ESMO2022 | From the perspective of the patient, pay attention to the benefit of MHSPC treatment by therogen receptor antagonist

*For medical professionals for reading reference

Effectively improve the symptoms and quality of life of patients, and it is also an important mission of anti -cancer treatment!

Prostate cancer can be divided into multiple different stages. Among them, metastatic hormone sensitivity prostate cancer (MHSPC) refers to patients who still respond to the treatment of androgen deprivation (ADT). Patients with effective treatment during the MHSPC stage delay patients going to the momentum. The progress of the refractory phase (MCRPC) is very important for extending the survival of patients.

The new androgen receptor pathogenesis (ARI) represented by Darolutamide (ARI) has reflected clear clinical benefits. In August 2022, Darlo has received the US Food and Drug Administration ( FDA) approves for MHSPC treatment and submitted the same application for listing applications in my country.

However, the clinical research of the new ARI is mostly based on the overall survival period (OS) and the time of treatment to the progress of the disease. The patient's disease symptoms improvement and the quality of life during treatment may not be fully valued. Therefore, clinical treatment needs to be needed. From the perspective of patients, choose the ideal treatment plan. During the recent annual meeting of the European Medicine Cancer Society (ESMO), a "Ending of Gland Cancer Before the Transformation" meeting was held. The experts attended the clinical needs that the participating experts had not yet been met and the clinical research of the new ARI. Discussion and sharing.

Looking back on ARASENS Research, the Daroamine Triple Plan creates a new pattern of treatment

Professor Bertrand Tombal, the University of Catholicism in Belgium, introduced the quality of life and patient -related endpoints in the key clinical III study of Darlo's treatment of MHSPC patients from the perspective of experts. The most common metastasis part of patients with MHSPC is pelvis. Patients may experience pain, fatigue, decreased weight loss, etc., which affects the quality of life. At present, most of the clinical MHSPC is based on ADT -based treatment, that is, using ADT alone or using ARI/chemotherapy on it. Although the efficacy is better, its safety is also worth noting.

As a new type of ARI, Darohamine has obtained a key clinical phase III study of non-metastatic resistance to the treatment of non-metastatic resistance and mHSPC. , Reflecting clear survival benefits. Among them, Arasens research on patients with MHSPC is the only MHSPC global and multi -center research in the control group that uses Dotci chemotherapy. The risk of death of the placebo control group decreased by 32%(HR = 0.68), while the 4 -year survival rate increased by 12%(62.7%/50.4%).

At this ESMO Annual Conference, the quality of life and patient -related endpoints studied by Arasens. The data shows that the use of Daroamine on the basis of the ADT+Dopsen can cause patients to deteriorate the symptoms of MHSPC and the pain that needs to be intervened. The time remains stable, and there is a medium to severe pain (BPI-SF meter pain score ≥5 points, which accounts for 15%of the overall population). There is a trend of pain that needs to be intervened (see the figure below), suggesting that the treatment of Daro amine therapy brings to the patient as "a quality extension with quality".

In terms of security, data as of 3.5 years of follow -up time shows that most of the adverse events that deserve special attention, such as falling, fractures, mental symptoms, etc. At the level, there is no significant difference in the placebo group (see the figure below), which reminds that Daro amine treatment is good for treatment and tolerance.

In summary, the Daroamine+ADT+Dorthecs scheme can maintain the quality of the patient's life while extending the median OS of the patient and have good safety. It has become a standard treatment plan for patients with MHSPC.

Focus on clinical needs that have not been met by patients with MHSPC

Erik Briers, a well -known European -known prostate cancer patient tissue EUROPA UOMO vice chairman, introduced the treatment needs of MHSPC patients from the perspective of patients. Overall, MHSPC patients have three major needs for clinical treatment, namely: extend survival and delay MCRPC to MCRPC. Progress and maintain quality of life.

EUROPA UOMO launched a research end of prostate cancer patients in 2021, which collected questionnaires from nearly 3,000 patients from 25 countries, further evaluating the various impacts brought by the quality of life and treatment of patients with prostate cancer. Data show that 42%of patients have certain anxiety or depression, and patients believe that anti -tumor therapy has the greatest impact on their sexual function (100 points in a full score, and the patient score is only 27 points) [3].

Therefore, clinicians need to further help patients understand the impact of existing anti -cancer treatment plans on survival and quality of life, maintain the quality of life as a key topic when communicating with doctors, and try to carry out multidisciplinary treatment (MDT) for each patient. The meeting also invited the patient representatives to attend and introduced the consultation, treatment and life experience after the diagnosis of MHSPC.

How to really change the ending of MHSPC? Experts have something to say on the online discussion session of the meeting. The representatives of the participating experts and patient organizations specifically conducted wonderful discussions on the topic of "transforming prostate cancer" and reached the following consistent opinions:

1. When communicating with doctors and patients, try to make each patient fully understand the advantages and disadvantages of the treatment plan. Treatment choice.

2. Carry out more and wider clinical studies, move the time to intervene in prostate cancer, and try various innovative treatment and joint treatment plans to strive for better prognosis of patients. It should be cooperated with patients to try to evaluate the treatment benefits and quality of life of patients.

3. From the perspective of patients, we can try to maintain the lifestyle before diagnosis of cancer and make anti -cancer treatment on daily life less, which is equivalent to "maintaining the quality of life". This has important reference value, but it also needs to fully consider the individual differences in patients. It can use the "patient diary" to dynamically evaluate the quality of life.

In August 2022, the US FDA has approved the treatment of MHSPC for Darolytharine combined with Dorca. At the same time, MHSPC's new access certificate has also been accepted by the my country Drug Administration (NMPA) Pharmaceutical Review Center. As the best partner of ADT, Daroamine has a strong effect and reducing PSA and opening the dual -nocity era! Looking forward to the approval of the new indications of Daroamine as soon as possible, so as to benefit more patients with prostate cancer and their families!

references:

[1] Fizazi K, Shore n, Tammela T L, et al.darolutamide in nonmetastative, Castration-Resist PRostate Cancer [J] .New ENGland Journal of Medicine, 2019,380 (13): 1235-1246.

[2] Smith M R, Hussain M, Saad F, Et Al.Darolutamide and Survival in Metastatic, Hormone-Sensitive PRostate Cancer [J] .New England Journal of Medicine, 2022,386 (12): 1132-1142-1142: 113-1142: 113-1142: 113-1142: 113-1142: 113-1142.

[3]Venderbos L D F,Deschamps A,Dowling J,et al.Europa uomo patient reported outcome study(EUPROMS):descriptive statistics of a prostate cancer survey from patients for patients[J].European Urology Focus,2021,7(5) : 987-994.

*This article is only used to provide scientific information to medical people, and does not represent the viewpoint of this platform

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