Editor's Note: Prostate cancer incidence rates in China are currently surging, with high mortality rates and a significant disease burden. Various studies have actively explored ways to improve patients' quality of life, and evidence for the combination of PARP inhibitors with NHA and immunotherapy has brought new options and hope for prostate cancer treatment. This year's ASCO annual meeting announced multiple latest advancements in prostate cancer research. "Oncology Frontier" invited Dr. Shanshan Wang from Fudan University Shanghai Cancer Center to summarize and share these findings.01 Abstract Number (Report Type): LBA5000 (Oral Abstract Session)
Cabazitaxel with abiraterone versus abiraterone alone randomized trial for extensive disease following docetaxel: The CHAARTED2 trial of the ECOG-ACRIN Cancer Research Group (EA8153)
Dr. Shanshan Wang：The CHAARTED2 study included mHSPC patients who progressed to mCRPC after ADT combined with docetaxel, representing first-line treatment for mCRPC. The study results indicated that cabazitaxel combined with abiraterone/prednisone significantly extended PFS compared to abiraterone/prednisone alone in patients with metastatic castration-resistant prostate cancer (mCRPC). Additionally, the combination therapy showed higher PSA response rates and delayed PSA progression time (TTPP), confirming that the combination therapy enhances the efficacy of abiraterone alone. Despite the PFS benefit, there was no significant OS difference between the two groups, at 25.0 months and 26.9 months (P=0.67). However, it should be noted that the study lacked the statistical power for the OS endpoint. As ADT combined with second-generation antiandrogens and ADT combined with second-generation antiandrogens plus docetaxel triple regimens are widely used in mHSPC, the application scenario of chemotherapy double regimens in mHSPC is gradually decreasing. Therefore, the applicability of these study results may be limited by changes in clinical practice or drug accessibility issues.
02 Abstract Number (Report Type): 5001 (Oral Abstract Session)
CYCLONE 2: A phase 3 study of abemaciclib with abiraterone in patients with metastatic castration-resistant prostate cancer.
Dr. Shanshan Wang：Abemaciclib has demonstrated clear therapeutic value in breast cancer and shown antitumor activity in multiple solid tumors, including prostate cancer. The interaction between androgen receptor (AR) signaling and the cyclin-dependent kinases 4 and 6 (CDK4 and CDK6) axis can jointly promote prostate cancer cell proliferation and progression, suggesting potential therapeutic value in combining CDK4/6 inhibitors and AR pathway inhibitors. Unfortunately, the CYCLONE 2 results indicate that the combination regimen did not observe significant PFS and OS benefits in metastatic castration-resistant prostate cancer, revealing no further treatment benefits. This highlights the complexity and challenges of tumor treatment, warranting further exploration of new drugs or other combination regimens.
03 Abstract Number (Report Type): LBA5002 (Oral Abstract Session)
A randomized, double-blind, placebo-controlled trial of metformin in reducing progression among men on expectant management for low-risk prostate cancer: The MAST (Metformin Active Surveillance Trial) study
Dr. Shanshan Wang：With increased understanding of endocrine pathways in tumor research, metformin, a common endocrine drug, has been re-evaluated for its antitumor properties. LBA5002 is an interesting study observing the effect of metformin on men with low-risk localized PCa under active surveillance. The study results indicated no significant difference in PFS between the metformin and placebo groups, suggesting that metformin does not delay disease progression in low-risk localized PCa patients.
04 Abstract Number (Report Type): LBA5004 (Oral Abstract Session)
MANCAN2: A multicentre randomised controlled trial of self-help cognitive behavioural therapy (CBT) to manage hot flush and night sweats (HFNS) symptoms in patients with prostate cancer receiving androgen deprivation therapy (ADT)
Dr. Shanshan Wang：In clinical practice, drug side effects are a significant concern for clinicians. Minor side effects can maintain patient treatment confidence, while severe side effects can cause physical and psychological issues. Prostate cancer patients on androgen deprivation therapy often experience side effects such as hot flushes and night sweats (HFNS). The MANCAN2 study results suggest that CBT (a 4-week self-help intervention including a manual and relaxation audio) effectively reduces short-term HFNS but does not maintain the effect long-term. Further research is needed to evaluate how to extend symptom relief.
Shanshan Wang
PhD in Oncology, graduated from Fudan University, attending physician in the Department of Urology (Comprehensive Treatment) at Fudan University Cancer Hospital. As the first or co-first author, she has published several SCI papers in journals such as PNAS and has participated in multiple clinical studies.
Professor Yao Zhu
Deputy Director of Urology, Deputy Director of Urology at Fudan University Cancer Hospital (Head of Urology at Pudong Branch), Shanghai Outstanding Academic Leader, Distinguished Professor of Shanghai Universities (Eastern Scholar), Shanghai “Medical Talent New Star” Outstanding Young Medical Talent, Vice Chairman of the Youth Council of the Chinese Anti-Cancer Association, Secretary General of the Prostate Cancer Expert Committee of the Chinese Society of Clinical Oncology, Editorial Board Member of Prostate Cancer and Prostatic Diseases.
Professor Dingwei Ye
Vice President of Fudan University Cancer Hospital, Chief Expert of Urologic Oncology MDT, Director of Shanghai Urologic Oncology Research Institute, Director of Fudan University Prostate Cancer Research Institute, Chairman of the Male Reproductive System Tumor Committee of the Chinese Anti-Cancer Association (CACA-GO), Chairman of the Prostate Cancer Expert Committee of the Chinese Society of Clinical Oncology (CSCO), Chairman of the Urology Committee of the China Primary Health Care Foundation, Former Chairman of the Urologic and Male Reproductive System Tumor Committee of the Chinese Anti-Cancer Association (CACA-GU), Deputy Leader of the Oncology Group of the Urology Branch of the Chinese Medical Association (CUA), Chairman of the Chinese Prostate Cancer Consortium (CPCC), Vice Chairman of the Urothelial Cancer Expert Committee of the Chinese Society of Clinical Oncology (CSCO), Vice Chairman of the Kidney Cancer Expert Committee of the Chinese Society of Clinical Oncology (CSCO), Vice Chairman of the Immunotherapy Expert Committee of the Chinese Society of Clinical Oncology (CSCO), Chairman of the Urologic Oncology Collaboration Group (UCOG) of Chinese Oncology Hospitals, Standing Director of the Chinese Anti-Cancer Association, Standing Director of the Chinese Society of Clinical Oncology, Deputy Editor-in-Chief of the Chinese Journal of Oncology, Member of the NCCN Asia Consensus Expert Committee for Prostate Cancer, Kidney Cancer, and Bladder Cancer, Member of the St. Gallen Consensus Expert Committee for Advanced Prostate Cancer, Chairman of the Urologic Oncology Committee of the Shanghai Anti-Cancer Association, Vice President of the Urology Division of the Shanghai Medical Association, Former President of the Asia-Pacific Prostate Society (APPS), Vice President of the Asia-Pacific Society of Cryosurgery, among others.
