Hormonal Agents in Localized and Advanced Prostate Cancer: Current Use and Future Perspectives.

Area of Science:

• Oncology
• Urology

Background:

• Prostate cancer (PC) is typically hormone-dependent, with androgen deprivation therapy (ADT) as a long-standing standard for metastatic disease.
• ADT's efficacy has been recognized in earlier stages, including localized disease and biochemical recurrence (BCR).
• Advances in understanding PC biology and ADT resistance have spurred the development of novel androgen receptor pathway inhibitors (ARPI).

Purpose of the Study:

• To review the current applications of androgen receptor-targeting agents in various prostate cancer stages.
• To discuss the evolving therapeutic landscape of ADT and ARPI.
• To outline future directions for androgen receptor pathway inhibition in PC management.

Main Methods:

• Literature review of studies on androgen deprivation therapy (ADT).
• Review of clinical trials and research on androgen receptor pathway inhibitors (ARPI).
• Analysis of treatment guidelines and expert opinions across different PC stages.

Main Results:

• ADT remains a cornerstone in metastatic prostate cancer and shows utility in earlier settings.
• ARPI have expanded their use from castration-resistant to hormone-naive and earlier disease stages.
• Evidence supports ARPI effectiveness in localized disease and biochemical recurrence, broadening treatment options.

Conclusions:

• Androgen receptor-targeting agents, including ADT and ARPI, play a vital and expanding role throughout the prostate cancer continuum.
• The strategic use of ARPI in conjunction with or as alternatives to ADT is transforming PC care.
• Future research will likely focus on optimizing sequencing and combination therapies involving these agents for improved patient outcomes.