Dr. Kantoff on Approaches for Progressive Prostate Cancer Following Androgen Blockade

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Philip W. Kantoff, MD, discusses current approaches for patients with metastatic hormone-sensitive prostate cancer, and nonmetastatic/metastatic castration-resistant prostate cancer who progress on androgen blocking agents.

Philip W. Kantoff, MD, chair of the Department of Medicine at Memorial Sloan Kettering Cancer Center and a 2014 Giants of Cancer Care® winner for Genitourinary Cancer, discusses current approaches for patients with metastatic hormone-sensitive prostate cancer (mHSPC), and nonmetastatic (nm)/metastatic castration-resistant prostate cancer (mCRPC) who progress on androgen blocking agents.

Androgen blocking agents are introduced either in the context of mHSPC, nmCRPC, or mCRPC, says Kantoff, who adds that they seem to work a bit better in the earlier-line setting and are more frequently used in these disease subtypes.

However, when a patient develops resistance to these agents, such as abiraterone acetate (Zytiga), enzalutamide (Xtandi), darolutamide (Nubeqa), and apalutamide (Erleada), their ability to be treated successfully with another 1 of those agents is minimal, says Kantoff. That is when patients move onto taxanes, such as docetaxel and cabazitaxel (Jevtana), or sipuleucel-T, which is an immunotherapy agent that was FDA-approved 10 years ago, concludes Kantoff.

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