E M Kwan1,2, I A Thangasamy3,4, J Teh3, O Alghazo3, N J Sathianathen3, N Lawrentschuk3,5, A A Azad6,7. 1. Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Australia. 2. Department of Medical Oncology, Monash Health, Melbourne, Australia. 3. Division of Cancer Surgery, Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Australia. 4. Faculty of Medicine, University of Queensland, Brisbane, Australia. 5. Department of Surgery, University of Melbourne, Austin Hospital, Melbourne, Australia. 6. Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia. arun.azad@petermac.org. 7. Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia. arun.azad@petermac.org.
Abstract
INTRODUCTION: The last decade has seen a remarkable shift in the treatment landscape of advanced prostate cancer, none more so than in the management of metastatic castration-naïve disease. METHODS: This narrative review will examine existing and emerging evidence supporting systemic therapy use for metastatic castration-naïve prostate cancer (mCNPC) and provide guidance on the selection of these agents with respect to optimising patient outcomes. RESULTS: The addition of either docetaxel (chemohormonal approach) or an AR pathway inhibitor (abiraterone, enzalutamide or apalutamide) is a reasonable standard of care option for men commencing long-term ADT for mCNPC. While the issue of disease volume as a predictive biomarker for docetaxel benefit has previously been debated, recent data support consideration of upfront docetaxel in all patients, regardless of metastatic burden. Decisions regarding systemic treatment for men with mCNPC should be based on comprehensive consideration of disease, patient and logistical factors. Multiple novel therapeutics for mCNPC are currently under active investigation. CONCLUSION: The introduction of potent systemic therapy earlier in the mCNPC disease course has resulted in dramatic improvements in clinical outcomes for patients. As the management of mCNPC continues to evolve, the future remains promising, with the expectation of ongoing improvements to patient outcomes and quality of life.
INTRODUCTION: The last decade has seen a remarkable shift in the treatment landscape of advanced prostate cancer, none more so than in the management of metastatic castration-naïve disease. METHODS: This narrative review will examine existing and emerging evidence supporting systemic therapy use for metastatic castration-naïve prostate cancer (mCNPC) and provide guidance on the selection of these agents with respect to optimising patient outcomes. RESULTS: The addition of either docetaxel (chemohormonal approach) or an AR pathway inhibitor (abiraterone, enzalutamide or apalutamide) is a reasonable standard of care option for men commencing long-term ADT for mCNPC. While the issue of disease volume as a predictive biomarker for docetaxel benefit has previously been debated, recent data support consideration of upfront docetaxel in all patients, regardless of metastatic burden. Decisions regarding systemic treatment for men with mCNPC should be based on comprehensive consideration of disease, patient and logistical factors. Multiple novel therapeutics for mCNPC are currently under active investigation. CONCLUSION: The introduction of potent systemic therapy earlier in the mCNPC disease course has resulted in dramatic improvements in clinical outcomes for patients. As the management of mCNPC continues to evolve, the future remains promising, with the expectation of ongoing improvements to patient outcomes and quality of life.
Authors: Nicholas D James; Johann S de Bono; Melissa R Spears; Noel W Clarke; Malcolm D Mason; David P Dearnaley; Alastair W S Ritchie; Claire L Amos; Clare Gilson; Rob J Jones; David Matheson; Robin Millman; Gerhardt Attard; Simon Chowdhury; William R Cross; Silke Gillessen; Christopher C Parker; J Martin Russell; Dominik R Berthold; Chris Brawley; Fawzi Adab; San Aung; Alison J Birtle; Jo Bowen; Susannah Brock; Prabir Chakraborti; Catherine Ferguson; Joanna Gale; Emma Gray; Mohan Hingorani; Peter J Hoskin; Jason F Lester; Zafar I Malik; Fiona McKinna; Neil McPhail; Julian Money-Kyrle; Joe O'Sullivan; Omi Parikh; Andrew Protheroe; Angus Robinson; Narayanan N Srihari; Carys Thomas; John Wagstaff; James Wylie; Anjali Zarkar; Mahesh K B Parmar; Matthew R Sydes Journal: N Engl J Med Date: 2017-06-03 Impact factor: 91.245
