Publication

Metastatic Prostate Cancer: Treatment Options

Journal Paper/Review - Nov 15, 2021

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Citation
Achard V, Putora P, Omlin A, Zilli T, Fischer S. Metastatic Prostate Cancer: Treatment Options. Oncology 2021; 100:48-59.
Project
Type
Journal Paper/Review (English)
Journal
Oncology 2021; 100
Publication Date
Nov 15, 2021
Issn Print
Issn Electronic
1423-0232
Pages
48-59
Publisher
Brief description/objective

BACKGROUND
Metastatic prostate cancer (PCa) is associated with considerable diminished overall survival (OS). Standard treatment for metastatic PCa has long been androgen deprivation therapy alone, with patients initially responding to this treatment and then progressing to a castration-resistant phase.

SUMMARY
The advent of novel therapeutic agents has changed this paradigm, with high-level evidence that upfront combination therapy with either docetaxel or new hormonal agents results in improved OS for patients with metastatic hormone-sensitive PCa. In the absence of a comprehensive clinical trial investigating the comparative efficacy and safety of all agents, clinicians are responsible for choosing the most appropriate therapy in close coordination with patients. Furthermore, the same therapeutic agents are also efficient in the castration-resistant phase, leading to the issue of the best therapeutic sequence. Finally, along with systemic therapy and molecular imaging advancements, radiotherapy was investigated in the oligometastatic setting, whether it is to treat the primary tumour or metastases. Key Messages: In this complex landscape, where providers have multiple effective therapeutic options to treat metastatic PCa patients, priority must be given to determine which treatment combination and sequence is best suited to a particular patient, given his comorbidities and preferences.