Diagnostic Strategies for Treatment Selection in Advanced Prostate Cancer

Abstract

Prostate Cancer (PCa) is a leading cause of morbidity and mortality among men worldwide. For most men with PCa, their disease will follow an indolent course. However, advanced PCa is associated with poor outcomes. There has been an advent of new therapeutic options with proven efficacy for advanced PCa in the last decade which has improved survival outcomes for men with this disease. Despite this, advanced PCa continues to be associated with a high rate of death. There is a lack of strong evidence guiding the timing and sequence of these novel treatment strategies. This paper focuses on a review of the strategies for diagnostic and the current evidence available for treatment selection in advanced PCa.

AR-V7 in Metastatic Prostate Cancer: A Strategy beyond Redemption

“…Various clinical markers (e.g., performance status, number of bone/visceral metastases, time to CRPC, and previous treatments) are generally used to predict prognosis in advanced prostate cancer [ 30 , 31 ]. In addition, PSA, lactate dehydrogenase, alkaline phosphatase, albumin, hemoglobin, neutrophil-lymphocyte ratio, and testosterone have prognostic or predictive significance [ 32 ].…”

“…Imaging techniques are commonly employed to assess the extent of prostate cancer spread and play a pivotal role in therapeutic decision-making [ 30 ]. Over the past few years, radionuclide bone scintigraphy (BS) and computed tomography (CT) have been the preferred methods; however, new techniques can provide more reliable detection of cancer spread [ 37 ].…”

BRCA Germline Mutations in Prostate Cancer: The Future Is Tailored

“…Prostate cancer (PCa) is the second most common neoplasm in men and the fifth leading cause of death worldwide [1]. Despite recent advancements in the diagnosis and treatment of this disease, the incidence of PCa is rising and the clinical outcomes of patients with metastatic castration-resistant prostate cancer (mCRPC) are still poor [2,3].…”

Antitumor Activity and Mechanism of Action of Hormonotoxin, an LHRH Analog Conjugated to Dermaseptin-B2, a Multifunctional Antimicrobial Peptide

“…For most men with PCa, their disease will follow an indolent course. The 5-year survival rates are encouraging: 98% and 83% in the USA and Europe, respectively [ 2 ]. Localized PCa may be cured with surgery or radionuclide therapy; however, the disease recurs in approximately 20% to 30% of men treated for localized PCa and advanced disease is associated with poor outcomes.…”

“…Although most men with metastatic PCa initially respond to this androgen-deprivation therapy (ADT), inevitably their cancer progresses on this treatment to a disease state known as castration-resistant prostate cancer (CRPC). Despite the appearance of a panel of new therapies in this indication since 2010, such as second-generation hormone therapy (abiraterone, enzalutamide), taxane-based chemotherapy (docetaxel, cabazitaxel), immunotherapy (sipuleucel-T), targeted therapy (ipilimumab, an anti-CTLA-4 antibody) and metabolic radiotherapy (Ra-223) for men with bone metastasis, the median survival for men with metastatic castration-resistant prostate cancer (mCRPC) is less than 2 years [ 2 ]. In this context, the development of innovative therapies therefore represents a major challenge in the hope of offering to patients a more effective treatment, combining low toxicity, and reduced side effects and resistance associated with conventional therapies.…”