Articles

New evolutions in the treatment of prostate cancer

BJMO - 2019, issue Special, march 2019

Prof. dr. Silke Gillessen

Summary

Over the last decade, the prostate cancer (PCa) treatment landscape changed dramatically. During her second lecture at BMUC 2019, Prof. dr. Silke Gillessen summarized the recent evolutions regarding systemic therapy across the PCa disease spectrum.

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Sequencing therapy in metastatic castration-resistant prostate cancer

BJMO - 2019, issue Special, march 2019

Prof. dr. Silke Gillessen

Summary

Since 2010, several new agents have joined the armamentarium for the treatment of metastatic castration-resistant prostate cancer (mCRPC) (Figure 1).1–7 This had dramatically improved the outcome for patients with mCRPC, but also confronts physicians with the question of how to optimally sequence the different therapeutic options. In addition to this, the increasing use of abiraterone acetate (AA) and docetaxel (and in the near future perhaps also enzalutamide) in the castration-sensitive metastatic prostate cancer (PCa) setting will further complicate this therapeutic sequencing. During BMUC 2019, dr. Silke Gillessen gave an overview of the available clinical data that can be used to steer the treatment choices in the mCRPC setting. Unfortunately, none of the pivotal trials evaluating the novel treatment agents compared the experimental agent against a regimen that would be considered standard of care nowadays. Moreover, none of the trials included patients who received androgen deprivation therapy (ADT) plus AA or docetaxel in the hormone sensitive setting.

FIGURE 1. Approved systemic therapies for mCRPC.

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