Daniel J. George, MD, professor of Medicine and Surgery, member, Duke Cancer Institute, discusses sequential therapy in metastatic prostate cancer.
For patients with metastatic hormone-sensitive prostate cancer, physicians are combining docetaxel-based therapies or secondary hormonal therapies, says George. Moving forward, there may be an opportunity to combine both of those agents together, especially in patients with high-volume, extensive-stage disease.
For patients with metastatic castration-resistant prostate cancer (mCRPC) who have progressed on agents such as abiraterone acetate (Zytiga) or enzalutamide (Xtandi), physicians are faced with selecting the optimal second-line therapy. Prognostic factors and tumor burden are 2 big components that must be considered, says George. Within this population, there are patients with a high tumor burden who are going undetected, and, as a result, are not receiving therapy that is aggressive enough. Mild progression of symptoms is still progression, he adds. Following progression on frontline therapy, the median survival of a patient with mCRPC is 18 months. By being cognizant of these changes, physicians can take a more proactive approach and try to maintain a patient’s performance status at 0 or 1 for as long as possible.
Source : https://www.onclive.com/onclive-tv/dr-george-on-sequential-therapy-in-metastatic-prostate-cancer