SEOM clinical guidelines for the treatment of advanced prostate cancer (2020).
Androgen Antagonists
/ therapeutic use
Androstenes
/ therapeutic use
Antineoplastic Agents
/ therapeutic use
Benzamides
/ therapeutic use
Combined Modality Therapy
/ methods
Docetaxel
/ therapeutic use
Genes, BRCA1
Genes, BRCA2
Genetic Testing
/ methods
Humans
Male
Medical Oncology
Nitriles
/ therapeutic use
Orchiectomy
Phenylthiohydantoin
/ therapeutic use
Phthalazines
/ therapeutic use
Piperazines
/ therapeutic use
Prostatic Neoplasms
/ genetics
Prostatic Neoplasms, Castration-Resistant
/ diagnosis
Radiotherapy
/ methods
Randomized Controlled Trials as Topic
Societies, Medical
Spain
Thiohydantoins
/ therapeutic use
Androgen
Biomarkers
Castration
Molecular
Research
Journal
Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico
ISSN: 1699-3055
Titre abrégé: Clin Transl Oncol
Pays: Italy
ID NLM: 101247119
Informations de publication
Date de publication:
May 2021
May 2021
Historique:
accepted:
27
01
2021
pubmed:
25
2
2021
medline:
31
8
2021
entrez:
24
2
2021
Statut:
ppublish
Résumé
The treatment of advanced prostate cancer has evolved due to recent advances in molecular research and new drug development. Dynamic aberrations in the androgen receptor, DNA repair genes, PTEN-PI3K, and other pathways drive the behavior of advanced prostate cancer allowing a better selection of therapies in each patient. Tumor testing for BRCA1 and BRCA2 is recommended for patients with metastatic prostate cancer, also considering a broad panel to guide decisions and genetic counseling. In symptomatic metastatic patients, castration should be stared to palliate symptoms and prolong survival. In high-risk or high-volume metastatic hormone-naïve patients, castration should be combined with docetaxel, abiraterone, enzalutamide or apalutamide. Radiotherapy to the primary tumor combined with systemic therapy is recommended in low-volume mHNPC patients. In patients with non-metastatic castration-resistant tumors, risk stratification can define the frequency of imaging. Adding enzalutamide, darolutamide or apalutamide to these patients prolongs metastasis-free and overall survival, but potential adverse events need to be taken into consideration. The choice of docetaxel, abiraterone or enzalutamide for treating metastatic castration-resistant patients depends on previous therapies, with cabazitaxel being also recommended after docetaxel. Olaparib is recommended in BRCA1/BRCA2 mutated castration-resistant patients after progression on at least one new hormonal therapy. Aggressive variants of prostate cancer respond to platinum-based chemotherapy. To optimize treatment efficiency, oncologists should incorporate all of these advances into an overall therapeutic strategy.
Identifiants
pubmed: 33625671
doi: 10.1007/s12094-021-02561-5
pii: 10.1007/s12094-021-02561-5
pmc: PMC8057980
doi:
Substances chimiques
Androgen Antagonists
0
Androstenes
0
Antineoplastic Agents
0
Benzamides
0
Nitriles
0
Phthalazines
0
Piperazines
0
Thiohydantoins
0
apalutamide
0
Docetaxel
15H5577CQD
Phenylthiohydantoin
2010-15-3
enzalutamide
93T0T9GKNU
abiraterone
G819A456D0
olaparib
WOH1JD9AR8
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
969-979Références
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