Prof Silke Gillessen talks to ecancer at ESMO 2024 about the phase 3 PEACE-3 trial results she presented.

These showed that adding Radium-223 to enzalutamide improves both radiological progression-free survival (rPFS) and overall survival in patients with metastatic castration-resistant prostate cancer with predominant bone metastases.

In the trial, patients receiving the combination therapy had a median rPFS of 19.4 months, compared to 16.4 months for those on enzalutamide alone. The 24-month rPFS rates were 45% versus 36%, respectively. Additionally, the median OS was 42.3 months with the combination therapy, compared to 35.0 months with enzalutamide alone.

The combination therapy also showed a significantly longer time to next systemic treatment. However, the results underscore the necessity of using a bone-protecting agent alongside Radium-223 and enzalutamide.

These findings support the combination as a potentially new first-line treatment option for mCRPC patients with bone metastases who haven't previously received an androgen-receptor pathway inhibitor.