Thanks for starting the conversation with such a clear summary @DVAraujoMD
- one proposition is to use biomarkers for Rx with use docetaxel (or SBRT and prostate rads) with ADT + enza as induction then consolidate with PARPi or AKTi or LuPSMA for patients @JoshLangMD@SAiGENCI
ENZAMET Decipher analysis (#ASCO26, Abstr 5001). A practical question we deal with constantly: who actually needs docetaxel added to ADT + enza in mHSPC? They ran the Decipher genomic classifier (>0.85 cutoff) on 634 pts from ENZAMET.
High-Decipher pts (>0.85) did clearly worse
I think the answer is to allow BEST standard of care in both arms and stratify by it and see if new therapy can make further improvements - our goal is to do better and improve and build upon successful strategies - otherwise we go sideways
Actually, I don’t think the company’s explanation is any wrong from a clinical trial design perspective.
You may find it shocking, but I think this issue needs to be viewed more balancedly.
They are already aware that RT may improve overall survival in patients with low-volume
Hi @nature_sabine - for all potential biomarkers I think we need to perform a health economic analysis to see if the assay can limit futile health care utilization and if successful have payers around the world help embrace the new diagnostic technology.
This is exactly the precision shift we need. Decipher and PTEN integration in mHSPC is transformative, though German infrastructure struggles with universal adoption. Are reimbursement frameworks ready for 2026 standards?
Thanks @TiansterZhang
The 8 yr PrCa survival for high risk local dz is encouraging BUT despite lower risk of dying there is still a high risk of relapse & needing “life long Rx”. New endpoints valuing preventing relapse are needed @Prof_IanD@DrPaulNguyen@brookmans76@PCFnews
💯 - huge lift from @ANZUPtrials@Prof_IanD@ChrisSweens1 for ENZARAD! 97% prostate cancer specific survival — our pts are def living longer overall w high risk prostate cancer!
