Przemyslaw W. Twardowski, MD
Key ongoing focal points in the treatment of advanced metastatic castration-resistant prostate cancer (mCRPC) include discovering an optimal sequence for patients, identifying biomarkers, and determining the value of bone-targeted agents, according to Przemyslaw W. Twardowski, MD.
, he describes the available therapies for patients with advanced mCRPC, including bone-targeted therapies; the work that still lies ahead with these treatments; and the challenges with finding biomarkers to help develop targeted agents.
OncLive: What is the current standard of care for patients with advanced mCRPC?
: We have several drugs available for treatment in various categories ranging from immunotherapy, to very potent second-generation hormone agents that suppress testosterone signaling, to chemotherapeutic agents, and also to 1 radioactive isotope treatment. Those are the main categories, and they’re examples of various drugs within groups.
The treatment, in general, involves sequencing of these agents, starting from immunotherapy through second-generation hormone agents, and then moving to chemotherapy and to radioactive isotopes. Then, there is the whole gambit of clinical trials, of course, that are looking at new drug development in this disease.
How do you know what the optimal sequence of agents is for a patient?
That is a great question, and there is really no good answer yet in prostate cancer. In other tumor types, there is some advantage because there are specific biomarkers that guide therapy. In a specific biomarker, expression predicts response to one drug and the other biomarker to the other drug. In prostate cancer, there is nothing like that.
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