The formal discussant of the study presented by James et al at the ESMO 2014 Congress was Bertrand Tombal, MD, PhD, Chairman of the Division of Urology and Associated Professor of Physiology at Université Catholique de Louvain, Brussels. He praised the STAMPEDE trial as “wonderful, because it informs current clinical practice and also addressed primary treatment in patients with positive nodes.”

“Too many of these patients are left to fate with [androgen-deprivation therapy] alone. This study gives us a strong signal to rethink how we treat these patients. The question was not addressed in the protocol, but the data suggest we should change the way we treat them. Local control is a crucial question, and maybe it is time to rethink our approach to the high-risk patient as well as the recurrent early [castration-resistant prostate cancer] patient,” he stated. ■

Disclosure: Dr. Tombal is a paid advisor or investigator for Amgen, Astellas, Bayer, Medivation, Ferring, Janssen, and Sanofi-Aventis.