Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 May 8:14:1391825.
doi: 10.3389/fonc.2024.1391825. eCollection 2024.

EORTC 2238 "De-Escalate": a pragmatic trial to revisit intermittent androgen deprivation therapy in the era of new androgen receptor pathway inhibitors

Guillaume Grisay  1 , Fabio Turco  2 , Saskia Litiere  3 , Béatrice Fournier  4 , Anna Patrikidou  5 , Enrique Gallardo  6 , Ray McDermott  7 , Ahu Alanya  8 , Silke Gillessen  2   9 , Bertrand Tombal  10
Affiliations

EORTC 2238 "De-Escalate": a pragmatic trial to revisit intermittent androgen deprivation therapy in the era of new androgen receptor pathway inhibitors

Guillaume Grisay et al. Front Oncol. .

Abstract

The landscape of treating metastatic prostate cancer has evolved with the addition of Androgen Receptor pathway inhibitor (ARPI) to Androgen Deprivation Therapy (ADT), significantly improving survival rates. However, prolonged use of these therapies introduces notable side effects, prompting a need to revisit intermittent treatment duration. The EORTC 2238 De-Escalate trial is a pragmatic trial seeking to reassess the role of intermittent therapy in patients undergoing maximal androgen blockade (MAB) for metastatic hormone naïve prostate cancer (mHNPC), i.e., the combination of ADT with an ARPI, with the aims of reducing side effects, enhancing Quality of Life (QoL) and optimizing resource usage, while maintaining oncological benefits.

Keywords: AR pathway inhibitor; de-escalation; mHNPC; maximal androgen blockade; quality of life.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Figures

Figure 1
Figure 1
Trial scheme.
Figure 2
Figure 2
PRECIS-2 evaluation of EORTC-2238.
See this image and copyright information in PMC

References

    1. Fizazi K, Tran N, Fein L, Matsubara N, Rodriguez-Antolin A, Alekseev BY, et al. . Abiraterone plus prednisone in metastatic, castration-sensitive prostate cancer. N Engl J Med. (2017) 377:352–60. doi: 10.1056/NEJMoa1704174 - DOI - PubMed
    1. James ND, de Bono JS, Spears MR, Clarke NW, Mason MD, Dearnaley DP, et al. . Abiraterone for prostate cancer not previously treated with hormone therapy. N Engl J Med. (2017) 377:338–51. doi: 10.1056/NEJMoa1702900 - DOI - PMC - PubMed
    1. Fizazi K, Foulon S, Carles J, Roubaud G, McDermott R, Fléchon A, et al. . Abiraterone plus prednisone added to androgen deprivation therapy and docetaxel in de novo metastatic castration-sensitive prostate cancer (PEACE-1): a multicentre, open-label, randomised, phase 3 study with a 2× 2 factorial design. Lancet. (2022) 399:1695–707. doi: 10.1016/S0140-6736(22)00367-1 - DOI - PubMed
    1. Chi KN, Chowdhury S, Bjartell A, Chung BH, Pereira de Santana Gomes AJ, Given R, et al. . Apalutamide in patients with metastatic castration-sensitive prostate cancer: final survival analysis of the randomized, double-blind, phase III TITAN study. J Clin Oncol. (2021) 39:2294–303. doi: 10.1200/JCO.20.03488 - DOI - PubMed
    1. Davis ID, Martin AJ, Stockler MR, Begbie S, Chi KN, Chowdhury S, et al. . Enzalutamide with standard first-line therapy in metastatic prostate cancer. N Engl J Med. (2019) 381:121–31. doi: 10.1056/NEJMoa1903835 - DOI - PubMed