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Rechallenge After Combo irAE — SCE Medical Oncology MCQ

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HardMelanoma & SkinRechallenge After Combo irAESCE Medical Oncology

A fit patient in England has newly diagnosed metastatic hormone-sensitive prostate cancer with high-volume bone and liver disease. Androgen-deprivation therapy has started and six cycles of docetaxel are planned. Which additional androgen-receptor-pathway agent has a NICE recommendation specifically with this triplet?

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Correct answer: B — Add darolutamide to androgen-deprivation therapy and planned docetaxel

NICE TA903 recommends darolutamide with androgen-deprivation therapy and docetaxel for eligible hormone-sensitive metastatic prostate cancer. Enzalutamide and apalutamide are androgen-receptor-pathway options in other regimens but are not the agent appraised in this commissioned triplet. Abiraterone-prednisolone has evidence in metastatic hormone-sensitive disease but is not the TA903 triplet answer. Olaparib is a PARP inhibitor used in molecularly selected later disease, not this unselected hormone-sensitive triplet.

Reference: NICE TA903 darolutamide with androgen deprivation and docetaxel for hormone-sensitive metastatic prostate cancer (Published June 2023; current NICE TA): https://www.nice.org.uk/guidance/ta903/chapter/1-Recommendations