Prostate cancer and novel pharmacological treatment options - what's new for 2022?

Androgen deprivation therapy (ADT) plus Androgen Receptor Target Agents (ARTAs) or docetaxel are the actual standard of care in prostate cancer (PC) first-line therapy. Several therapeutic options are currently available for pretreated patients: cabazitaxel, olaparib and rucaparib for BRCA mutations, Radium-223 for selected patients with symptomatic bone metastasis, sipuleucel T and 177 Lu-PSMA-617.

This article reviews the new potential therapeutic approaches and the most impacting recent published trials to provide an overview on the future management of PC.

Currently, there is a growing interest in the potential role of triplet therapies encompassing ADT, chemotherapy and ARTAs. These strategies, explored in different settings, appeared to be particularly promising in metastatic hormone-sensitive PC. Recent trials investigating ARTAs plus poly (adenosine diphosphate-ribose) polymerase (PARPi) inhibitor provided helpful insights for patients with metastatic castration resistant disease, regardless of homologous recombination genes status. Otherwise, the publication of the complete data is awaited, and more evidence is required. In advanced settings, several combination approaches are under investigation, to date with contradictory results, such as immunotherapy plus PARPi or chemotherapy. The radionuclide 177Lu-PSMA-617 proved successful outcomes in pretreated mCRPC patients. Additional studies will better clarify the appropriate candidates to each strategy and the correct treatments' sequence.

Expert review of clinical pharmacology. 2023 Feb 15 [Epub ahead of print]

Andrea Marchetti, Elisa Tassinari, Matteo Rosellini, Alessandro Rizzo, Francesco Massari, Veronica Mollica

Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy., Struttura Semplice Dipartimentale di Oncologia Medica per la Presa in Carico Globale del Paziente Oncologico "Don Tonino Bello", I.R.C.C.S. Istituto Tumori "Giovanni Paolo II", Bari, Italy.