Prostate Cancer unveiled: Advancements in Metastatic Prostate Cancer Management
This library guide is to help support you in your professional development. Please give us feedback so we can improve this list in the future.
Some sections are under construction and will be ready later in the year. If you are presenting at a later Grand Rounds, please contact lynne.roberts3@health.nsw.gov.au and tell us about the content of your paper so we can add appropriate resources to the list for when you present your paper.
If you have any questions, please contact the Clinical Library on 9722 8250 or email SWSLHD-BankstownLibrary@health.nsw.gov.au or visit us Monday to Fridays, 8.30am - 5.00pm.
Gebrael, G., et al. (2023). "Advances in the treatment of metastatic prostate cancer." Trends in Cancer 9(10): 840-854 https://doi.org/10.1016/j.trecan.2023.06.009 doi: 10.1016/j.trecan.2023.06.009.
The field of metastatic prostate cancer (mPCa) has seen unprecedented therapeutic advances in the past decade. In the past 2 years, recent approvals include the triplet therapy regimens of androgen deprivation therapy (ADT), docetaxel, and an androgen receptor (AR) pathway inhibitor (ARPI) in the castration-sensitive setting and lutetium-177 vipivotide tetraxetan (177Lu-PSMA-617) and the combination of poly(ADP) ribose polymerase (PARP) inhibitors (PARPis) and ARPIs in the castration-resistant setting. With many agents currently undergoing investigation in registration trials, the therapeutic armamentarium will expand rapidly, making treatment selection and sequencing challenging. Herein, we review the landmark clinical trials ongoing or reported in the past 2 years, discuss the optimal approach to treatment selection, and provide insight into future directions. Request this article
Lokeshwar, S. D., et al. (2023). "Personalizing approaches to the management of metastatic hormone sensitive prostate cancer: role of advanced imaging, genetics and therapeutics." World Journal of Urology 41(8): 2007-2019 https://doi.org/10.1007/s00345-023-04409-9
To summarize contemporary and emerging strategies for the diagnosis and management of metastatic hormone sensitive prostate cancer (mHSPC), focusing on diagnostic testing and therapeutics.
Nevedomskaya, E., et al. (2018). "Recent advances in prostate cancer treatment and drug discovery." International Journal of Molecular Sciences 19(5): 1359
Novel drugs, drug sequences and combinations have improved the outcome of prostate cancer in recent years. The latest approvals include abiraterone acetate, enzalutamide and apalutamide which target androgen receptor (AR) signaling, radium-223 dichloride for reduction of bone metastases, sipuleucel-T immunotherapy and taxane-based chemotherapy. Adding abiraterone acetate to androgen deprivation therapy (ADT) in order to achieve complete androgen blockade has proven highly beneficial for treatment of locally advanced prostate cancer and metastatic hormone-sensitive prostate cancer (mHSPC). Also, ADT together with docetaxel treatment showed significant benefit in mHSPC. Ongoing clinical trials for different subgroups of prostate cancer patients include the evaluation of the second-generation AR antagonists enzalutamide, apalutamide and darolutamide, of inhibitors of the phosphatidylinositol-4,5-bisphosphate 3-kinase (PI3K) pathway, of inhibitors of DNA damage response, of targeted alpha therapy and of prostate-specific membrane antigen (PSMA) targeting approaches. Advanced clinical studies with immune checkpoint inhibitors have shown limited benefits in prostate cancer and more trials are needed to demonstrate efficacy. The identification of improved, personalized treatments will be much supported by the major progress recently made in the molecular characterization of early- and late-stage prostate cancer using “omics” technologies. This has already led to novel classifications of prostate tumors based on gene expression profiles and mutation status, and should greatly help in the choice of novel targeted therapies best tailored to the needs of patients.
