Materiały źródłowe

• #1 Metastatic prostate cancer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/metastatic-prostate-cancer/diagnosis-treatment/drc-20377972

  Metastatic prostate cancer diagnosis often involves blood tests and imaging tests. A metastatic prostate cancer is an advanced cancer that has spread to other parts of the body. This makes it a stage 4 prostate cancer. […] Treatment for metastatic prostate cancer often starts with hormone therapy. This treatment blocks the effects of hormones that prostate cancer cells use to help them grow. If the cancer starts growing again, other treatments may be used. […] Eventually most metastatic prostate cancers find ways to grow without hormones. When this happens, healthcare professionals call these advanced cancers castration-resistant prostate cancers. Hormone therapy treatments usually continue. But other medicines might be added to the treatment plan. These other treatments might include chemotherapy, targeted therapy, immunotherapy and radiopharmaceutical treatments.

• #2 Treatment options for metastatic prostate cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/prostate-cancer/metastatic-cancer/treatment/options

  Metastatic prostate cancer means that a cancer that began in the prostate has spread to other parts of the body. It is sometimes called advanced prostate cancer. […] When prostate cancer is advanced, it usually means it can no longer be cured. Treatment can help to reduce symptoms, make you feel better and help you to live longer. Many men with advanced prostate cancer live a normal life for a number of years. […] Your treatment depends on: where your cancer is and where it has spread to, your general health and level of fitness, your PSA blood test level, the symptoms you might have, the treatment you have had. […] You usually have a combination of these treatments: hormone therapy, chemotherapy, radiotherapy, targeted cancer drugs, symptom control such as treatments to help with bone pain.

• #3 Treatment options for metastatic prostate cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/prostate-cancer/metastatic-cancer/treatment/options

  Metastatic prostate cancer means that a cancer that began in the prostate has spread to other parts of the body. It is sometimes called advanced prostate cancer. […] When prostate cancer is advanced, it usually means it can no longer be cured. Treatment can help to reduce symptoms, make you feel better and help you to live longer. Many men with advanced prostate cancer live a normal life for a number of years. […] Your treatment depends on: where your cancer is and where it has spread to, your general health and level of fitness, your PSA blood test level, the symptoms you might have, the treatment you have had. […] You usually have a combination of these treatments: hormone therapy, chemotherapy, radiotherapy, targeted cancer drugs, symptom control such as treatments to help with bone pain.

• #4 Metastatic Prostate Cancer—A Review of Current Treatment Options and Promising New Approaches

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9856730/

  Prostate cancer is the most common tumor in men. Although there have been many new developments in the last few years, metastatic castration resistant prostate cancer remains a deadly disease. This article provides an overview of currently approved treatment options as well as new therapies that are not standard of care yet. All relevant developments from classical androgen deprivation therapy (ADT) to bispecific T-cell engagers (BiTE) are considered. […] Androgen deprivation therapy (ADT) alone has been the standard of care for many years in men with metastatic prostate cancer. Due to the limited survival under this monotherapy, many new treatment options have been developed in the last few years. […] Additionally, in patients with metastatic castration-resistant prostate cancer, there are many new therapeutic approaches. Chemotherapy alone has been the standard of care in this situation. In the last years, some new therapeutic options have been developed, which led to an improved survival after progression under chemotherapy. These therapies include ARSI, PARP inhibitors and Lu-PSMA radioligand therapy.

• #5 Metastatic prostate cancer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/metastatic-prostate-cancer/diagnosis-treatment/drc-20377972

  Many treatments are available for metastatic prostate cancer, which also is called stage 4 prostate cancer. If one treatment stops working, there often are other options. Metastatic prostate cancer treatments may slow the cancer and extend your life. But metastatic prostate cancer often can’t be cured. […] Hormone therapy for prostate cancer is a treatment that stops the hormone testosterone either from being made or from reaching prostate cancer cells. Prostate cancer cells rely on testosterone to help them grow. Cutting off the supply of testosterone may cause cancer cells to die or to grow more slowly. […] Hormone therapy treatments for metastatic prostate cancer include: Medicines that stop the body from making testosterone. Some medicines stop cells from getting the signals that tell them to make testosterone. These medicines are called luteinizing hormone-releasing hormone agonists and antagonists. Another name for these medicines is LHRH agonists and antagonists.

• #6 Metastatic Prostate Cancer Treatments | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/prostate/treatment/metastatic-prostate-cancer-treatments

  Hormone therapy slows or blocks prostate cancer cells from growing. Testosterone can cause prostate cancer cells to grow. Hormone therapy lowers the amount of testosterone your testicles make. It also blocks the action of testosterone and other male hormones. […] Chemotherapy for prostate cancer is an important treatment option when the disease has metastasized (spread). If you have cancer that has spread to your bones, chemotherapy can help you live longer, with less pain. Docetaxel (Taxotere) is considered the standard of care in chemotherapy for prostate cancer that is resistant to hormone therapy. […] Another chemotherapy drug for treating castration-resistant prostate cancer is cabazitaxel (Jevtana). […] Immunotherapy uses the power of the immune system to target cancer cells. […] The first immunotherapy treatment for people with advanced metastatic prostate cancer approved by the FDA was sipuleucel-T (Provenge).

• #7 Metastatic prostate cancer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/metastatic-prostate-cancer/diagnosis-treatment/drc-20377972

  Many treatments are available for metastatic prostate cancer, which also is called stage 4 prostate cancer. If one treatment stops working, there often are other options. Metastatic prostate cancer treatments may slow the cancer and extend your life. But metastatic prostate cancer often can’t be cured. […] Hormone therapy for prostate cancer is a treatment that stops the hormone testosterone either from being made or from reaching prostate cancer cells. Prostate cancer cells rely on testosterone to help them grow. Cutting off the supply of testosterone may cause cancer cells to die or to grow more slowly. […] Hormone therapy treatments for metastatic prostate cancer include: Medicines that stop the body from making testosterone. Some medicines stop cells from getting the signals that tell them to make testosterone. These medicines are called luteinizing hormone-releasing hormone agonists and antagonists. Another name for these medicines is LHRH agonists and antagonists.

• #8 Treatment options for metastatic prostate cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/prostate-cancer/metastatic-cancer/treatment/options

  The first treatment you have is usually hormone therapy in combination with more hormone therapy such as apalutamide and enzalutamide or chemotherapy. […] Hormone therapy blocks or lowers the amount of testosterone in the body. Common hormone therapy injections include goserelin and degarelix. […] Chemotherapy is a type of anti cancer drug treatment. The drugs work by killing prostate cancer cells. The most common chemotherapy drug used for prostate cancer is docetaxel. […] A combination of different hormone therapy drugs or hormone therapy with chemotherapy often controls metastatic prostate cancer for many months to years. But sometimes the cancer can start to grow again after the initial treatment. […] This means that hormone therapy is no longer working. If this happens, your doctor might suggest: a different type of hormone therapy with chemotherapy, an additional hormone therapy drug, chemotherapy with steroids, bisphosphonates, radiotherapy, radioisotope therapy such as Radium-223 and Lutetium-177-PSMA.

