT on recurrent prostate

cancer: Preliminary results from a phase 2/3 prospective

trial. Presented Monday, June 4, 2018

Abstract #: 5006

Keypoints

- 250 patienter blev inkluderet i studiet (38% PSA <1, 82% r/p, 34% Gl. >8)

- PSA < 1 -- fund af læsion i 40%

- PSA > 1 -- fund af læsion i 80%

- 78% af fundne læsioner var ikke lokale

Lokal behandling

Påvirkning af testosteron niveauet

Behandling efter LHRH agonister

og antiandrogener

Kemoterapi

Efter kemoterapi

Død

Kirurgi/strålebe-handling

Standard antihormon behandling

Tidlig docetaxel

Docetaxel -Taxotere Cabazitaxel - Jevtana

Abirateron - Zytiga

Enzalutamide - Xtandi

Radium-223 – Alfaradin -

Xofigo

Denosumab (Xgeva), Zoledronic Acid (Zometa)

Tidlig abirateron

Strålebehandling med 18 vs 36 mdr. ADT

AD-RAD

Ga-PSMA PET/CT

Prostvac

LHRH + abirateron

x x

Lokal behandling



og antiandrogener

Kemoterapi

Efter kemoterapi

Død



Tidlig docetaxel


Abirateron - Zytiga



Xofigo


Tidlig abirateron


AD-RAD

Ga-PSMA PET/CT

Prostvac

LHRH + abirateron

x x AR-V7 splice varianter

Among the contributors to castration-resistant Prostate Cancer are AR splice variants that lack the ligand-binding domain

Lokal behandling



og antiandrogener

Kemoterapi

Efter kemoterapi

Død



Tidlig docetaxel


Abirateron - Zytiga



Xofigo


Tidlig abirateron


AD-RAD

Ga-PSMA PET/CT

Prostvac

LHRH + abirateron


Pembrolisumab

Lokal behandling



og antiandrogener

Kemoterapi

Efter kemoterapi

Død



Tidlig docetaxel Docetaxel -Taxotere Cabazitaxel - Jevtana

Abirateron - Zytiga



Xofigo


Tidlig abirateron

Strålebehandling med 18

vs 36 mdr. ADT

PARP-hæmmer: patienter med Homolog Recombination Deficiency, forandringer I BRCA eller ATM mutation

Lokal behandling



og antiandrogener

Kemoterapi

Efter kemoterapi

Død



Tidlig docetaxel


Abirateron - Zytiga



Xofigo


Tidlig abirateron


AD-RAD

Ga-PSMA PET/CT

Prostvac

LHRH + abirateron


Pembrolisumab

Olaparib + abi vs abirateron

homologous recombination repair mutation (HRRm) status was assessed using optional tumor (n = 68), whole-blood and plasma samples

Statistically significant increase in rPFS seen with the combination (13.8 months) vs abiraterone alone (8.2 month), a 5.6 month PFS benefit (HR 0.65, P= 0.03)

homologous recombination repair mutation (HRRm)

status did not seem to impact this benefit

Lokal behandling



og antiandrogener

Kemoterapi

Efter kemoterapi

Død



Tidlig docetaxel


Abirateron - Zytiga



Xofigo


Tidlig abirateron


AD-RAD

Ga-PSMA PET/CT

Prostvac

LHRH + abirateron

AR-V7 splice varianter

Pembrolisumab


Radium223 standard vs

højdosis vs 12 serier

Lokal behandling



og antiandrogener

Kemoterapi

Efter kemoterapi

Død



Tidlig docetaxel


Abirateron - Zytiga



Xofigo


Tidlig abirateron


AD-RAD

Ga-PSMA PET/CT

Prostvac

LHRH + abirateron


Pembrolisumab


Radium223 standard vs

højdosis vs 12 serier ? x

Prostata cancer

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post-ASCO 2018 · PROSTVAC-V/F (PRO) in men with asymptomatic or minimally symptomatic metastatic, castration-resistant prostate cancer. Presented Monday, June 4, 2018 Abstract ...

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