Earle Burgess: How should we incorporate the results of the Embark trial

Earle Burgess, Genitourinary Medical Oncologist at Atrium Health Levine Cancer, posted on LinkedIn:

“How should we incorporate the results of the Embark trial for patients with non-metastatic castrate sensitive prostate cancer into practice?

I’m not sure. The results aren’t really interpretable for real world use.

Why?

Patients and physicians were blinded from the patients’ PSA values on the trial. Although an elegant experimental design, that’s not how prostate cancer is managed.

We always know the PSA result, and we use it to make clinical decisions. So would the primary results of the Embark study have been different if the PSA results had been known to the trial participants?

Probably.

Therefore, to say the Embark trial results are directly applicable to real world practice is like saying you can drive your car to somewhere you’ve never been without a map and expect to get to the same place as you would using a map.

And if we are not sure the efficacy results are applicable to real world practice, then how do we justify the side effects of adding enza to ADT in this setting?

This is a complex discussion to have with patients. Updated results from the Embark study presented at GU24.”

View the paper on outcomes of EMBARK.
Read further.
Source: Earle Burgess/LinkedIn