Atish D. Choudhury, MD, PhD, senior doctor, chair, Gelb Heart for Translational Analysis, Dana-Farber Most cancers Heart, assistant professor of medication, Harvard Medical Faculty, discusses the potential and rationale to conduct future potential trials evaluating the interruption of remedy in sufferers with metastatic hormone-sensitive prostate most cancers (mHSPC) who expertise distinctive responses to preliminary remedy consisting of androgen deprivation remedy (ADT) plus a novel androgen receptor (AR) pathway inhibitor.
This method is at the moment being investigated within the part 2 A-DREAM trial (NCT05241860), which was detailed on the 2024 ASCO Annual Assembly. If findings from this examine are constructive, Choudhury emphasizes the potential for a bigger, randomized trial to check steady remedy with intermittent remedy on this affected person inhabitants. A randomized examine might present extra sturdy information on long-term outcomes and security with the intermittent method, he notes.
Incorporating superior biomarkers, equivalent to imaging-based PET biomarkers, might additionally symbolize one other key route for figuring out sufferers who might obtain related advantages with an intermittent method, Choudhury explains. He highlights the chance to combine these biomarkers to raised predict remedy response and information choices on when to pause and resume remedy. The usage of PET-based biomarkers might refine affected person choice and optimize the timing of remedy discontinuation, doubtlessly enhancing the efficacy of intermittent remedy, he explains.
Choudhury additionally notes ongoing discussions inside cooperative teams might decide the optimum design and timing for subsequent research. These discussions intention to leverage the findings of the A-DREAM trial to tell the event of trials that may validate and broaden upon the preliminary outcomes, he says.
Even earlier than the launch of bigger trials, Choudhury means that the A-DREAM trial’s findings might immediate essential scientific discussions between suppliers and sufferers with mHSPC relating to remedy period. Whether it is discovered that sufferers might safely discontinue remedy with out rising the danger of illness relapse, it could encourage shared decision-making relating to the dangers and advantages of steady vs intermittent remedy, he concludes.
