[Metastatic castration-resistant prostate cancer-what are rational sequential treatment options?] 2023

Jana Horak, and Ulf Petrausch, and Aurelius Omlin
Zentrum für Urologie Zürich - Klinik Hirslanden, Witellikerstr. 40, 8032, Zürich, Schweiz.

BACKGROUND In advanced prostate cancer, disease progression during ongoing androgen deprivation therapy (ADT) is referred to as castration-resistant prostate cancer (CRPC). Various therapeutic modalities are available for its treatment, including endocrine therapy, chemotherapy, poly (ADP-ribose) polymerase [PARP] inhibition, radionuclide therapy, and radioligand therapy. OBJECTIVE This review outlines practical aspects and considerations regarding treatment sequencing in mCRPC. METHODS The findings are based on existing prospective phase 3 studies that have demonstrated clinically relevant and statistically significant benefits in radiographically progression-free and/or overall survival. RESULTS Sequential therapy, aside from numerous patient-specific factors, depends on the treatment patients received in the hormone-sensitive prostate cancer (mHSPC) setting. Following pretreatment with ADT alone or ADT plus docetaxel in the mHSPC context, additional endocrine therapy is the standard approach. In the event of progression under combined endocrine therapy initiated in the mHSPC setting, docetaxel currently serves as the standard for the majority of patients. Patients who received triplet therapy as a pretreatment in the mHSPC scenario can be treated with radioligand therapy or second-line chemotherapy. CONCLUSIONS Various active and well-tolerated treatment options are available for patients with metastatic castration-resistant prostate cancer (mCRPC). The choice of therapy is primarily determined by previous treatments, but many other individual factors are also taken into consideration.

UI MeSH Term Description Entries
D008297 Male Males
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000077143 Docetaxel A semisynthetic analog of PACLITAXEL used in the treatment of locally advanced or metastatic BREAST NEOPLASMS and NON-SMALL CELL LUNG CANCER. Docetaxel Anhydrous,Docetaxel Hydrate,Docetaxel Trihydrate,Docetaxol,N-Debenzoyl-N-tert-butoxycarbonyl-10-deacetyltaxol,NSC 628503,RP 56976,RP-56976,Taxoltere Metro,Taxotere,N Debenzoyl N tert butoxycarbonyl 10 deacetyltaxol,RP56976
D000726 Androgen Antagonists Compounds which inhibit or antagonize the biosynthesis or actions of androgens. Androgen Antagonist,Antiandrogen,Antiandrogens,Anti-Androgen Effect,Anti-Androgen Effects,Antiandrogen Effect,Antiandrogen Effects,Antagonist, Androgen,Antagonists, Androgen,Anti Androgen Effect,Anti Androgen Effects,Effect, Anti-Androgen,Effect, Antiandrogen,Effects, Anti-Androgen,Effects, Antiandrogen
D064129 Prostatic Neoplasms, Castration-Resistant Tumors or cancer of the PROSTATE which can grow in the presence of low or residual amount of androgen hormones such as TESTOSTERONE. Androgen-Independent Prostatic Cancer,Androgen-Independent Prostatic Neoplasms,Androgen-Insensitive Prostatic Cancer,Androgen-Insensitive Prostatic Neoplasms,Androgen-Resistant Prostatic Cancer,Androgen-Resistant Prostatic Neoplasms,Castration-Resistant Prostatic Cancer,Castration-Resistant Prostatic Neoplasms,Hormone Refractory Prostatic Cancer,Hormone Refractory Prostatic Neoplasms,Prostatic Cancer, Androgen-Independent,Prostatic Cancer, Androgen-Insensitive,Prostatic Cancer, Androgen-Resistant,Prostatic Cancer, Castration-Resistant,Prostatic Cancer, Hormone Refractory,Prostatic Neoplasms, Androgen-Independent,Prostatic Neoplasms, Androgen-Insensitive,Prostatic Neoplasms, Androgen-Resistant,Prostatic Neoplasms, Hormone Refractory,Androgen Independent Prostatic Cancer,Androgen Independent Prostatic Neoplasms,Androgen Insensitive Prostatic Cancer,Androgen Insensitive Prostatic Neoplasms,Androgen Resistant Prostatic Cancer,Androgen Resistant Prostatic Neoplasms,Androgen-Independent Prostatic Cancers,Androgen-Independent Prostatic Neoplasm,Androgen-Insensitive Prostatic Cancers,Androgen-Insensitive Prostatic Neoplasm,Androgen-Resistant Prostatic Cancers,Androgen-Resistant Prostatic Neoplasm,Cancer, Androgen-Independent Prostatic,Cancer, Androgen-Insensitive Prostatic,Cancer, Androgen-Resistant Prostatic,Cancer, Castration-Resistant Prostatic,Cancers, Androgen-Independent Prostatic,Cancers, Androgen-Insensitive Prostatic,Cancers, Androgen-Resistant Prostatic,Cancers, Castration-Resistant Prostatic,Castration Resistant Prostatic Cancer,Castration Resistant Prostatic Neoplasms,Castration-Resistant Prostatic Cancers,Castration-Resistant Prostatic Neoplasm,Neoplasm, Androgen-Independent Prostatic,Neoplasm, Androgen-Insensitive Prostatic,Neoplasm, Androgen-Resistant Prostatic,Neoplasm, Castration-Resistant Prostatic,Neoplasms, Androgen-Independent Prostatic,Neoplasms, Androgen-Insensitive Prostatic,Neoplasms, Androgen-Resistant Prostatic,Neoplasms, Castration-Resistant Prostatic,Prostatic Cancer, Androgen Independent,Prostatic Cancer, Androgen Insensitive,Prostatic Cancer, Androgen Resistant,Prostatic Cancer, Castration Resistant,Prostatic Cancers, Androgen-Independent,Prostatic Cancers, Androgen-Insensitive,Prostatic Cancers, Androgen-Resistant,Prostatic Cancers, Castration-Resistant,Prostatic Neoplasm, Androgen-Independent,Prostatic Neoplasm, Androgen-Insensitive,Prostatic Neoplasm, Androgen-Resistant,Prostatic Neoplasm, Castration-Resistant,Prostatic Neoplasms, Androgen Independent,Prostatic Neoplasms, Androgen Insensitive,Prostatic Neoplasms, Androgen Resistant,Prostatic Neoplasms, Castration Resistant

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