Navigating therapeutic sequencing in the metastatic castration-resistant prostate cancer patient journey.

IF 5.1 2区医学 Q1 ONCOLOGY

Prostate Cancer and Prostatic Diseases Pub Date : 2024-10-17 DOI:10.1038/s41391-024-00906-z

Hannah D McManus, Tanya Dorff, Alicia K Morgans, Oliver Sartor, Neal Shore, Andrew J Armstrong

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引用次数: 0

Abstract

Background: Novel therapies for metastatic castration-resistant prostate cancer (mCRPC) have improved patient outcomes. However, there is uncertainty on the optimal selection of therapeutic agents for subsequent lines of therapy.

Methods: We conducted a comprehensive review of published evidence from pivotal clinical trials and recent guidelines for the treatment of mCRPC. We further identify gaps in knowledge and areas for future research.

Results: Key considerations to help guide treatment selection for patients with mCRPC include personal treatment history, individual clinical characteristics, symptoms, prognosis, availability of clinical trials, and other patient-specific factors. Genetic testing and prostate-specific membrane antigen-targeted imaging are important tools to evaluate candidacy for newer therapeutic options such as poly (ADP-ribose) polymerase inhibitors, alone or in combination with androgen receptor pathway inhibitors, and [¹⁷⁷Lu]Lu-PSMA-617.

Conclusion: This article provides an overview of the evolving treatment landscape of mCRPC, discussing guideline-recommended treatment options and data from key clinical trials, while highlighting ongoing trials that may impact the future treatment landscape. Recommendations for optimal treatment sequencing based on individual patient factors are provided.

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为转移性抗性前列腺癌患者的治疗排序导航。

背景：治疗转移性抗性前列腺癌（mCRPC）的新型疗法改善了患者的预后。然而，在后续治疗中如何选择最佳治疗药物仍存在不确定性：方法：我们全面回顾了关键临床试验中已发表的证据和近期治疗 mCRPC 的指南。我们进一步确定了知识空白和未来研究领域：帮助指导mCRPC患者选择治疗方法的主要考虑因素包括个人治疗史、个体临床特征、症状、预后、临床试验的可用性以及其他患者特异性因素。基因检测和前列腺特异性膜抗原靶向成像是评估新治疗方案（如聚（ADP-核糖）聚合酶抑制剂，单独使用或与雄激素受体通路抑制剂联合使用，以及[177Lu]Lu-PSMA-617）候选资格的重要工具：本文概述了不断发展的mCRPC治疗方法，讨论了指南推荐的治疗方案和主要临床试验的数据，同时重点介绍了可能影响未来治疗方法的正在进行的试验。文章还提供了基于患者个体因素的最佳治疗排序建议。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Prostate Cancer and Prostatic Diseases 医学-泌尿学与肾脏学

CiteScore

10.00

自引率

6.20%

发文量

142

审稿时长

6-12 weeks

期刊介绍： Prostate Cancer and Prostatic Diseases covers all aspects of prostatic diseases, in particular prostate cancer, the subject of intensive basic and clinical research world-wide. The journal also reports on exciting new developments being made in diagnosis, surgery, radiotherapy, drug discovery and medical management. Prostate Cancer and Prostatic Diseases is of interest to surgeons, oncologists and clinicians treating patients and to those involved in research into diseases of the prostate. The journal covers the three main areas - prostate cancer, male LUTS and prostatitis. Prostate Cancer and Prostatic Diseases publishes original research articles, reviews, topical comment and critical appraisals of scientific meetings and the latest books. The journal also contains a calendar of forthcoming scientific meetings. The Editors and a distinguished Editorial Board ensure that submitted articles receive fast and efficient attention and are refereed to the highest possible scientific standard. A fast track system is available for topical articles of particular significance.