Treatment decisions in new era of individualized therapy for metastatic hormone-sensitive prostate cancer

Medical Xpress / Dana-Farber Cancer Institute / Journal of Clinical Oncology ^ | June 9, 2023 | Jeremiah Wala et al

[ConservativeMind]

Oncologists have traditionally prescribed androgen deprivation therapy (ADT) alone for patients with metastatic hormone-sensitive prostate cancer (mHSPC).

Now, there are many possible treatment options. Clinical trials have shown that more aggressive up-front treatment with a range of combination therapies improves outcomes. This case study shows how Dana-Farber Cancer Institute oncologists interpreted the evidence from these trials and applied it to an individual patient with mHSPC.

The researchers recommend aggressive up-front treatment with triplet therapy (ADT, an androgen-receptor pathway inhibitor, and chemotherapy) for patients who can tolerate chemotherapy, and especially for patients with high-volume disease. For patients with low-volume disease, they recommend adding radiation therapy if feasible.

The researchers also recommend the use of PSMA-PET scans to find metastases, evaluate treatment response, and identify potential sites for radiation.

Choosing a treatment approach requires interpretation of the results of many trials and the consideration of multiple factors unique to each patient. This case study provides that interpretation and gives evidence-based guidance for how to navigate decision-making for individual patients.

[ConservativeMind]

After reviewing the issues around metastatic hormone-sensitive prostate cancer, these oncologists say it’s best to throw everything at it, all at once.

[ConservativeMind]

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[Midwesterner53]

I survived prostate cancer found in Sept 2012 early as stage 1C. I had the traditional seeds and 35 days of radiation. My PSA never went higher than 4.2 but had doubled from it’s usual 2 so my alert MD sent me to a urologist for a biopsy. The biopsy was very uncomfortable but worth the time and trouble obviously. Praising God for success.

[ConservativeMind]

Congratulations!

[cicero2k]

20 year survivor here on ADT + an androgen-receptor pathway inhibitor. Expect to get off these after nine months, and start another “vacation”.

[ConservativeMind]

Excellent! That is encouraging to hear.

All men are expected to get prostate cancer, if we live long enough, and success stories like yours provide hope.

[Magic Fingers]

Were you dx’d with metastases 20 years ago? If so, outstanding and congratulations!