Prostate Cancer, Pathophysiology and Recent Developments in Management: A Narrative Review

Area of Science:

• Oncology
• Urology
• Medical Research

Background:

• Prostate cancer is the second most common cancer in men, presenting in various stages from localized to metastatic.
• Treatment strategies vary significantly based on cancer stage, including localized, locally advanced, non-metastatic castration-resistant prostate cancer (M0 CRPCa), and metastatic disease.

Purpose of the Study:

• To review current and emerging treatments for different stages of prostate cancer.
• To highlight recent advancements in drug development for metastatic castration-resistant prostate cancer (mCRPCa).

Main Methods:

• Review of current therapeutic options for localized, locally advanced, M0 CRPCa, and metastatic prostate cancer.
• Analysis of recent drug approvals and ongoing clinical trials for advanced prostate cancer.

Main Results:

• For M0 CRPCa and hormone-naive metastatic prostate cancer, treatments include androgen deprivation therapy with agents like apalutamide, darolutamide, or enzalutamide.
• For metastatic castration-resistant prostate cancer (mCRPCa), treatments such as sipuleucel-T, radium-223, abiraterone, enzalutamide, and cabazitaxel are used to slow progression.
• Recently approved drugs for mCRPCa, including PARP inhibitors and Lutetium-177, demonstrate significant improvements in overall survival and radiographic progression-free survival.

Conclusions:

• Current treatments offer good outcomes for various prostate cancer stages, with notable advancements in managing advanced disease.
• Emerging therapies like PARP inhibitors, Lutetium-177, and those in clinical trials (e.g., cabozantinib, CAR T-cell therapy) hold promise for improving survival and progression-free survival in advanced prostate cancer.