Insights into Doublet Therapy and Clinical Trial Takeaways for Metastatic Prostate Cancer Treatment : Episode 9
Opinion
Video
Radium-223 and Enzalutamide: Game-Changing PEACE III Phase 3 Data in mCRPC
Author(s):
Key Takeaways
- The PEACE III trial showed that BPAs reduced skeletal fracture risk from 33% to 3% in patients receiving radium-223.
- The radium-223 triplet regimen is considered superior to the enzalutamide doublet for metastatic castration-resistant prostate cancer.
Panelists discuss how the PEACE III trial findings demonstrate the superiority of combining radium-223 with enzalutamide in treating metastatic castration-resistant prostate cancer, highlighting improved efficacy, the critical importance of bone-protective agents in reducing fracture risk, and the potential for this triplet therapy to become the new standard of care over enzalutamide alone.
Video Content above is prompted by the following:
- Discuss the findings from the PEACE III trial, which compared enzalutamide with enzalutamide plus radium-223 in patients with previously untreated castration-resistant prostate cancer that has metastasized to bone.
- Giving bone-protective agents (BPAs) to patients receiving radium-223 in PEACE III nearly eliminated risk for skeletal fracture (fracture incidence was 33% without BPAs and 3% with BPAs) (Tombal et al [2019])
- This is proving that enzalutamide doublet shouldn’t be used anymore. Radium-223 triplet on top of ARI doublet (in metastatic castration-resistant prostate cancer) is superior combination. Unless there’s a big safety signal, this study will now prove that radium-223 triplet beats enzalutamide doublet.
- In which patients would you consider using an enzalutamide–radium-223 combination? (Shariftabrizi et al [2023])
- What would be absolute or relative contraindications for radium-223 use?
- What bone support/monitoring strategies (eg, bone-protective agent use, bone density scans) are needed to improve safety of radium-223 in clinical practice? (Tombal et al [2019])
- What strategies would you recommend for increasing utilization for bone health in general for all metastatic patients?
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