Prostate cancer treatment has rapidly evolved in the last few years. Androgen deprivation therapy has been the backbone of treatment for locally advanced and metastatic prostate cancer but incremental benefits in survival has been shown by adding androgen-receptor pathway inhibitors (ARPI) across various spectrums of disease state. In addition, docetaxel chemotherapy remains the first-line chemotherapy regimen available with survival benefits shown with triplet therapy in those who are chemotherapy-eligible. However, disease progression remains inevitable and novel agents such as radioligand therapy with lutetium have shown improvement in survival.
This review discusses the pivotal trials that led to the US FDA approval of agents utilized in metastatic prostate cancer and explores the use of novel agents including PSMA-targeting agents, radioligands, cell-based therapy, CAR-T, BiTE, and antibody drug conjugates.
Treatment landscape for metastatic castrate-resistant prostate cancer (mCRPC) has evolved beyond additional agents with ARPI and/or docetaxel, including other treatments with sipuleucel-T, radium, cabazitaxel, PARP inhibitors, and lutetium, which have specific indications and role in sequencing. Novel therapies remain critically needed after progression from lutetium.
Expert review of anticancer therapy. 2023 Apr 26 [Epub ahead of print]
Mohammad Atiq, Elias Chandran, Fatima Karzai, Ravi A Madan, Jeanny B Aragon-Ching
Genitourinary Malignancy Branch, Cancer Institute, Bethesda, MD, United States., GU Medical Oncology, Inova Schar Cancer Institute, Fairfax, VA, United States.