Centers of Excellence
The Latest Research on mHSPC
Advances in Treatment for Metastatic Hormone Sensitive Prostate Cancer: With so many options, can we really go wrong?
As we all look forward to another prostate cancer awareness month, I find myself reeling with the advances the field has seen in the past year, particularly in the area of hormone sensitive metastatic prostate cancer. We learned that men may live longer if we can radiate the primary tumor if they have low volume metastatic disease. We also learned that enzalutamide and
Alicia Morgans, MD, MPH is an Associate Professor of Medicine in the Division of Hematology/Oncology at the Northwestern University Feinberg School of Medicine in Chicago, Illinois. She is a clinician and physician investigator specializing is investigating complications of systemic therapy for prostate cancer survivors. She has expertise in clinical trials and patient reported outcome measures, and as well as incorporating patient preferences and beliefs into clinical decision making.
In the United States and Europe, prostate cancer is the second most common malignancy and the second leading cause of cancer mortality among men1. While approximately 3% of men in the United States present with metastatic disease2, higher rates are experienced globally3. For the past 70 years, androgen deprivation therapy (ADT) has been the mainstay of therapy for locally advanced or metastatic disease, considering that the androgen receptor (AR) pathway is critical for prostate cancer progression4. While the majority of patients will benefit from a biochemical and clinical response to ADT, most eventually develop castrate-resistant prostate cancer (CRPC) despite castrate levels of testosterone5. In the absence of new treatment options, for nearly twenty years, there had been no appreciable improvement in survival among men diagnosed with metastatic hormone-sensitive prostate cancer6. Since 2004, there has been considerable progress in the treatment options and outcomes for men with castrate-resistant prostate cancer, as summarized in the UroToday Center of Excellence article entitled “Evidence-Based Therapeutic Approaches for mCRPC”. However, only since 2016, has there been evidence-based treatment options with proven survival benefit for men with metastatic hormone-sensitive prostate cancer, also known as metastatic castrate sensitive or hormone naïve disease.