• #9 Advanced prostate cancer | Prostate Cancer UK

  https://prostatecanceruk.org/prostate-information-and-support/just-diagnosed/advanced-prostate-cancer/

  Advanced prostate cancer can cause symptoms, such as fatigue (extreme tiredness), bone pain, and problems urinating. […] Its not possible to cure advanced prostate cancer. But treatments can help keep it under control and manage any symptoms. […] If you have advanced prostate cancer, treatment wont cure your cancer. But it can help keep it under control and manage any symptoms. […] If youve just been diagnosed with advanced prostate cancer, you may be offered the following treatments: hormone therapy, chemotherapy with hormone therapy, clinical trials. […] There are newer types of hormone therapy that can be used to treat some men with advanced prostate cancer. […] Triplet therapy is a new treatment. It combines the hormone therapy, darolutamide (Nubeqa) with both standard hormone therapy and chemotherapy (docetaxel).

• #10 Metastatic Prostate Cancer—A Review of Current Treatment Options and Promising New Approaches

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9856730/

  In summary, the combination therapy of ADT + AAP provided a significant survival benefit over ADT monotherapy. […] The results of these trials indicated that the combination therapy of ADT and ARSI improved OS in mHSPC patients than ADT alone. Both patient groups, high volume disease and low volume disease had a benefit from combination therapy. […] As a result, triple therapies show a promising survival benefit in mHSPC patients, especially in those with high tumor burden. […] First-line treatment in men with mCRPC differ. Most trials explored the role of treatments after the failure of ADT alone. […] The efficacy of abiraterone acetate before chemotherapy was shown in the placebo controlled COU-AA-302 trial. […] The value of AAP in treatment of mHSPC has already been mentioned above. Additionally, in mCRPC it is a possible therapy option after docetaxel.

• #11 Metastatic Prostate Cancer—A Review of Current Treatment Options and Promising New Approaches

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9856730/

  In summary, the combination therapy of ADT + AAP provided a significant survival benefit over ADT monotherapy. […] The results of these trials indicated that the combination therapy of ADT and ARSI improved OS in mHSPC patients than ADT alone. Both patient groups, high volume disease and low volume disease had a benefit from combination therapy. […] As a result, triple therapies show a promising survival benefit in mHSPC patients, especially in those with high tumor burden. […] First-line treatment in men with mCRPC differ. Most trials explored the role of treatments after the failure of ADT alone. […] The efficacy of abiraterone acetate before chemotherapy was shown in the placebo controlled COU-AA-302 trial. […] The value of AAP in treatment of mHSPC has already been mentioned above. Additionally, in mCRPC it is a possible therapy option after docetaxel.

• #12 Prostate Cancer Treatment & Management: Approach Considerations, Localized Prostate Cancer, Management of Advanced and Metastatic Disease

  https://emedicine.medscape.com/article/1967731-treatment

  mHSPC remains incurable. While ADT, with or without nonsteroidal antiandrogens, has been the backbone of mHSPC treatment for many decades, ADT alone is no longer considered sufficient treatment for mHSPC. Multiple studies have shown that additional therapy with either docetaxel or androgen pathway-directed therapy (abiraterone acetate plus prednisone, apalutamide, enzalutamide) significantly extends overall and progression-free survival. […] In a study of men with newly diagnosed metastatic prostate cancer, treatment with prostate radiation and ADT led to substantially longer survival compared with treatment with ADT alone. In the study, which included 6382 men, combination therapy yield superior median survival (55 vs 37 months) and 5-year overall survival (49% vs 33%) (P 0.001). […] Physicians have suggested that the benefits seen from radiation to the prostate point to the benefits of local therapy, raising the question of whether radical prostatectomy might have the same results. Trials are ongoing, and at present the use of surgery should be considered investigational and conducted only within the context of a trial. However, transurethral resection is sometimes needed in men who develop obstruction secondary to local tumor growth. Bilateral orchiectomy can be used to produce androgen deprivation in patients with widely advanced and metastatic prostate cancer.

• #13 Attacking metastatic prostate cancer early with combination treatment approach improves outcomes in preliminary study | UCLA Health

  https://www.uclahealth.org/news/release/attacking-metastatic-prostate-cancer-early-with-combination

  Nearly all men who are diagnosed with metastatic hormone-sensitive prostate cancer are treated with androgen deprivation therapy, a type of hormonal therapy that aims to lower the levels of male hormones called androgens that can stimulate the growth of prostate cancer cells. […] One way to prolong the use of hormonal therapy while controlling PSA levels is to leverage a combination of therapies, including stereotactic body radiation therapy (SBRT), which delivers highly focused and intense doses of radiation to the tumor while minimizing exposure to surrounding healthy tissues in short duration. […] The UCLA team conducted a single-arm phase 2 trial to evaluate whether the addition of metastasis-directed SBRT and dual androgen receptor pathway inhibitors, a more potent but shorter course of hormonal therapy, to intermittent androgen deprivation therapy improves the recurrence rates for men.

• #14 Metastatic prostate cancer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/metastatic-prostate-cancer/diagnosis-treatment/drc-20377972

  Metastatic prostate cancer diagnosis often involves blood tests and imaging tests. A metastatic prostate cancer is an advanced cancer that has spread to other parts of the body. This makes it a stage 4 prostate cancer. […] Treatment for metastatic prostate cancer often starts with hormone therapy. This treatment blocks the effects of hormones that prostate cancer cells use to help them grow. If the cancer starts growing again, other treatments may be used. […] Eventually most metastatic prostate cancers find ways to grow without hormones. When this happens, healthcare professionals call these advanced cancers castration-resistant prostate cancers. Hormone therapy treatments usually continue. But other medicines might be added to the treatment plan. These other treatments might include chemotherapy, targeted therapy, immunotherapy and radiopharmaceutical treatments.

• #15 Patient education: Treatment for advanced prostate cancer (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/treatment-for-advanced-prostate-cancer-beyond-the-basics

  ADT is usually recommended as the initial treatment for males with metastatic prostate cancer. […] The recommended treatment approach depends on several factors, including how quickly the disease is expected to progress and the number and location of metastases. […] Options at the time of disease progression — Most males with advanced prostate cancer initially respond well to treatment that includes ADT (which is often given in combination with docetaxel, with or without a third drug), but then their prostate cancer comes back, often within a few years. […] Secondary hormone therapy — Even when prostate cancer becomes castration resistant, some form of ADT is continued because at least a portion of the cancer cells might still respond. […] Chemotherapy — Chemotherapy may be offered to males with advanced prostate cancer who have stopped responding to their initial therapy, including all forms of hormone therapy.

• #16 Treatment options for metastatic prostate cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/prostate-cancer/metastatic-cancer/treatment/options

  The first treatment you have is usually hormone therapy in combination with more hormone therapy such as apalutamide and enzalutamide or chemotherapy. […] Hormone therapy blocks or lowers the amount of testosterone in the body. Common hormone therapy injections include goserelin and degarelix. […] Chemotherapy is a type of anti cancer drug treatment. The drugs work by killing prostate cancer cells. The most common chemotherapy drug used for prostate cancer is docetaxel. […] A combination of different hormone therapy drugs or hormone therapy with chemotherapy often controls metastatic prostate cancer for many months to years. But sometimes the cancer can start to grow again after the initial treatment. […] This means that hormone therapy is no longer working. If this happens, your doctor might suggest: a different type of hormone therapy with chemotherapy, an additional hormone therapy drug, chemotherapy with steroids, bisphosphonates, radiotherapy, radioisotope therapy such as Radium-223 and Lutetium-177-PSMA.

