Drug development in metastatic prostate cancer: lessons from ACIS
Mené dans 17 pays sur 982 patients atteints d'un cancer métastatique de la prostate résistant à la castration, cet essai de phase III évalue l'efficacité, du point de vue de la survie sans progression mesurée par radiographie, et la toxicité de l'ajout de l'apalutamide à un traitement combinant acétate d'abiratérone et prednisone
Metastatic castration-resistant prostate cancer (mCRPC) remains fatal with currenttherapies. In The Lancet Oncology, Fred Saad and colleagues report the results of the ACIS trial, which was a randomised, phase 3, placebo-controlledstudy evaluating apalutamide plus abiraterone–prednisone versus placebo plus abiraterone–prednisone,in patients with mCRPC. The results showed that compared with abiraterone–prednisonealone, the combination of abiraterone–prednisone plus apalutamide significantly improvedthe primary endpoint of investigator-assessed radiographic progression-free survival,but did not improve the secondary endpoints of overall survival, time to initiationof cytotoxic chemotherapy, time to chronic opioid use, or time to pain progression.Although these results are unlikely to change clinical practice, several importantlessons could be learned to guide future drug development.
The Lancet Oncology , commentaire, 2020