Enrique Gallardo, MD, highlights PEACE-3 results in mCRPC

In this interview, Enrique Gallardo, MD, discusses the final overall survival (OS) results from the EORTC 1333/PEACE-3 trial of enzalutamide plus radium-223 in patients with metastatic castration-resistant prostate cancer (mCRPC).These results were presented at the 2026 ASCO Genitourinary Cancers Symposium in San Francisco, California.¹

Gallardo is a medical oncologist at Parc Taulí University Hospital in Sabadell, Spain.

To begin the discussion, Gallardo explained the clinical rationale behind combining enzalutamide with radium-223 for the treatment of patients with mCRPC. Both agents have independently demonstrated an OS benefit in this setting, prompting investigators to explore whether their distinct and potentially complementary mechanisms of action could enhance patient outcomes when used together.

Earlier findings from the trial showed that the combination significantly improved radiographic progression-free survival vs enzalutamide alone. The final OS analysis now builds on these results, demonstrating that the addition of radium-223 to enzalutamide in the first-line mCRPC setting was associated with an OS vs enzalutamide monotherapy (HR, 0.76; 95% CI, 0.60 to 0.96). The median OS reached 38.21 months in the combination arm, representing an improvement of 5.6 months over the control group (median OS, 32.62).

While the dual regimen was associated with a modest increase in toxicity, the safety profile was considered manageable. The incidence of grade 3 to 5 drug-related treatment-emergent adverse events was higher in the combination arm (treatment arm, 28.9%; control, 18.8%), but no single adverse event increased by more than 5%.

Overall, these findings support the feasibility of combining enzalutamide with radium-223 as a potential first-line treatment strategy for patients with mCRPC.

REFERENCE

1. Gallardo E. Final overall survival results from the EORTC 1333/PEACE-3 trial: Enzalutamide with or without radium-223 in metastatic castration-resistant prostate cancer. J Clin Oncol. 2026;44(suppl 7; abstr 15)