• #17 Metastatic Prostate Cancer Treatments | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/prostate/treatment/metastatic-prostate-cancer-treatments

  Hormone therapy slows or blocks prostate cancer cells from growing. Testosterone can cause prostate cancer cells to grow. Hormone therapy lowers the amount of testosterone your testicles make. It also blocks the action of testosterone and other male hormones. […] Chemotherapy for prostate cancer is an important treatment option when the disease has metastasized (spread). If you have cancer that has spread to your bones, chemotherapy can help you live longer, with less pain. Docetaxel (Taxotere) is considered the standard of care in chemotherapy for prostate cancer that is resistant to hormone therapy. […] Another chemotherapy drug for treating castration-resistant prostate cancer is cabazitaxel (Jevtana). […] Immunotherapy uses the power of the immune system to target cancer cells. […] The first immunotherapy treatment for people with advanced metastatic prostate cancer approved by the FDA was sipuleucel-T (Provenge).

• #18 Metastatic Prostate Cancer Treatments | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/prostate/treatment/metastatic-prostate-cancer-treatments

  Hormone therapy slows or blocks prostate cancer cells from growing. Testosterone can cause prostate cancer cells to grow. Hormone therapy lowers the amount of testosterone your testicles make. It also blocks the action of testosterone and other male hormones. […] Chemotherapy for prostate cancer is an important treatment option when the disease has metastasized (spread). If you have cancer that has spread to your bones, chemotherapy can help you live longer, with less pain. Docetaxel (Taxotere) is considered the standard of care in chemotherapy for prostate cancer that is resistant to hormone therapy. […] Another chemotherapy drug for treating castration-resistant prostate cancer is cabazitaxel (Jevtana). […] Immunotherapy uses the power of the immune system to target cancer cells. […] The first immunotherapy treatment for people with advanced metastatic prostate cancer approved by the FDA was sipuleucel-T (Provenge).

• #19 Chemotherapy for metastatic prostate cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/prostate-cancer/metastatic-cancer/treatment/chemotherapy

  Chemotherapy is a common treatment for metastatic or advanced prostate cancer. Chemotherapy uses anti cancer drugs to destroy prostate cancer cells. The most common type of chemotherapy used for prostate cancer is docetaxel. […] Chemotherapy for metastatic prostate cancer can help relieve symptoms. It can also help to control the cancer and improve your quality of life. But it cant cure metastatic prostate cancer. […] The most common types of chemotherapy treatment for metastatic prostate cancer are: docetaxel (Taxotere) and cabazitaxel (Jevtana). […] You usually have docetaxel first. You may have this with hormone therapy and steroids. […] And then you might have cabazitaxel if your cancer continues to grow after you’ve had treatment with docetaxel. […] You have docetaxel and cabazitaxel directly into your bloodstream through a drip (intravenously).

• #20 Metastatic Prostate Cancer Treatments | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/prostate/treatment/metastatic-prostate-cancer-treatments

  Hormone therapy slows or blocks prostate cancer cells from growing. Testosterone can cause prostate cancer cells to grow. Hormone therapy lowers the amount of testosterone your testicles make. It also blocks the action of testosterone and other male hormones. […] Chemotherapy for prostate cancer is an important treatment option when the disease has metastasized (spread). If you have cancer that has spread to your bones, chemotherapy can help you live longer, with less pain. Docetaxel (Taxotere) is considered the standard of care in chemotherapy for prostate cancer that is resistant to hormone therapy. […] Another chemotherapy drug for treating castration-resistant prostate cancer is cabazitaxel (Jevtana). […] Immunotherapy uses the power of the immune system to target cancer cells. […] The first immunotherapy treatment for people with advanced metastatic prostate cancer approved by the FDA was sipuleucel-T (Provenge).

• #21 Medical management of metastatic prostate cancer – Australian Prescriber

  https://australianprescriber.tg.org.au/articles/medical-management-of-metastatic-prostate-cancer.html

  Cabazitaxel is a newer taxane. In patients with cancer that has progressed following or during docetaxel chemotherapy it improved survival by 2.4 months compared with mitoxantrone. […] Radium-223 is a well-tolerated treatment when added to standard androgen deprivation therapy. It resulted in a 30% improvement in overall survival and the delay of the onset of first skeletal-related events when compared to placebo in patients with bony metastases. […] Studies of the optimal sequence of treatment have found that early introduction of the drugs previously reserved for castrate-resistant disease can improve overall survival in other patients with metastases. […] Long-term androgen deprivation therapy increases the risk of osteoporosis. […] Bisphosphonates and denosumab can reduce the risk of fracture in men on long-term androgen deprivation therapy. […] Advanced prostate cancer is a complex disease with an often prolonged course. There are many treatment options which are used sequentially and should be tailored for each patient.

• #22 Chemotherapy for metastatic prostate cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/prostate-cancer/metastatic-cancer/treatment/chemotherapy

  Chemotherapy is a common treatment for metastatic or advanced prostate cancer. Chemotherapy uses anti cancer drugs to destroy prostate cancer cells. The most common type of chemotherapy used for prostate cancer is docetaxel. […] Chemotherapy for metastatic prostate cancer can help relieve symptoms. It can also help to control the cancer and improve your quality of life. But it cant cure metastatic prostate cancer. […] The most common types of chemotherapy treatment for metastatic prostate cancer are: docetaxel (Taxotere) and cabazitaxel (Jevtana). […] You usually have docetaxel first. You may have this with hormone therapy and steroids. […] And then you might have cabazitaxel if your cancer continues to grow after you’ve had treatment with docetaxel. […] You have docetaxel and cabazitaxel directly into your bloodstream through a drip (intravenously).

• #23 Chemotherapy for metastatic prostate cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/prostate-cancer/metastatic-cancer/treatment/chemotherapy

  You usually have chemotherapy as cycles of treatment. Each cycle is usually a 3 week period. This means that you have a docetaxel or cabazitaxel drip once every 3 weeks. […] Common treatments for metastatic prostate cancer include chemotherapy and hormone therapy. Treatments can help to reduce symptoms and help you feel better.

• #24 Metastatic Prostate Cancer—A Review of Current Treatment Options and Promising New Approaches

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9856730/

  The use of a bispecific T-cell engager (BiTE) in this setting is a new promising therapeutic approach, which has not been established as standard of care yet. […] Overall, many new treatment options make prostate cancer therapy a challenging and promising field. […] ADT is the standard treatment approach in mHSPC patients and may consist of Luteinizing hormone-releasing hormone (LHRH) agonists, LHRH antagonists or bilateral orchiectomy. […] Today, therapies that combine ADT with ARSI, chemotherapy, or both, yielded superior OS results. […] The advent of combination therapies has intensified medical treatment and improved OS prognosis in prostate cancer patients with mHSPC. […] As a result, OS in newly diagnosed metastatic hormone-sensitive prostate cancer is superior for ADT + docetaxel than ADT alone, but that effect of chemotherapy is restricted to high volume disease only.

