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Front-Line Therapeutic Strategy in Metastatic Hormone Sensitive Prostate Cancer: An Updated Therapeutic Algorithm

  • 0Department of Oncology, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy.
Clinical Genitourinary Cancer +

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May 17, 2024

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May 17, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Metastatic hormone-sensitive prostate cancer (mHSPC) treatment advances include new drug combinations. This review outlines pivotal trials and proposes a treatment algorithm for mHSPC, emphasizing a multidisciplinary approach.

Area Of Science

  • Oncology
  • Urology

Background

  • Prostate cancer (PC) is a leading global cancer, with 17% of new cases in 2020 being de novo metastatic (mPC), carrying a poor 5-year survival rate of 32%.
  • Metastatic hormone-sensitive prostate cancer (mHSPC) describes metastatic disease at diagnosis or after initial therapy without long-term androgen deprivation therapy (ADT), often progressing to castration-resistant prostate cancer (CRPC).
  • Androgen deprivation therapy (ADT), using agents like LHRH agonists (leuprorelin) and antagonists (degarelix), has been the standard for 80 years.

Purpose Of The Study

  • To review pivotal clinical trials that led to recent drug approvals for mHSPC.
  • To propose a treatment decision algorithm for mHSPC based on expert consensus.
  • To highlight the importance of a multidisciplinary approach in managing mHSPC.

Main Methods

  • Literature review of landmark clinical trials in mHSPC treatment.
  • Synthesis of expert statements from the Tuscan Interdisciplinary Uro-Oncological Group.
  • Development of a treatment decision-making framework.

Main Results

  • Recent advances incorporate combination strategies using drugs effective in CRPC.
  • Prognostic factors such as disease volume and presentation are critical for treatment selection.
  • A structured algorithm can guide treatment intensity and risk-benefit assessment.

Conclusions

  • Novel therapeutic strategies are evolving for mHSPC, moving beyond traditional ADT.
  • Personalized treatment selection, guided by clinical factors and expert consensus, is essential.
  • A multidisciplinary team approach optimizes patient outcomes in mHSPC management.

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