Current Systemic Therapy in Men with Metastatic Castration-Sensitive Prostate Cancer

Area of Science:

• Oncology
• Urology
• Medical Treatments

Background:

• Metastatic castration-sensitive prostate cancer (mCSPC) treatment has rapidly evolved.
• Recent evidence highlights significant advancements in systemic therapies.

Purpose of the Study:

• To review the current landscape of mCSPC treatments.
• To explore the impact of treatment intensification on patient outcomes.

Main Methods:

• Review of chronological evidence on systemic treatment intensification.
• Analysis of combination therapies including docetaxel, androgen deprivation therapy (ADT), and androgen receptor pathway inhibitors (ARPIs).
• Evaluation of the role of radiotherapy and emerging biomarkers.

Main Results:

• Systemic treatment intensification with docetaxel improves survival in mCSPC.
• Combining ARPIs with ADT enhances outcomes.
• Triplet therapy (ADT, ARPI, docetaxel) further improves survival.
• Radiotherapy for low-volume mCSPC is recommended; its combination with intensified therapy shows potential synergy.
• Role of metastases-directed therapies and biomarkers is under investigation.

Conclusions:

• Treatment intensification is the standard of care for de novo mCSPC, improving survival.
• The standard of care for mCSPC is rapidly evolving with new therapeutic strategies.
• Further research is needed for metastatic relapse and biomarker integration.