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. 2023 Aug;41(8):2021-2031.
doi: 10.1007/s00345-022-04135-8. Epub 2022 Aug 27.

Future directions in systemic treatment of metastatic hormone-sensitive prostate cancer

Kenneth Chen #  1   2 , Louise Kostos #  2   3 , Arun A Azad  4   5
Affiliations

Future directions in systemic treatment of metastatic hormone-sensitive prostate cancer

Kenneth Chen et al. World J Urol. 2023 Aug.

Abstract

The landscape of advanced prostate cancer treatment has evolved tremendously in past decades. The treatment paradigm has shifted from androgen deprivation therapy (ADT) alone to doublet combinations comprising ADT with docetaxel or an androgen receptor inhibitor, and now triplet therapy involving all 3 classes of agents. Robust clinical data has demonstrated survival benefits with this strategy of upfront treatment intensification. Subgroup analysis has alluded to the importance of tailoring treatment according to metastatic disease burden. However, defining the volume of disease is becoming increasingly controversial due to the advent of next generation molecular imaging. Several trials testing established agents in the castrate-resistant setting are now underway in metastatic hormone sensitive prostate cancer patients. As the treatment milieu is enriched earlier in the disease trajectory, future studies should elucidate biomarkers to further define specific patient populations who will benefit most from treatment intensification and/or de-escalation, with what agents and for what duration.

Keywords: Advanced prostate cancer; Androgen pathway receptor inhibitors; Combination treatment; Prostate cancer; Treatment intensification.

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Conflict of interest statement

Dr Kenneth Chen has received reimbursement for participation in advisory boards and delivering lectures from Astellas Pharmaceuticals, Janssen Pharma, Bayer and Astra Zeneca. Dr Louise Kostos has no conflicts of interest to declare. A/Prof Arun Azad has the following disclosures: Consultant — Astellas, Janssen, Novartis, Aculeus Therapeutics Speakers Bureau — Astellas, Janssen, Novartis, Amgen, Ipsen, Bristol Myers Squibb; Merck Serono, Bayer Honoraria — Astellas, Novartis, Sanofi, AstraZeneca, Tolmar, Telix; Merck Serono; Janssen, Bristol Myers Squibb, Ipsen, Bayer, Pfizer, Amgen, Noxopharm, Merck Sharpe Dome, Aculeus TherapeuticsScientific Advisory Board — Astellas, Novartis, Sanofi, AstraZeneca, Tolmar, Pfizer, Telix; Merck Serono; Janssen, Bristol Myers Squibb, Ipsen, Bayer, Merck Sharpe Dome, Amgen, Noxopharm Travel + Accommodation—Astellas, Merck Serono, Amgen, Novartis, Janssen, Tolmar, PfizerResearch Funding —Astellas (investigator), Merck Serono (investigator), Astra Zeneca (investigator), Bristol Myers Squibb (institutional), Astra Zeneca (institutional), Aptevo Therapeutics (institutional), Glaxo Smith Kline (institutional), Pfizer (institutional), MedImmune (institutional), Astellas (institutional), SYNthorx (institutional), Bionomics (institutional), Sanofi Aventis (institutional), Novartis (institutional), Ipsen (institutional), Exelixis (institutional), Merck Sharpe Dome (institutional), Janssen (institutional), Eli Lilly (institutional), Gilead Sciences(institutional), Merck Serono (institutional).

References

    1. Sayegh N, Swami U, Agarwal N. Recent advances in the management of metastatic prostate cancer. JCO Oncol Pract. 2021 doi: 10.1200/OP.21.00206. - DOI - PubMed
    1. Schally AV, Arimura A, Kastin AJ, et al. Gonadotropin-releasing hormone: one polypeptide regulates secretion of luteinizing and follicle-stimulating hormones. Science. 1971;173(4001):1036–1038. doi: 10.1126/science.173.4001.1036. - DOI - PubMed
    1. Albertsen PC, Klotz L, Tombal B, Grady J, Olesen TK, Nilsson J. Cardiovascular morbidity associated with gonadotropin releasing hormone agonists and an antagonist. Eur Urol. 2014;65(3):565–573. doi: 10.1016/j.eururo.2013.10.032. - DOI - PubMed
    1. Shore ND, Saad F, Cookson MS, et al. Oral relugolix for androgen-deprivation therapy in advanced prostate cancer. N Engl J Med. 2020;382(23):2187–2196. doi: 10.1056/NEJMoa2004325. - DOI - PubMed
    1. Sylvester RJ, Denis L, de Voogt H. The importance of prognostic factors in the interpretation of two EORTC metastatic prostate cancer trials. European Organization for Research and Treatment of Cancer (EORTC) Genito-Urinary Tract Cancer Cooperative Group. Eur Urol. 1998;33(2):134–43. doi: 10.1159/000019545. - DOI - PubMed

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