Treatment Approach for Patients With Metastatic CRPC

This is a synopsis of an Educated Patient Sound Bites series featuring Alicia Morgans, MD, MPH, of Dana-Farber Cancer Institute; Rashid K. Sayyid, MD, MSc, of the University of Toronto; and Reginald Tucker-Seeley, MA, ScM, ScD, of ZERO Prostate Cancer.

Dr Rashid K. Sayyid overviews radium Ra 223 dichloride, approved in 2013 for bone metastases based on the ALSYMPCA trial showing improved survival by 3 months. The ongoing REASSURE observational study recently showed 16-month median overall survival, 35% rate of adverse events, and reduced pain scores.

Dr Sayyid then covers Lutetium Lu 177-PSMA-617, approved for prostate-specific membrane antigen (PSMA) positive mCRPC after chemotherapy and antiandrogens. The VISION and TheraP trials support Lu 177-PSMA-617 efficacy. Ongoing trials like SPLASH may soon move it earlier in treatment lines.

PARP inhibitors like olaparib, rucaparib, and talazoparib are also discussed. The PROfound trial showed olaparib improves survival by 3.5 months for BRCA 1/2–mutated mCRPC after antiandrogens, supporting 2020 approval. Similarly, the TRITON2 trial supported rucaparib third-line approval after chemotherapy and antiandrogens improved imaging-based progression-free survival.

In summary, Dr Rashid K. Sayyid overviews promising first/second-line castration-resistant prostate cancer treatments like radium Ra 223 dichloride, Lutetium Lu 177-PSMA-617 for PSMA positive disease, and PARP inhibitors olaparib and rucaparib.

*Video synopsis is AI-generated and reviewed by CURE editorial staff.