Xiao X Wei1, Eric C Ko, Charles J Ryan. 1. aDivision of Hematology/Oncology, University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, California bDepartment of Radiation Oncology, Weill Cornell Medicine, New York, New York, USA.
Abstract
PURPOSE OF REVIEW: There are currently limited data to guide the optimal management of patients with low-volume metastatic castration-resistant prostate cancer (mCRPC). In this review, we critically assess the most relevant clinical data, and discuss opportunities for advancing therapeutic options in this patient population. RECENT FINDINGS: Over the past decade, treatment options for mCRPC have expanded beyond taxanes to include abiraterone/prednisone, enzalutamide, sipuleucel-T, and radium-223. However, only a subset of patients in the landmark phase 3 studies would meet criteria consistent with low-volume mCRPC, and optimal treatment approach for this patient population is unclear. There is emerging evidence that mCRPC patients who harbor low-volume or indolent disease may derive the most benefit from immunotherapy. Whereas prospective data are lacking, stereotactic body radiation appears to be well tolerated and effective for local control of metastases in oligometastatic CRPC. SUMMARY: Prospective studies are needed to establish optimal therapeutic approaches in carefully selected low-volume mCRPC patients. Advances in functional imaging and molecular profiling should provide opportunities to optimize patient selection for effective treatment strategies.
PURPOSE OF REVIEW: There are currently limited data to guide the optimal management of patients with low-volume metastatic castration-resistant prostate cancer (mCRPC). In this review, we critically assess the most relevant clinical data, and discuss opportunities for advancing therapeutic options in this patient population. RECENT FINDINGS: Over the past decade, treatment options for mCRPC have expanded beyond taxanes to include abiraterone/prednisone, enzalutamide, sipuleucel-T, and radium-223. However, only a subset of patients in the landmark phase 3 studies would meet criteria consistent with low-volume mCRPC, and optimal treatment approach for this patient population is unclear. There is emerging evidence that mCRPC patients who harbor low-volume or indolent disease may derive the most benefit from immunotherapy. Whereas prospective data are lacking, stereotactic body radiation appears to be well tolerated and effective for local control of metastases in oligometastatic CRPC. SUMMARY: Prospective studies are needed to establish optimal therapeutic approaches in carefully selected low-volume mCRPC patients. Advances in functional imaging and molecular profiling should provide opportunities to optimize patient selection for effective treatment strategies.
Authors: Christoph Henkenberens; Thorsten Derlin; Frank Bengel; Tobias L Ross; Markus A Kuczyk; Frank A Giordano; Gustavo R Sarria; Leonard Christopher Schmeel; Hans Christiansen; Christoph A J von Klot Journal: Front Oncol Date: 2021-04-19 Impact factor: 6.244