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Oncology and Therapy
Published in: Oncology and Therapy 2/2020

Open Access 01-12-2020 | Prostate Cancer | Review

Metastatic Hormone-Sensitive Prostate Cancer (mHSPC): Advances and Treatment Strategies in the First-Line Setting

Authors: Kenrick Ng, Shievon Smith, Jonathan Shamash

Published in: Oncology and Therapy | Issue 2/2020

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Abstract

The treatment landscape of metastatic hormone-sensitive prostate cancer (mHSPC) has changed radically in recent years. Androgen deprivation therapy (ADT) alone was for decades the standard of care for treating mHSPC. This changed when studies showed that the addition of docetaxel chemotherapy or abiraterone acetate to ADT significantly increases overall survival of patients with mHSPC, followed by more recent evidence showing the efficacy of androgen receptor antagonists, such as enzalutamide and apalutamide, in this setting. While this rapid therapeutic evolution is welcome, it presents clinicians with a crucial challenge: the choice of treatment selection and sequencing. In the first-line setting there are no comparative data currently available to guide treatment choice between the different available regimens, and no prospective data to guide clinical decision after progression. Decisions on treatment will now need to be personalised based on indirect comparison of the available efficacy data from multiple phase 3 studies, together with considerations of disease volume, comorbidities, treatment aims, toxicity profile and cost reimbursement within the healthcare setting. Here, we provide an overview of the clinical trial data to date and propose some biological and clinical insights which may be helpful in making decisions on treatment selection and sequencing.
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Metadata
Title
Metastatic Hormone-Sensitive Prostate Cancer (mHSPC): Advances and Treatment Strategies in the First-Line Setting
Authors
Kenrick Ng
Shievon Smith
Jonathan Shamash
Publication date
01-12-2020
Publisher
Springer Healthcare
Published in
Oncology and Therapy / Issue 2/2020
Print ISSN: 2366-1070
Electronic ISSN: 2366-1089
DOI
https://doi.org/10.1007/s40487-020-00119-z

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