• #25 Prostate Cancer Treatment Challenge: Which Drugs to Use First

  https://www.renalandurologynews.com/features/prostate-cancer-treatment/

  American Society of Clinical Oncology guidelines recommend triplet therapy consisting of either darolutamide or abiraterone combined with docetaxel and ADT for patients with metastatic hormone-sensitive prostate cancer (mHSPC). […] Triplet therapy with docetaxel plus an ARPI and ADT has become a widely accepted first-line treatment for patients with high-volume synchronous mHSPC especially for those with visceral metastases and who can tolerate chemotherapy. […] Trial data support ADT/ARPI doublet therapy and radiation to the primary tumor (and possibly metastasis-directed radiation) for patients with synchronous low-volume disease. […] In a network meta-analysis that included 10 RCTs with 11,043 patients with mHSPC, investigators found that triplet therapies of darolutamide plus docetaxel and ADT and abiraterone plus docetaxel and ADT are significantly associated with 32% and 25% lower risks for death, respectively, compared with docetaxel plus ADT doublet therapy.

• #26 Metastatic Prostate Cancer—A Review of Current Treatment Options and Promising New Approaches

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9856730/

  In summary, the combination therapy of ADT + AAP provided a significant survival benefit over ADT monotherapy. […] The results of these trials indicated that the combination therapy of ADT and ARSI improved OS in mHSPC patients than ADT alone. Both patient groups, high volume disease and low volume disease had a benefit from combination therapy. […] As a result, triple therapies show a promising survival benefit in mHSPC patients, especially in those with high tumor burden. […] First-line treatment in men with mCRPC differ. Most trials explored the role of treatments after the failure of ADT alone. […] The efficacy of abiraterone acetate before chemotherapy was shown in the placebo controlled COU-AA-302 trial. […] The value of AAP in treatment of mHSPC has already been mentioned above. Additionally, in mCRPC it is a possible therapy option after docetaxel.

• #27 Patient education: Treatment for advanced prostate cancer (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/treatment-for-advanced-prostate-cancer-beyond-the-basics/print

  ADT is usually recommended as the initial treatment for males with metastatic prostate cancer. […] The recommended treatment approach depends on several factors, including how quickly the disease is expected to progress and the number and location of metastases. […] Timing of ADT — Whether to start ADT immediately or delay it depends on how far the disease has spread and the risk of further progression. […] Chemotherapy is now often recommended in combination with ADT as the initial treatment for males whose cancer has already spread outside of the prostate, typically to the bones or other organs. […] At least two studies have shown that combining ADT with six cycles of docetaxel and either darolutamide or abiraterone („triplet therapy”) improves outcomes over ADT plus docetaxel for people whose cancer has already spread outside of the prostate.

• #28 Advanced prostate cancer | Prostate Cancer UK

  https://prostatecanceruk.org/prostate-information-and-support/just-diagnosed/advanced-prostate-cancer/

  Advanced prostate cancer can cause symptoms, such as fatigue (extreme tiredness), bone pain, and problems urinating. […] Its not possible to cure advanced prostate cancer. But treatments can help keep it under control and manage any symptoms. […] If you have advanced prostate cancer, treatment wont cure your cancer. But it can help keep it under control and manage any symptoms. […] If youve just been diagnosed with advanced prostate cancer, you may be offered the following treatments: hormone therapy, chemotherapy with hormone therapy, clinical trials. […] There are newer types of hormone therapy that can be used to treat some men with advanced prostate cancer. […] Triplet therapy is a new treatment. It combines the hormone therapy, darolutamide (Nubeqa) with both standard hormone therapy and chemotherapy (docetaxel).

• #29 Prostate Cancer Treatment Challenge: Which Drugs to Use First

  https://www.renalandurologynews.com/features/prostate-cancer-treatment/

  American Society of Clinical Oncology guidelines recommend triplet therapy consisting of either darolutamide or abiraterone combined with docetaxel and ADT for patients with metastatic hormone-sensitive prostate cancer (mHSPC). […] Triplet therapy with docetaxel plus an ARPI and ADT has become a widely accepted first-line treatment for patients with high-volume synchronous mHSPC especially for those with visceral metastases and who can tolerate chemotherapy. […] Trial data support ADT/ARPI doublet therapy and radiation to the primary tumor (and possibly metastasis-directed radiation) for patients with synchronous low-volume disease. […] In a network meta-analysis that included 10 RCTs with 11,043 patients with mHSPC, investigators found that triplet therapies of darolutamide plus docetaxel and ADT and abiraterone plus docetaxel and ADT are significantly associated with 32% and 25% lower risks for death, respectively, compared with docetaxel plus ADT doublet therapy.

• #30 Prostate Cancer Treatment Challenge: Which Drugs to Use First

  https://www.renalandurologynews.com/features/prostate-cancer-treatment/

  American Society of Clinical Oncology guidelines recommend triplet therapy consisting of either darolutamide or abiraterone combined with docetaxel and ADT for patients with metastatic hormone-sensitive prostate cancer (mHSPC). […] Triplet therapy with docetaxel plus an ARPI and ADT has become a widely accepted first-line treatment for patients with high-volume synchronous mHSPC especially for those with visceral metastases and who can tolerate chemotherapy. […] Trial data support ADT/ARPI doublet therapy and radiation to the primary tumor (and possibly metastasis-directed radiation) for patients with synchronous low-volume disease. […] In a network meta-analysis that included 10 RCTs with 11,043 patients with mHSPC, investigators found that triplet therapies of darolutamide plus docetaxel and ADT and abiraterone plus docetaxel and ADT are significantly associated with 32% and 25% lower risks for death, respectively, compared with docetaxel plus ADT doublet therapy.

• #31 New Treatment Options for Men Presenting With De Novo Metastatic Prostate Cancer – American Urological Association

  https://auanews.net/issues/articles/2024/january-extra-2024/new-treatment-options-for-men-presenting-with-de-novo-metastatic-prostate-cancer

  Newly presenting or de novo metastatic hormone-sensitive prostate cancer (mHSPC) accounts for 5% to 10% of all prostate cancer (PC) diagnoses, but it is responsible for nearly 50% of PC-related deaths. […] However, the prognosis of mHSPC has improved due to the introduction of new hormonal agents and chemotherapy, combined with standard androgen deprivation therapy (ADT) in the first-line setting. […] Advanced PC guidelines recommend the use of combination therapy rather than ADT alone for patients with mHSPC. […] This chemohormonal therapy approach was validated in several additional phase 3 trials including STAMPEDE and GETUG-AFU15. […] More recently, the need for treatment intensification was expanded by employing so-called “triplet therapy” in patients with high-risk mHSPC. […] Both ARASENS and PEACE-1 show that upfront treatment intensification with the combination of ADT, docetaxel, and an ASI for de novo mHSPC improved survival outcomes with an acceptable safety profile.

