TITAN trial; shifting focus from hormone-refractory to hormone-sensitive prostate cancer

• Published in: Indian journal of urology Vol. 36; no. 2; pp. 144 - 145
• Main Author: Kumar, Gautam
• Format: Journal Article
• Language: English
• Published: Vellore Wolters Kluwer India Pvt. Ltd 01.04.2020; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer - Medknow; Wolters Kluwer Medknow Publications
• Subjects: Androgens; Chemotherapy; Metastasis; Prostate cancer; Standard of care; Uroscan
• ISSN: 0970-1591; 1998-3824
• DOI: 10.4103/iju.IJU_315_19

[1] It included CSPC patients with distant metastatic disease measured by ≥1 lesion on bone scan, with or without visceral/lymph node involvement and ECOG performance status of 0–1. CHAARTED/STAMPEDE (arm C/E), GETUG-AFU15, and subsequent meta-analysis established ADT + docetaxel as a standard of care (SOC) for high-volume mCSPC with good performance status and LATITUDE/STAMPEDE arm G, established ADT + abiraterone acetate and prednisone as a SOC for mCSPC, regardless of the disease volume status and performance status. [...]ADT + docetaxel should be preferred for men with good performance status, who have high-volume disease, desire shorter total treatment time, or have concerns of prescription drug costs, while ADT + abiraterone should be considered for men regardless of disease volume, who desire to avoid possible chemotherapy toxicity, or who want to minimize facility visits for docetaxel administration. [5] Again, during the preclinical development in animal model, apalutamide as compared to enzalutamide showed a steady-state plasma concentration 2–4-fold lower for the equivalent doses, whereas inter-tumoral level was roughly equivalent, with a greater antitumor activity at a lower dose and higher tumor/plasma ratio.