Dr. Zhu on Stratifying Treatments in Node-Positive Prostate Cancer

Jason Zhu, MD, a medical oncologist at Levine Cancer Institute, Atrium Health, discusses the process of stratifying treatments for patients with node-positive prostate cancer.

For patients with clinical node-positive disease, it is important to consider the Gleason score from their original prostate biopsy, Zhu says. If the patient’s Gleason score is 6 or 7, androgen-deprivation therapy (ADT) plus radiation therapy can be utilized. However, if a patient is otherwise fit but with more aggressive disease and has a Gleason score of 8 or higher, abiraterone (Zytiga) can be added to that regimen, Zhu explains. This because the agent can add benefit by helping to prevent the development of metastases, Zhu notes.

In patients with a Gleason score that is higher than 8 who have many other medical comorbidities, such as uncontrolled atrial fibrillation or other cardiac toxicities, it is reasonable to administer ADT plus radiation, Zhu concludes.