Current Treatment Options for Metastatic Hormone-Sensitive Prostate Cancer.

The possible treatments options for metastatic hormone-sensitive prostate cancer (mHSPC) have dramatically increased during the last years. The old backbone, which androgen-deprivation therapy (ADT) is the exclusive approach for hormone-naïve patients, has been disrupted. Despite the fact that several high-quality, randomized, controlled phase 3 trials have been conducted in this setting, no direct comparison is currently available among the different strategies. Inadequate power, absence of preplanning and small sample size frequently affect the subgroup analyses according to disease volume or patient's risk. The choice between ADT alone and ADT combined with docetaxel, abiraterone acetate, enzalutamide, apalutamide or radiotherapy to the primary tumor remains challenging. Factors that are related to the tumor, patient or drug side effects, currently guide these clinical decisions. This comprehensive review aims to indirectly compare the phase 3 trials in the mHSPC setting, in order to extrapolate data useful for treatment selection, providing also perspectives on future biomarkers.

Cancers. 2019 Sep 12*** epublish ***

Carlo Cattrini, Elena Castro, Rebeca Lozano, Elisa Zanardi, Alessandra Rubagotti, Francesco Boccardo, David Olmos

Academic Unit of Medical Oncology, IRCCS San Martino Polyclinic Hospital, 16132 Genoa, Italy. ., Prostate Cancer Clinical Research Unit, Spanish National Cancer Research Centre (CNIO), 28029 Madrid, Spain. ., Prostate Cancer Clinical Research Unit, Spanish National Cancer Research Centre (CNIO), 28029 Madrid, Spain. ., Academic Unit of Medical Oncology, IRCCS San Martino Polyclinic Hospital, 16132 Genoa, Italy. ., Academic Unit of Medical Oncology, IRCCS San Martino Polyclinic Hospital, 16132 Genoa, Italy. ., Academic Unit of Medical Oncology, IRCCS San Martino Polyclinic Hospital, 16132 Genoa, Italy. ., Prostate Cancer Clinical Research Unit, Spanish National Cancer Research Centre (CNIO), 28029 Madrid, Spain. .

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