• #32 Metastatic prostate cancer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/metastatic-prostate-cancer/diagnosis-treatment/drc-20377972

  Chemotherapy treats cancer with strong medicines. Chemotherapy medicines are sometimes used with hormone therapy medicines for metastatic prostate cancer. Chemotherapy also helps treat advanced prostate cancer when hormone therapy isn’t working. […] Targeted therapy for cancer is a treatment that uses medicines that attack the cancer cells in a specific way that causes the cells to die. […] For metastatic prostate cancer, immunotherapy treatments most often involve medicines called immune checkpoint inhibitors. These medicines help immune system cells find cancer cells. […] Radiopharmaceutical treatments are medicines that contain a radioactive substance. Radiopharmaceutical treatments used for cancer can deliver radiation to cancer cells. […] Palliative care is a special type of healthcare that helps you feel better when you have a serious illness. If you have cancer, palliative care can help relieve pain and other symptoms. […] When palliative care is used with all of the other appropriate treatments, people with cancer may feel better and live longer.

• #33 Metastatic Prostate Cancer Treatments | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/prostate/treatment/metastatic-prostate-cancer-treatments

  Hormone therapy slows or blocks prostate cancer cells from growing. Testosterone can cause prostate cancer cells to grow. Hormone therapy lowers the amount of testosterone your testicles make. It also blocks the action of testosterone and other male hormones. […] Chemotherapy for prostate cancer is an important treatment option when the disease has metastasized (spread). If you have cancer that has spread to your bones, chemotherapy can help you live longer, with less pain. Docetaxel (Taxotere) is considered the standard of care in chemotherapy for prostate cancer that is resistant to hormone therapy. […] Another chemotherapy drug for treating castration-resistant prostate cancer is cabazitaxel (Jevtana). […] Immunotherapy uses the power of the immune system to target cancer cells. […] The first immunotherapy treatment for people with advanced metastatic prostate cancer approved by the FDA was sipuleucel-T (Provenge).

• #34 Metastatic Prostate Cancer Treatments | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/prostate/treatment/metastatic-prostate-cancer-treatments

  Hormone therapy slows or blocks prostate cancer cells from growing. Testosterone can cause prostate cancer cells to grow. Hormone therapy lowers the amount of testosterone your testicles make. It also blocks the action of testosterone and other male hormones. […] Chemotherapy for prostate cancer is an important treatment option when the disease has metastasized (spread). If you have cancer that has spread to your bones, chemotherapy can help you live longer, with less pain. Docetaxel (Taxotere) is considered the standard of care in chemotherapy for prostate cancer that is resistant to hormone therapy. […] Another chemotherapy drug for treating castration-resistant prostate cancer is cabazitaxel (Jevtana). […] Immunotherapy uses the power of the immune system to target cancer cells. […] The first immunotherapy treatment for people with advanced metastatic prostate cancer approved by the FDA was sipuleucel-T (Provenge).

• #35 How We Treat Prostate Cancer | Dana-Farber Cancer Institute

  https://www.dana-farber.org/cancer-care/types/prostate-cancer/treatment

  For certain men with advanced, metastatic (spreading) prostate cancer that is resistant to hormone therapy, an FDA-approved cancer vaccine called Provenge is available. […] Clinical trials may be suggested at any stage of the disease. […] Our researchers are committed to creating trials for all stages of prostate cancer, and are especially dedicated to creating hormone therapy and immunotherapy trial options.

• #36 Advanced Prostate Cancer: AUA/SUO Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/advanced-prostate-cancer

  8. In mCRPC patients without PSA progression or new symptoms, clinicians should perform imaging at least annually. (Expert Opinion) […] […] 9. In mCRPC patients with disease progression (PSA or radiographic progression or new disease-related symptoms) having previously received docetaxel and androgen pathway inhibitor, who are considering 177Lu-PSMA-617, clinicians should order PSMA PET imaging. (Expert Opinion) […] […] 10. Clinicians should offer germline (if not already performed) and somatic genetic testing to identify DNA repair deficiency, MSI status, tumor mutational burden, and other potential mutations that may inform prognosis and familial cancer risk as well as direct potential targeted therapies. (Clinical Principle) […] […] 11. In newly diagnosed mCRPC patients, who have not received prior androgen receptor pathway inhibitors, clinicians should offer continued ADT with abiraterone acetate plus prednisone, docetaxel, or enzalutamide. (Strong Recommendation; Evidence Level: Grade A [abiraterone acetate plus prednisone and enzalutamide]/Grade B [docetaxel]) […]

• #37 Prostate cancer: New therapy could reverse drug resistance

  https://www.medicalnewstoday.com/articles/researchers-discover-new-therapy-for-treatment-resistant-prostate-cancer

  Some forms of prostate cancer are more challenging to treat and may not respond to conventional treatments. […] Metastatic castration-resistant prostate cancer is a type of advanced prostate cancer that no longer responds to normal treatments and has spread to other parts of the body. […] Now, researchers from the Institute of Cancer Research, London, have discovered the treatment resistance of metastatic castration-resistant prostate cancer can be reversed in some people by stopping white blood cells from being hijacked and pulled into tumors. […] During the study, scientists used a combination of an experimental drug called AZD5069 and a hormone therapy commonly used to treat prostate cancer called enzalutamide to stop myeloid cells from being pulled into tumors. […] Of the 21 study participants with metastatic castration-resistant prostate cancer, researchers reported five of them responded to the treatment by either their tumor shrinking in size by over 30%, a decrease in circulating levels of prostate-specific antigen (PSA), or a drop in circulating tumor cell blood levels.

• #38 Metastatic Prostate Cancer Treatment – UChicago Medicine

  https://www.uchicagomedicine.org/cancer/types-treatments/prostate-cancer/treatment/metastatic-prostate-cancer

  Chemotherapy for metastatic prostate cancer can reduce bone pain and lengthen survival. […] Sipuleucel-T is an FDA-approved immunotherapy for the treatment of metastatic CRPC. […] Lutetium-177 PSMA therapy (also known as Lu-177 or Pluvicto) is a new theranostic medicine for advanced metastatic prostate cancer. […] This FDA-approved intravenous therapy is known to prolong life, reduce pain and improve the quality of life for patients with metastatic prostate cancer within the bones. […] Our radiation oncology team routinely administers radiation therapy to sites of metastatic prostate cancer for local control or to alleviate symptoms, such as pain.

• #39 Metastatic Prostate Cancer: Treatment Options & Prognosis | ZERO Prostate Cancer

  https://zerocancer.org/stages-and-grades/metastatic-prostate-cancer

  Bisphosphonates prevent the thinning of the bone, help make them stronger, and help relieve bone pain. […] There are several types of radiation therapies that can be used to treat and manage the cancer and the pain it can cause when it grows in the bones. […] If several areas of the skeletal system are affected by cancer then radiation, in the form of radiopharmaceuticals, can be administered via IV injection into the blood stream through a vein. […] When facing a metastatic prostate cancer diagnosis, many patients want to get a better understanding of their prognosis and survival rates in hope that this will help them make informed decisions about their treatment and care. […] Survival rates for metastatic prostate cancer can vary widely depending on individual factors. […] Remember, while metastatic prostate cancer is a serious diagnosis, many patients can live for several years with appropriate treatment and support.

