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A Bioluminescent and Fluorescent Orthotopic Syngeneic Murine Model of Androgen-dependent and Castration-resistant Prostate Cancer
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Next-Generation Androgen Receptor-Signaling Inhibitors for Prostate Cancer: Considerations for Older Patients

Zizhen Feng1, Julie N Graff2,3

  • 1Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA.

Drugs & Aging
|February 9, 2021
PubMed

Insights

Novel hormonal therapies offer new prostate cancer treatment options for older men. However, practitioners must carefully manage unique side effects and drug interactions in this vulnerable population.

Area of Science:

  • Oncology
  • Geriatric Medicine
  • Pharmacology

Background:

  • Prostate cancer incidence rises with age, posing unique treatment challenges for older adults due to frailty, side effects, and drug interactions.
  • The US FDA has approved novel next-generation hormonal therapies, expanding treatment options for various prostate cancer stages.
  • Older patients require special consideration due to increased vulnerability to adverse events and potential drug interactions.

Purpose of the Study:

  • To review the mechanism of action and metabolism of new hormonal therapies for prostate cancer.
  • To present efficacy and safety data for these agents across different prostate cancer stages.
  • To discuss the specific considerations for treating elderly men with prostate cancer using these novel therapies.

Main Methods:

  • Literature review of next-generation hormonal therapies for prostate cancer.
  • Analysis of clinical trial data regarding efficacy and safety in non-metastatic castration-resistant, metastatic hormone-sensitive, and metastatic castration-resistant prostate cancer.
  • Discussion of geriatric-specific issues related to these treatments.

Main Results:

  • Next-generation hormonal therapies include apalutamide, enzalutamide, darolutamide, and abiraterone.
  • Enzalutamide and apalutamide may increase fall and fracture risk in older men.
  • Abiraterone necessitates concurrent glucocorticoid use, potentially causing side effects in the elderly.

Conclusions:

  • Older men with prostate cancer require careful management of novel hormonal therapies due to age-related vulnerabilities.
  • Practitioners must be aware of specific side effects, such as falls, fractures, and glucocorticoid-related issues.
  • Thorough consideration of potential drug-drug interactions is crucial for optimizing treatment outcomes in elderly patients.

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