Authors: Christopher J Sweeney; Yu-Hui Chen; Michael Carducci; Glenn Liu; David F Jarrard; Mario Eisenberger; Yu-Ning Wong; Noah Hahn; Manish Kohli; Matthew M Cooney; Robert Dreicer; Nicholas J Vogelzang; Joel Picus; Daniel Shevrin; Maha Hussain; Jorge A Garcia; Robert S DiPaola Journal: N Engl J Med Date: 2015-08-05 Impact factor: 91.245
Authors: Gwenaelle Gravis; Karim Fizazi; Florence Joly; Stéphane Oudard; Franck Priou; Benjamin Esterni; Igor Latorzeff; Remy Delva; Ivan Krakowski; Brigitte Laguerre; Fréderic Rolland; Christine Théodore; Gael Deplanque; Jean Marc Ferrero; Damien Pouessel; Loïc Mourey; Philippe Beuzeboc; Sylvie Zanetta; Muriel Habibian; Jean François Berdah; Jerome Dauba; Marjorie Baciuchka; Christian Platini; Claude Linassier; Jean Luc Labourey; Jean Pascal Machiels; Claude El Kouri; Alain Ravaud; Etienne Suc; Jean Christophe Eymard; Ali Hasbini; Guilhem Bousquet; Michel Soulie Journal: Lancet Oncol Date: 2013-01-08 Impact factor: 41.316
Authors: Nicholas D James; Matthew R Sydes; Noel W Clarke; Malcolm D Mason; David P Dearnaley; Melissa R Spears; Alastair W S Ritchie; Christopher C Parker; J Martin Russell; Gerhardt Attard; Johann de Bono; William Cross; Rob J Jones; George Thalmann; Claire Amos; David Matheson; Robin Millman; Mymoona Alzouebi; Sharon Beesley; Alison J Birtle; Susannah Brock; Richard Cathomas; Prabir Chakraborti; Simon Chowdhury; Audrey Cook; Tony Elliott; Joanna Gale; Stephanie Gibbs; John D Graham; John Hetherington; Robert Hughes; Robert Laing; Fiona McKinna; Duncan B McLaren; Joe M O'Sullivan; Omi Parikh; Clive Peedell; Andrew Protheroe; Angus J Robinson; Narayanan Srihari; Rajaguru Srinivasan; John Staffurth; Santhanam Sundar; Shaun Tolan; David Tsang; John Wagstaff; Mahesh K B Parmar Journal: Lancet Date: 2015-12-21 Impact factor: 79.321
Authors: Claire L Vale; Sarah Burdett; Larysa H M Rydzewska; Laurence Albiges; Noel W Clarke; David Fisher; Karim Fizazi; Gwenaelle Gravis; Nicholas D James; Malcolm D Mason; Mahesh K B Parmar; Christopher J Sweeney; Matthew R Sydes; Bertrand Tombal; Jayne F Tierney Journal: Lancet Oncol Date: 2015-12-21 Impact factor: 41.316
Authors: N W Clarke; A Ali; F C Ingleby; A Hoyle; C L Amos; G Attard; C D Brawley; J Calvert; S Chowdhury; A Cook; W Cross; D P Dearnaley; H Douis; D Gilbert; S Gillessen; R J Jones; R E Langley; A MacNair; Z Malik; M D Mason; D Matheson; R Millman; C C Parker; A W S Ritchie; H Rush; J M Russell; J Brown; S Beesley; A Birtle; L Capaldi; J Gale; S Gibbs; A Lydon; A Nikapota; A Omlin; J M O'Sullivan; O Parikh; A Protheroe; S Rudman; N N Srihari; M Simms; J S Tanguay; S Tolan; J Wagstaff; J Wallace; J Wylie; A Zarkar; M R Sydes; M K B Parmar; N D James Journal: Ann Oncol Date: 2019-12-01 Impact factor: 32.976
Authors: Christos E Kyriakopoulos; Yu-Hui Chen; Michael A Carducci; Glenn Liu; David F Jarrard; Noah M Hahn; Daniel H Shevrin; Robert Dreicer; Maha Hussain; Mario Eisenberger; Manish Kohli; Elizabeth R Plimack; Nicholas J Vogelzang; Joel Picus; Matthew M Cooney; Jorge A Garcia; Robert S DiPaola; Christopher J Sweeney Journal: J Clin Oncol Date: 2018-01-31 Impact factor: 50.717
Authors: Edmond M Kwan; Heidi Fettke; Megan Crumbaker; Maria M Docanto; Sarah Q To; Patricia Bukczynska; Andrew Mant; Nicole Ng; Siavash Foroughi; Lisa-Jane K Graham; Anne-Maree Haynes; Sarah Azer; Lisi Elizabeth Lim; Eva Segelov; Kate Mahon; Ian D Davis; Phillip Parente; Carmel Pezaro; Tilman Todenhöfer; Niranjan Sathianathen; Christine Hauser; Lisa G Horvath; Anthony M Joshua; Arun A Azad Journal: Transl Androl Urol Date: 2021-04