One of the other studies that I’m presenting at EAU is some additional analyses coming from PEACE-3. This is an EORTC multi-intergroup study including Canada that reported at ESMO that by adding radium to enzalutamide significantly improved radiographic progression free survival and looked like it might be actually improving overall survival with a hazard ratio of 0.69 for both of those endpoints.

The question of the use of bone-protective agents in patients with mCRPC is a recurring discussion. When the study started there was no obligation to use a bone-protective agent; after about 119 patients it became obligatory to be giving a bone-protective agent based on another randomised phase III study that showed the detrimental effect of not using a bone-protective agent. So we had the opportunity to look at patients with or without a bone-protective agent before the urgent safety letter that made it mandatory.

So what we are presenting here at EAU is that in the 115 patients that received study treatment about half had a bone-protective agent and about half did not. And very strong suggestion that adding a bone-protective agent patients did much better. There was a much better rPFS in patients with a bone-protective agent, regardless of which arm they were on, compared to patients who were not. This is over a one-year advantage in rPFS and almost a year and a half advantage in overall survival. So really a very important analysis, even though it’s a small group of patients but with long follow-up that strongly suggests that adding a bone-protective agent goes beyond the benefit of bone protection, it might actually play a role in therapeutic efficacy.