Current diagnostic and therapeutic options in de novo low-volume metastatic hormone-sensitive prostate cancer.

IF 2.9 3区医学 Q2 ONCOLOGY

Expert Review of Anticancer Therapy Pub Date : 2025-05-21 DOI:10.1080/14737140.2025.2509760

Gianluca Ingrosso, Andrea Lancia, Lilia Bardoscia, Carlotta Becherini, Marta Bottero, Niccolò Bertini, Tommaso Cai, Saverio Caini, Claudia Caserta, Chiara Doccioli, Eleonora Festa, Giulio Francolini, Irene Giacomelli, Federico Paolieri, Daniele Scartoni, Antonio Rosario Pisani, Rita Bellavita, Lorenzo Livi, Cynthia Aristei, Beatrice Detti

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引用次数: 0

Abstract

Introduction: de novo low-volume metastatic hormone-sensitive prostate cancer (mHSPC) patients are characterized by a limited number of metastases at diagnosis. Intensifying the current diagnostic and therapeutic approach including multimodality therapy seems to be key in the clinical management of such patients.

Areas covered: We comprehensively review the current staging and treatment options for de novo low-volume mHSPC.

Expert opinion: PSMA-PET should be used in staging high-risk prostate cancer to detect metastatic disease and better stratify patients for individualized treatment. In the era of Androgen Receptor Pathway Inhibitors (ARPIs), Androgen Deprivation Therapy (ADT) alone should be considered an undertreatment for the majority of the patients. Based on current data in the literature, the most effective therapeutic strategy seems to be the combination of intensified systemic treatment (including ADT + ARPI) and radiotherapy for the primary tumor. The role of cytoreductive radical prostatectomy is currently being investigated as well as metastasis-directed therapy to metastatic sites.

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新发小体积转移性激素敏感前列腺癌的当前诊断和治疗选择。

新发低体积转移性激素敏感前列腺癌（mHSPC）患者的特点是诊断时转移数量有限。加强当前的诊断和治疗方法，包括多模式治疗似乎是关键在这类患者的临床管理。涵盖的领域：我们全面回顾了目前低剂量mHSPC的分期和治疗方案。专家意见：PSMA-PET应用于高危前列腺癌分期，以发现转移性疾病，更好地分层患者进行个体化治疗。在雄激素受体途径抑制剂（arpi）时代，对于大多数患者来说，单独使用雄激素剥夺疗法（ADT）是一种治疗不足的方法。根据目前的文献资料，最有效的治疗策略似乎是对原发肿瘤进行强化全身治疗（包括ADT + ARPI）和放疗的结合。目前正在研究细胞减减性根治性前列腺切除术的作用以及针对转移部位的转移性治疗。

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

Expert Review of Anticancer Therapy 医学-肿瘤学

CiteScore

5.10

自引率

3.00%

发文量

100

审稿时长

4-8 weeks

期刊介绍： Expert Review of Anticancer Therapy (ISSN 1473-7140) provides expert appraisal and commentary on the major trends in cancer care and highlights the performance of new therapeutic and diagnostic approaches. Coverage includes tumor management, novel medicines, anticancer agents and chemotherapy, biological therapy, cancer vaccines, therapeutic indications, biomarkers and diagnostics, and treatment guidelines. All articles are subject to rigorous peer-review, and the journal makes an essential contribution to decision-making in cancer care. Comprehensive coverage in each review is complemented by the unique Expert Review format and includes the following sections: Expert Opinion - a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results Article Highlights – an executive summary of the author’s most critical points.