• #40 Medical management of metastatic prostate cancer – Australian Prescriber

  https://australianprescriber.tg.org.au/articles/medical-management-of-metastatic-prostate-cancer.html

  Cabazitaxel is a newer taxane. In patients with cancer that has progressed following or during docetaxel chemotherapy it improved survival by 2.4 months compared with mitoxantrone. […] Radium-223 is a well-tolerated treatment when added to standard androgen deprivation therapy. It resulted in a 30% improvement in overall survival and the delay of the onset of first skeletal-related events when compared to placebo in patients with bony metastases. […] Studies of the optimal sequence of treatment have found that early introduction of the drugs previously reserved for castrate-resistant disease can improve overall survival in other patients with metastases. […] Long-term androgen deprivation therapy increases the risk of osteoporosis. […] Bisphosphonates and denosumab can reduce the risk of fracture in men on long-term androgen deprivation therapy. […] Advanced prostate cancer is a complex disease with an often prolonged course. There are many treatment options which are used sequentially and should be tailored for each patient.

• #41 Metastatic prostate cancer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/metastatic-prostate-cancer/diagnosis-treatment/drc-20377972

  Chemotherapy treats cancer with strong medicines. Chemotherapy medicines are sometimes used with hormone therapy medicines for metastatic prostate cancer. Chemotherapy also helps treat advanced prostate cancer when hormone therapy isn’t working. […] Targeted therapy for cancer is a treatment that uses medicines that attack the cancer cells in a specific way that causes the cells to die. […] For metastatic prostate cancer, immunotherapy treatments most often involve medicines called immune checkpoint inhibitors. These medicines help immune system cells find cancer cells. […] Radiopharmaceutical treatments are medicines that contain a radioactive substance. Radiopharmaceutical treatments used for cancer can deliver radiation to cancer cells. […] Palliative care is a special type of healthcare that helps you feel better when you have a serious illness. If you have cancer, palliative care can help relieve pain and other symptoms. […] When palliative care is used with all of the other appropriate treatments, people with cancer may feel better and live longer.

• #42 Patient education: Treatment for advanced prostate cancer (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/treatment-for-advanced-prostate-cancer-beyond-the-basics

  Immunotherapy — A newer approach to treating advanced prostate cancer involves immunotherapy. This is a type of treatment that uses the body’s immune system to help slow or stop cancer growth. […] Treatments targeting bone metastases — The bones are a common place for prostate cancer to spread. ADT can often control the cancer that has spread to the bones. […] Radium-223 — Radium-223 is a radioactive element that localizes in bone. For males whose advanced prostate cancer consists almost exclusively of extensive bone metastases, treatment with radium-223 is often effective at relieving bone pain, preventing complications (broken bones, need for radiation therapy, spinal cord injury caused by the cancer), and extending life.

• #43 Treatment options for metastatic prostate cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/prostate-cancer/metastatic-cancer/treatment/options

  The first treatment you have is usually hormone therapy in combination with more hormone therapy such as apalutamide and enzalutamide or chemotherapy. […] Hormone therapy blocks or lowers the amount of testosterone in the body. Common hormone therapy injections include goserelin and degarelix. […] Chemotherapy is a type of anti cancer drug treatment. The drugs work by killing prostate cancer cells. The most common chemotherapy drug used for prostate cancer is docetaxel. […] A combination of different hormone therapy drugs or hormone therapy with chemotherapy often controls metastatic prostate cancer for many months to years. But sometimes the cancer can start to grow again after the initial treatment. […] This means that hormone therapy is no longer working. If this happens, your doctor might suggest: a different type of hormone therapy with chemotherapy, an additional hormone therapy drug, chemotherapy with steroids, bisphosphonates, radiotherapy, radioisotope therapy such as Radium-223 and Lutetium-177-PSMA.

• #44 Patient education: Treatment for advanced prostate cancer (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/treatment-for-advanced-prostate-cancer-beyond-the-basics

  Immunotherapy — A newer approach to treating advanced prostate cancer involves immunotherapy. This is a type of treatment that uses the body’s immune system to help slow or stop cancer growth. […] Treatments targeting bone metastases — The bones are a common place for prostate cancer to spread. ADT can often control the cancer that has spread to the bones. […] Radium-223 — Radium-223 is a radioactive element that localizes in bone. For males whose advanced prostate cancer consists almost exclusively of extensive bone metastases, treatment with radium-223 is often effective at relieving bone pain, preventing complications (broken bones, need for radiation therapy, spinal cord injury caused by the cancer), and extending life.

• #45 Metastatic Prostate Cancer Treatment – UChicago Medicine

  https://www.uchicagomedicine.org/cancer/types-treatments/prostate-cancer/treatment/metastatic-prostate-cancer

  Today, men facing metastatic prostate cancer have many treatment options. The goal of these therapies is to halt cancer growth, control pain, alleviate symptoms and prolong survival. […] In addition, we were the first in the state to provide Lutetium-177 PSMA therapy (Pluvicto), an advanced theranostics treatment that targets prostate cancer cells with fewer side effects than alternate treatment options. […] Medical oncologists with expertise in prostate cancer manage the treatment of men with metastatic disease. […] We continually research and develop new therapies for metastatic prostate cancer. Systemic therapies medications used to treat cancer by attacking it throughout the body for metastatic prostate cancer include: […] Hormone therapy is the standard of care for metastatic prostate cancer.

• #46 Metastatic Prostate Cancer Treatment – UChicago Medicine

  https://www.uchicagomedicine.org/cancer/types-treatments/prostate-cancer/treatment/metastatic-prostate-cancer

  Chemotherapy for metastatic prostate cancer can reduce bone pain and lengthen survival. […] Sipuleucel-T is an FDA-approved immunotherapy for the treatment of metastatic CRPC. […] Lutetium-177 PSMA therapy (also known as Lu-177 or Pluvicto) is a new theranostic medicine for advanced metastatic prostate cancer. […] This FDA-approved intravenous therapy is known to prolong life, reduce pain and improve the quality of life for patients with metastatic prostate cancer within the bones. […] Our radiation oncology team routinely administers radiation therapy to sites of metastatic prostate cancer for local control or to alleviate symptoms, such as pain.

• #47 What to know about metastatic prostate cancer | MD Anderson Cancer Center

  https://www.mdanderson.org/cancerwise/what-to-know-about-metastatic-prostate-cancer.h00-159703068.html

  During this phase, treatments directed toward the testosterone hormones are working well to keep the cancer from growing. […] Prostate cancer is smart, and eventually, it learns how to grow without testosterone. […] On average, metastatic prostate cancer takes 2 to 3 years to become castration-resistant, but it could be longer or shorter depending on the features of the cancer. […] In 2022, the Food and Drug Administration (FDA) approved a targeted nuclear medicine therapy called lutetium Lu 177 vipivotide tetraxetan to treat prostate-specific membrane antigen (PSMA) metastatic castration-resistant prostate cancer. […] A Phase III clinical trial showed that patients who received lutetium Lu 177 vipivotide tetraxetan lived longer than those in the control arm who received a different treatment.

