Toxicities of novel androgen receptor pathway inhibitor targeted therapies in advanced prostate cancer.

Abstract

Purpose of review: Advanced prostate cancer (PCa) is still dependent on the androgen receptor (AR) pathway, which has led to the development of new compounds - beyond androgen receptor pathway inhibitors (ARPIs) currently used in clinical practice - and that are able to overcome acquired resistance through AR mutations, splice variants or amplifications. With these new drugs, novel toxicities occur with new challenges for both patients and physicians. This narrative review aims to report and discuss emergent and/or related adverse events associated with these new hormonal therapies.

Recent findings: Adrenal insufficiency-like events and cardiac disorders were the main specific adverse events associated with these new hormonal therapies for advanced PCa. Different profiles of toxicities were also related to either combination of these drugs with usual ARPIs or to compounds with multiple effects on AR pathway, mainly AR antagonism.

Summary: As these new treatments are still under development, physicians need to keep up-to-date with potential emerging toxicities and manage acute and long-term toxicities.