The Insight Corner Hub: The Next Phase of Clinical Evolution in Metastatic Hormone-Sensitive and Castration-Resistant Prostate Cancer

Prostate cancer is a significant health concern worldwide, and its management has seen considerable advancements over the years¹². The treatment landscape for metastatic hormone-sensitive prostate cancer (mHSPC) and castration-resistant prostate cancer (CRPC) has evolved significantly, with new therapies being explored and introduced¹².

Metastatic Hormone-Sensitive Prostate Cancer (mHSPC)

The treatment of mHSPC has radically changed in recent years. Androgen deprivation therapy (ADT) alone was the standard of care for treating mHSPC for decades¹. This changed when studies showed that the addition of docetaxel chemotherapy or abiraterone acetate to ADT significantly increases the overall survival of patients with mHSPC¹. More recent evidence shows the efficacy of androgen receptor antagonists, such as enzalutamide and apalutamide, in this setting¹.

While this rapid therapeutic evolution is welcome, it presents clinicians with a crucial challenge: the choice of treatment selection and sequencing¹. In the first-line setting, there are no comparative data currently available to guide treatment choice between the different available regimens, and no prospective data to guide clinical decision after progression¹.

Castration-Resistant Prostate Cancer (CRPC)

CRPC is a stage where the cancer continues to progress despite the decrease in testosterone⁷. In men with CRPC, the cancer progresses to metastatic CRPC in most cases⁶. There are therapies that can help slow the advance of the disease, although they do not cure the cancer⁷.

The Future Landscape

The future landscape for both mHSPC and CRPC is promising with new medications and formulations being developed². Treatments recently approved by the US Food and Drug Administration (FDA) for pediatric patients with attention-deficit/hyperactivity disorder (ADHD) include 2 medications that address some of the common issues associated with standard stimulant treatments². Another development is the use of devices to manage ADHD symptoms².

Conclusion

In conclusion, the next phase of clinical evolution in metastatic hormone-sensitive and castration-resistant prostate cancer involves a deeper understanding of these conditions, development of new therapies, and making informed decisions about treatment selection and sequencing. As our understanding of these conditions evolves, so too will our approach to their management.

References:

1. Metastatic Hormone-Sensitive Prostate Cancer (mHSPC): Advances and .... https://link.springer.com/article/10.1007/s40487-020-00119-z.
2. The Next Clinical Phase in Metastatic Hormone-Sensitive and Castration .... https://www.medscape.org/viewarticle/995735_4.
3. Castration-Resistant Prostate Cancer: Treatment, Outlook, and More. https://www.healthline.com/health/prostate-cancer/castration-resistant-prostate-cancer.
4. What is castration-resistant prostate cancer? - Medical News Today. https://www.medicalnewstoday.com/articles/castration-resistant-prostate-cancer.
5. Three-drug combination prolongs survival in men with metastatic .... https://www.sciencedaily.com/releases/2022/02/220218110716.htm.
6. Results that Potentially Accelerate Phase 3 Clinical Trials in .... https://zerocancer.org/stay-informed/prostate-cancer-news/results-potentially-accelerate-phase-3-clinical-trials.
7. Pattern of Clinical Progression Until Metastatic Castration-Resistant .... https://link.springer.com/article/10.1007/s11523-022-00899-6.
8. Metastatic Castration-Resistant Prostate Cancer Clinical - GlobeNewswire. https://www.globenewswire.com/news-release/2022/07/11/2477510/0/en/Metastatic-Castration-Resistant-Prostate-Cancer-Clinical-Trial-Pipeline-Insights-DelveInsight.html.