3 Prostate Cancer Results From ESMO 2026 Patients Should Know

November brings Movember, a month focused on men's health, including prostate cancer. At the European Society for Medical Oncology (ESMO) Congress 2026, held Oct. 23 to 27 in Madrid, three phase 3 trials added to what patients know about treating prostate cancer, from high-risk disease that has not spread to cancer that has spread at diagnosis. CURE's top five ESMO 2026 takeaways also covered a prostate cancer trial of Nubeqa (darolutamide) with radiation.

1. Metastatic Prostate Cancer: Adding Abiraterone Helped Men Live Nearly 2 Years Longer

The phase 3 PEACE-1 trial enrolled 1,173 men whose prostate cancer had already spread when it was first found and was still sensitive to hormone therapy. All men received standard care, androgen deprivation therapy (ADT, which lowers testosterone), with or without docetaxel chemotherapy, and were randomly assigned to also receive abiraterone, radiation to the prostate, both or neither. After a median follow-up of 7.7 years, men who received abiraterone lived longer. Among the 710 men who received ADT plus docetaxel, median survival was 6.2 years with abiraterone added vs. 4.4 years without it. At eight years, 40.3% of men on the three-drug approach were alive, compared with 27.1% on ADT plus docetaxel.

Severe high blood pressure was more common with abiraterone (21% vs. 14%), and no new long-term safety problems were found. Abiraterone (Zytiga) is already approved in the U.S. for metastatic hormone-sensitive prostate cancer, so this combination is available now.

2. High-Risk Prostate Cancer: Erleada Before and After Surgery Cut Risk of Recurrence by 62%

A separate phase 3 part of the PROTEUS trial enrolled 408 men with high-risk prostate cancer that had not spread and who planned to have their prostate removed. Men received either Erleada (apalutamide) plus ADT for about six months before and six months after surgery, or surgery alone. After three years, 63.0% of men in the Erleada group had no sign of the cancer returning (such as a rising PSA) or spreading, compared with 41.4% of men who had surgery alone. Men in the Erleada group also went longer before needing more treatment.

Serious side effects occurred in 31% of men who received Erleada and ADT vs. 22% with surgery alone. Hot flashes were the most common side effect (64% vs. less than 1%), followed by fatigue and rash. Urinary leaking and erection problems were similar in both groups, reflecting the effects of surgery. Erleada is approved in the U.S. for other stages of prostate cancer, but not for use around surgery. The results have been accepted for publication in European Urology.

3. PTEN-Deficient Metastatic Prostate Cancer: Updated Truqap Results

The phase 3 CAPItello-281 trial enrolled 1,012 men whose prostate cancer had spread at diagnosis and whose tumors were missing a protein called PTEN, a feature linked to more aggressive disease. Men received abiraterone plus either Truqap (capivasertib), a targeted pill, or a placebo. In the earlier analysis, scans showed the cancer was kept from growing for a median of 33.2 months with Truqap vs. 25.7 months with placebo. That result led to FDA approval of Truqap for this use on June 12, 2026, along with a test to find PTEN-deficient tumors.

At ESMO 2026, researchers presented updated survival data. Men on Truqap lived longer on average, but the difference did not meet the statistical bar the trial set, so it is not yet proof of a survival benefit. Common side effects of Truqap include diarrhea, high blood sugar and rash. CURE has reported on quality of life with Truqap plus Zytiga.

What's Still Unknown

It is not yet known whether Erleada around surgery helps men live longer, because survival follow-up is ongoing. The CAPItello-281 survival results will need more time to show whether the benefit is real. The PEACE-1 long-term results have been presented but not yet published in full.

What It Means for You

If your prostate cancer had already spread when it was found, PEACE-1 supports discussing abiraterone with ADT, with or without docetaxel, which is available now. If you have high-risk cancer and plan surgery, ask whether hormone therapy before and after surgery, or a clinical trial, makes sense. If your cancer has spread, ask whether PTEN testing applies to you.

Questions to Ask Your Care Team

• Is my prostate cancer considered high risk, and what does that mean for my treatment?
• Should abiraterone be part of my treatment if my cancer has spread?
• Has my tumor been tested for PTEN or other gene changes?
• How can we manage side effects like hot flashes, high blood pressure or high blood sugar?

References

1. "ESMO 2026: Adding abiraterone to ADT and docetaxel improves survival in metastatic prostate cancer." European Society for Medical Oncology. Oct. 24, 2026.
2. "Johnson & Johnson announces ERLEADA (apalutamide) treatment before and after surgery reduces risk of recurrence or death by 62% versus surgery alone in high-risk prostate cancer." Johnson & Johnson. Oct. 24, 2026.
3. "Truqap combination approved in the US as first and only targeted treatment for PTEN-deficient metastatic hormone-sensitive prostate cancer." AstraZeneca. June 12, 2026.

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