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Evolving Treatment Paradigms in Metastatic Hormone-Sensitive Prostate Cancer: Expert Narrative Review.
Vineet Talwar1, Kaushal Kalra2, Akhil Kapoor3
1Department of Medical Oncology, Rajiv Gandhi Cancer Institute and Research Centre (RGCIRC), New Delhi 110085, India.
Triplet therapy, including androgen deprivation therapy (ADT), docetaxel, and androgen receptor signalling inhibitors (ARSIs), improves survival for metastatic hormone-sensitive prostate cancer (mHSPC). Personalized treatment is key for optimizing patient outcomes.
Area of Science:
- Oncology
- Urology
- Pharmacology
Background:
- Metastatic hormone-sensitive prostate cancer (mHSPC) treatment has evolved with triplet therapy.
- Clinical guidelines recommend early intensification, but real-world application faces challenges.
Purpose of the Study:
- To review the current evidence and expert insights on triplet therapy for mHSPC in India.
- To address challenges in real-world practice, including patient heterogeneity and treatment sequencing.
Main Methods:
- Narrative review integrating landmark trial data.
- Incorporation of clinical guidelines and Indian oncologist expert insights.
Main Results:
- Triplet therapy, especially with darolutamide, enhances survival in high-volume mHSPC.
- Personalized treatment decisions should consider disease burden, comorbidities, and genomic profiles.
Conclusions:
- Harmonizing guideline-based care with individualized, real-world decision-making is crucial for mHSPC.
- Further research on real-world data, sequencing, and biomarkers is needed for precision medicine.
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