Metastatic CRPC Management: Future Directions in Care

Closing out their review of the metastatic CRPC treatment paradigm, Tanya Dorff, MD, and Elisabeth Heath, MD, FACP, look toward future evolutions in care.


Tanya Dorff, MD: We’ve covered a lot of ground in metastatic castration-resistant prostate cancer, discussing some of the data with cabazitaxel and the new agent, lutetium PSMA. [Do you have] any final pearls of wisdom or a wish list for unmet needs?

Elisabeth Heath, MD, FACP: A lot of it requires thinking about our patients. The good news is, just as our patients are diverse, there are now a lot of tools in our tool kit, and the key is being thoughtful about the patient’s entire journey. With mCRPC, you wonder, “What percentage of people are going to get second line and third line and fourth line?” When it’s bladder cancer, we might say, “There are a lot of fragile patients, but many of them don’t get second line or third line. We’re getting much better at figuring out how to treat prostate cancer patients, and those in the CRPC [castration-resistant prostate cancer] state have a lot of options, but we have to be really thoughtful about the [whole] journey instead of thinking, “That’s going to be the next [hurdle] and I’ll figure it out as I go.” Because we may not end up on the right route or sequence, and that becomes a disservice to the patients. How about you, Dr Dorff? What do you think?

Tanya Dorff, M: I couldn’t agree more about not forgetting to keep the patient at the center of our thinking [when we plan] sequence of treatments and [consider] our options. One aspect of patient care that sometimes gets dropped is bone support. Bone morbidity really drives our patients’ quality of life at some point in the disease. And when you look at real-world studies, you find that bone-supportive agents aren’t used as much as they should be in mCRPC. It comes back to the basics: it’s making sure that we ask our patients what their goals are and trying to align our treatment plan with those goals and trying to support their whole body as they go through treatment, and hopefully, the patients will be able to access multiple lines of therapy.

Elisabeth Heath, MD, FACP: That sounds great; thanks so much. I had an enjoyable conversation with you about the complexities of mCRPC for patients. I think the news is good. We now have a lot of tools in our tool kit; we just must be savvy enough to know what to use and when.

Tanya Dorff, MD: Definitely. Thanks so much.

Elisabeth Heath, MD, FACP: Thank you.

Transcript edited for clarity.

Related Videos
Experts on renal cell carcinoma
Experts on renal cell carcinoma
Evan Y. Yu, MD, professor, medical oncology, assistant fellowship director, University of Washington School of Medicine, professor, Clinical Research Division, clinical research director, Genitourinary Medical Oncology, Fred Hutchinson Cancer Center, medical director, clinical research support, Fred Hutchinson Cancer Research Consortium
Michael A. Carducci, MD, professor of oncology, AEGON Professor of Prostate Cancer Research, Johns Hopkins Medicine
Michael S. Cookson, MD, MMHC, professor, chairman of urology, University of Oklahoma College of Medicine, chief, Urology, Stephenson Cancer Center
Andrei H. Iagaru, MD, professor of Radiology - Nuclear Medicine, chief, Division of Nuclear Medicine and Molecular Imaging, Stanford University Medical Center
Jeremie Calais, MD, MSc, assistant professor of nuclear medicine and theranostics, David Geffen School of Medicine, University of California, Los Angeles (UCLA), UCLA Health,
Tanya Dorff, MD, medical oncologist, associate clinical professor, Department of Medical Oncology & Therapeutics Research, City of Hope
Matthew Rettig, MD, chief, hematology-oncology, VA Medical Center, professor of medicine and urology, David Geffen School of Medicine, University of California, Los Angeles (UCLA) Health
Tian Zhang, MD, MHS
Related Content