• #48 FDA Expands New Treatment for Prostate Cancer: Targets a Protein Called PSMA | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/news/fda-approves-promising-therapy-advanced-prostate

  In 2019, Michael Rosenblum received an experimental new prostate cancer treatment after the disease spread to his bones. He remains symptom-free. The treatment is now approved for more patients. […] More patients with prostate cancer are now eligible for a treatment that uses radiopharmaceuticals to zero in on cancer cells to destroy them. The U.S. Food and Drug Administration has expanded approval for 177Lu-PSMA-617 (Pluvicto) so it can be used earlier in treatment. The therapy uses a molecule that selectively seeks out and attaches to a specific protein on the cancer cell surface called PSMA (prostate-specific membrane antigen). It delivers radiation that damages DNA and destroys the cancer cell. […] The FDA had earlier approved 177Lu-PSMA-617 for patients with metastatic castration-resistant prostate cancer that had spread despite treatment with an androgen receptor pathway inhibitor (ARPI) and taxane-based chemotherapy. Now results from a phase 3 trial has led the FDA to expand the use of 177Lu-PSMA-617 to patients who have not yet received taxane therapy.

• #49 Targeted Therapy | ZERO Prostate Cancer

  https://zerocancer.org/treatment-options/systemic-therapies/targeted-therapy

  Targeted therapy for prostate cancer is a type of therapy that identifies, or targets, a particular genetic component of the tumor. The goal is to interfere with the specific molecules that drive the growth of the tumor. […] There are currently two main types of targeted therapies for metastatic prostate cancer patients: PARP inhibitors and PSMA-targeted therapies. […] PARP inhibitors are a type of targeted therapy that affects how DNA is repaired in cancer cells. They target certain genetic mutations. Therefore, they’re only used in patients who are known to have the targeted genetic mutation found through genetic testing. […] The following PARP inhibitors have been approved by the FDA for treatment of metastatic castration resistant prostate cancer (mCRPC), for patients who have certain gene mutations.

• #50 Targeted Therapy | ZERO Prostate Cancer

  https://zerocancer.org/treatment-options/systemic-therapies/targeted-therapy

  Targeted therapy for prostate cancer is a type of therapy that identifies, or targets, a particular genetic component of the tumor. The goal is to interfere with the specific molecules that drive the growth of the tumor. […] There are currently two main types of targeted therapies for metastatic prostate cancer patients: PARP inhibitors and PSMA-targeted therapies. […] PARP inhibitors are a type of targeted therapy that affects how DNA is repaired in cancer cells. They target certain genetic mutations. Therefore, they’re only used in patients who are known to have the targeted genetic mutation found through genetic testing. […] The following PARP inhibitors have been approved by the FDA for treatment of metastatic castration resistant prostate cancer (mCRPC), for patients who have certain gene mutations.

• #51 Targeted Therapy | ZERO Prostate Cancer

  https://zerocancer.org/treatment-options/systemic-therapies/targeted-therapy

  Niraparib combined with abiraterone acetate (Akeega) can be used to treat mCRPC patients with a known BRCA gene mutation. […] Olaparib (Lynparza) can be used to treat mCRPC patients with a known BRCA gene mutation in two ways: In combination with the hormone therapy drug abiraterone (Zytiga) or by itself, if the cancer has progressed after treatment with a hormone therapy drug such as enzalutamide (Xtandi) or abiraterone. […] Rucaparib (Rubraca) can be used to treat mCRPC that has grown after treatment with chemotherapy and hormone therapy, and in patients with a known BRCA gene mutation. […] Talazoparib (Talzenna) can be used to treat mCRPC patients that have homologous recombination repair (HRR) gene mutation(s) and haven’t received prior treatment for castration-resistant disease. Talazoparib can be given with enzalutamide once per day.

• #52 Advanced Prostate Cancer: AUA/SUO Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/advanced-prostate-cancer

  8. In mCRPC patients without PSA progression or new symptoms, clinicians should perform imaging at least annually. (Expert Opinion) […] […] 9. In mCRPC patients with disease progression (PSA or radiographic progression or new disease-related symptoms) having previously received docetaxel and androgen pathway inhibitor, who are considering 177Lu-PSMA-617, clinicians should order PSMA PET imaging. (Expert Opinion) […] […] 10. Clinicians should offer germline (if not already performed) and somatic genetic testing to identify DNA repair deficiency, MSI status, tumor mutational burden, and other potential mutations that may inform prognosis and familial cancer risk as well as direct potential targeted therapies. (Clinical Principle) […] […] 11. In newly diagnosed mCRPC patients, who have not received prior androgen receptor pathway inhibitors, clinicians should offer continued ADT with abiraterone acetate plus prednisone, docetaxel, or enzalutamide. (Strong Recommendation; Evidence Level: Grade A [abiraterone acetate plus prednisone and enzalutamide]/Grade B [docetaxel]) […]

• #53 Advanced Prostate Cancer: Hormone vs. Nonhormone Treatments

  https://www.healthline.com/health/prostate-cancer/hormone-vs-non-hormone-treatments

  Nonhormone treatments for advanced prostate cancer include: Chemotherapy such as docetaxel (Taxotere), cabazitaxel (Jevtana), and mitoxantrone (Novantrone) is sometimes given in combination with a steroid known as prednisone. Radiation therapy uses high energy beams or radioactive seeds to destroy tumors. In addition to standard radiation therapy, Lutetium-177 vipivotide tetraxetan PSMA therapy (Pluvicto) is a new theranostic medicine for advanced metastatic prostate cancer. Its a type of radiation that specifically targets a molecule on the surface of prostate cancer cells called prostate-specific membrane antigen (PSMA). Immunotherapy, including sipuleucel-T (Provenge), works by using the bodys own immune system to kill cancer cells. Radium Ra 223 (Xofigo) contains a small amount of radiation and is used to destroy prostate cancer cells that have spread to the bone.

• #54 Metastatic Prostate Cancer: Treatment Options & Prognosis | ZERO Prostate Cancer

  https://zerocancer.org/stages-and-grades/metastatic-prostate-cancer

  Metastatic prostate cancer means that the cancer has spread beyond the prostate to distant lymph nodes or organs, often to bones. […] Prostate cancer most frequently spreads to the bones, liver, or lungs. […] Prostate cancer that spread to the bone is still considered prostate cancer. It is still treated with therapy for prostate cancer. […] While there is no cure for metastatic prostate cancer, there is hope to manage the disease effectively. It’s often a whole-body approach that may include hormone therapy, immunotherapy, targeted therapy, chemo, and/or radiopharmaceuticals. […] Fortunately, there are ways to strengthen and repair your bones including medicines and lifestyle changes. […] When making a metastatic prostate cancer treatment plan, it is important to include strategies to maintain good bone health.