Keywords:
prostate cancer; androgen receptor; PI3K pathway; DNA repair; “omics” technologies Request this article
Posdzich, P., et al. (2023). "Metastatic Prostate Cancer—A Review of Current Treatment Options and Promising New Approaches." Cancers 15(2): 461 https://www.mdpi.com/2072-6694/15/2/461 Free Full Test at lInk
Androgen deprivation therapy (ADT) alone has been the standard of care for many years in men with metastatic prostate cancer. Due to the limited survival under this monotherapy, many new treatment options have been developed in the last few years. Regarding hormone-sensitive prostate cancer, combination therapies of two or three agents of ADT, androgen receptor signaling inhibitors (ARSI) and chemotherapy have been established and led to a significant benefit in overall survival. Additionally, in patients with metastatic castration-resistant prostate cancer, there are many new therapeutic approaches. Chemotherapy alone has been the standard of care in this situation. In the last years, some new therapeutic options have been developed, which led to an improved survival after progression under chemotherapy. These therapies include ARSI, PARP inhibitors and Lu-PSMA radioligand therapy. The use of a bispecific T-cell engager (BiTE) in this setting is a new promising therapeutic approach, which has not been established as standard of care yet. The role of immunotherapy in prostate cancer is still under investigation. Overall, many new treatment options make prostate cancer therapy a challenging and promising field.
Keywords:
prostate cancer; ADT; PSMA Bite; PSMA radioligand therapy; immunotherapy; bispecific T-cell engager Request this article
Sayegh, N., et al. (2022). "Recent Advances in the Management of Metastatic Prostate Cancer." JCO Oncology Practice 18(1): 45-55 https://ascopubs.org/doi/abs/10.1200/OP.21.00206
Management of metastatic prostate cancer has undergone a revolution over the past decade with the introduction of several novel agents and repurposing of others. Several clinical trials reported improved outcomes with the intensification of androgen deprivation therapy by the addition of docetaxel chemotherapy or novel hormonal agents (abiraterone, enzalutamide, or apalutamide) in the metastatic castration-sensitive state. Relugolix has been recently approved as the first oral gonadotropin-releasing hormone receptor antagonist agent with a superior cardiovascular side-effect profile, and serum testosterone suppression compared with a gonadotropin-releasing hormone agonist, leuprolide. Poly-ADP ribose polymerase inhibitors (olaparib and rucaparib) have demonstrated significant clinical benefit for patients harboring deleterious mutations in genes belonging to the homologous recombination repair pathway and have received Food and Drug Administration approval. Recently, lutetium-177-prostate-specific membrane antigen-617 with standard of care treatment has shown to improve overall survival in men with advanced-stage prostate-specific membrane antigen–positive metastatic castration-resistant prostate cancer. These recent approvals, successes, and the ongoing investigation of multiple novel agents are expected to continue to dramatically improve survival outcomes of men with metastatic prostate cancer in the coming years. Request this article
Yap, T. A., et al. (2016). "Drug discovery in advanced prostate cancer: translating biology into therapy." Nature Reviews Drug Discovery 15(10): 699-718 https://doi.org/10.1038/nrd.2016.120
Castration-resistant prostate cancer (CRPC) is associated with a poor prognosis and poses considerable therapeutic challenges.Recent genetic and technological advances have provided insights into prostate cancer biology and enabled the identification of novel drug targets and potent molecularly targeted therapeutics for the disease.Promising targets in CRPC include the androgen receptor and its variants, key signalling pathways such as phosphoinositide 3-kinase (PI3K)–AKT and WNT signalling, and DNA repair defects.The therapeutic landscape of CRPC is evolving, with an increased focus on research into tumour heterogeneity, immuno-oncology, minimally invasive circulating tissue biomarkers, and modern clinical trial designs.The use of state-of-the-art, high-throughput, genomic platforms enabling patient stratification will permit optimization of the development of current and future drugs for CRPC. Request this article
Oxford Textbook of Oncology by 
Textbook of Uncommon Cancer by 
Abeloff's Clinical Oncology by 
Precision Medicine in Oncology by 
Radiation Oncology Management Decisions by 
SarcomaeviQ : cancer treatments online
A free resource of evidence-based, consensus driven cancer treatment protocols and information for use at the point of care. eviQ is developed for the Australian context and supports health professionals in the delivery of cancer treatments.
Cancer iChart - available via CIAP
Dive into what it means to practice love, compassion, courage and all the hard work of showing up to shape a compassion revolution across health care.
Join the Compassion Revolution Podcast on Apple or Google Podcast, or wherever you listen to your podcasts.
Discussions with some of the most fascinating individuals in the world of healthcare and medical education.