• #55 Attacking metastatic prostate cancer early with combination treatment approach improves outcomes in preliminary study | UCLA Health

  https://www.uclahealth.org/news/release/attacking-metastatic-prostate-cancer-early-with-combination

  A team of UCLA Health Jonsson Comprehensive Cancer Center investigators has shown the combination of a short course of powerful and intense hormonal therapy with targeted radiation is safe and effective in treating people with prostate cancer that has come back and has spread to other parts of the body. […] In the small study, researchers found that 50% of the patients who were treated with the combination therapy had no signs of the cancer and remained free of recurrence six months after their treatment, with less than a quarter experiencing severe side effects from the treatment. […] These results suggest a substantial improvement and strongly suggest there can be a meaningful impact namely, delaying the need for hormonal therapy and thus without the significant side effects of it by attacking metastatic prostate cancer early.

• #56 Treatments for metastatic castration-sensitive prostate cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/prostate/treatment/metastatic-castration-sensitive

  Chemotherapy may be offered for metastatic castration-sensitive prostate cancer. It uses anticancer drugs to destroy cancer cells. […] Treatments for bone metastases when prostate cancer spreads to other parts of the body, it most often spreads to the bones. The most common treatments for prostate cancer that has spread to the bones are: bisphosphonates, such as zoledronic acid (Zometa), denosumab (Xgeva), which is a type of monoclonal antibody therapy, corticosteroids, such as prednisone and dexamethasone, external radiation therapy, systemic radiation therapy with radium-223 dichloride (Xofigo), a procedure to stabilize a collapsed bone (called kyphoplasty), pain medicines. […] Watchful waiting may be a treatment option for older men (who aren’t expected to live long and whose cancer is not causing symptoms) or for those who are unable to have treatment because of other health conditions.

• #57 Prostate Cancer Treatment – NCI

  https://www.cancer.gov/types/prostate/patient/prostate-treatment-pdq

  Bisphosphonate drugs, such as clodronate or zoledronate, reduce bone disease when cancer has spread to the bone. […] Treatment of stage IV prostate cancer may include: Hormone therapy, Hormone therapy combined with chemotherapy, Bisphosphonate therapy, External radiation therapy. […] Treatment of recurrent hormone-sensitive or hormone-resistant prostate cancer may include: Hormone therapy, Chemotherapy for patients already treated with hormone therapy, Immunotherapy with sipuleucel-T for patients already treated with hormone therapy.

• #58 Metastatic Prostate Cancer: Treatment Options & Prognosis | ZERO Prostate Cancer

  https://zerocancer.org/stages-and-grades/metastatic-prostate-cancer

  Bisphosphonates prevent the thinning of the bone, help make them stronger, and help relieve bone pain. […] There are several types of radiation therapies that can be used to treat and manage the cancer and the pain it can cause when it grows in the bones. […] If several areas of the skeletal system are affected by cancer then radiation, in the form of radiopharmaceuticals, can be administered via IV injection into the blood stream through a vein. […] When facing a metastatic prostate cancer diagnosis, many patients want to get a better understanding of their prognosis and survival rates in hope that this will help them make informed decisions about their treatment and care. […] Survival rates for metastatic prostate cancer can vary widely depending on individual factors. […] Remember, while metastatic prostate cancer is a serious diagnosis, many patients can live for several years with appropriate treatment and support.

• #59 Medical management of metastatic prostate cancer – Australian Prescriber

  https://australianprescriber.tg.org.au/articles/medical-management-of-metastatic-prostate-cancer.html

  Cabazitaxel is a newer taxane. In patients with cancer that has progressed following or during docetaxel chemotherapy it improved survival by 2.4 months compared with mitoxantrone. […] Radium-223 is a well-tolerated treatment when added to standard androgen deprivation therapy. It resulted in a 30% improvement in overall survival and the delay of the onset of first skeletal-related events when compared to placebo in patients with bony metastases. […] Studies of the optimal sequence of treatment have found that early introduction of the drugs previously reserved for castrate-resistant disease can improve overall survival in other patients with metastases. […] Long-term androgen deprivation therapy increases the risk of osteoporosis. […] Bisphosphonates and denosumab can reduce the risk of fracture in men on long-term androgen deprivation therapy. […] Advanced prostate cancer is a complex disease with an often prolonged course. There are many treatment options which are used sequentially and should be tailored for each patient.

• #60 Attacking metastatic prostate cancer early with combination treatment approach improves outcomes in preliminary study | UCLA Health

  https://www.uclahealth.org/news/release/attacking-metastatic-prostate-cancer-early-with-combination

  A team of UCLA Health Jonsson Comprehensive Cancer Center investigators has shown the combination of a short course of powerful and intense hormonal therapy with targeted radiation is safe and effective in treating people with prostate cancer that has come back and has spread to other parts of the body. […] In the small study, researchers found that 50% of the patients who were treated with the combination therapy had no signs of the cancer and remained free of recurrence six months after their treatment, with less than a quarter experiencing severe side effects from the treatment. […] These results suggest a substantial improvement and strongly suggest there can be a meaningful impact namely, delaying the need for hormonal therapy and thus without the significant side effects of it by attacking metastatic prostate cancer early.

• #61 Patient education: Treatment for advanced prostate cancer (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/treatment-for-advanced-prostate-cancer-beyond-the-basics

  Immunotherapy — A newer approach to treating advanced prostate cancer involves immunotherapy. This is a type of treatment that uses the body’s immune system to help slow or stop cancer growth. […] Treatments targeting bone metastases — The bones are a common place for prostate cancer to spread. ADT can often control the cancer that has spread to the bones. […] Radium-223 — Radium-223 is a radioactive element that localizes in bone. For males whose advanced prostate cancer consists almost exclusively of extensive bone metastases, treatment with radium-223 is often effective at relieving bone pain, preventing complications (broken bones, need for radiation therapy, spinal cord injury caused by the cancer), and extending life.

• #62 Treatments for metastatic castration-sensitive prostate cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/prostate/treatment/metastatic-castration-sensitive

  Chemotherapy may be offered for metastatic castration-sensitive prostate cancer. It uses anticancer drugs to destroy cancer cells. […] Treatments for bone metastases when prostate cancer spreads to other parts of the body, it most often spreads to the bones. The most common treatments for prostate cancer that has spread to the bones are: bisphosphonates, such as zoledronic acid (Zometa), denosumab (Xgeva), which is a type of monoclonal antibody therapy, corticosteroids, such as prednisone and dexamethasone, external radiation therapy, systemic radiation therapy with radium-223 dichloride (Xofigo), a procedure to stabilize a collapsed bone (called kyphoplasty), pain medicines. […] Watchful waiting may be a treatment option for older men (who aren’t expected to live long and whose cancer is not causing symptoms) or for those who are unable to have treatment because of other health conditions.

• #63 Advanced Prostate Cancer: AUA/SUO Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/advanced-prostate-cancer

  15. Clinicians should recommend preventative treatment for fractures and skeletal-related events, including supplemental calcium, vitamin D, smoking cessation, and weight-bearing exercise, to advanced prostate cancer patients on ADT. (Clinical Principle) […] […] 16. In advanced prostate cancer patients at high fracture risk due to bone loss, clinicians should recommend preventative treatments with bisphosphonates or denosumab and referral to physicians who have familiarity with the management of osteoporosis when appropriate. (Clinical Principle) […] […] 17. Clinicians should prescribe a bone-protective agent (denosumab or zoledronic acid) for mCRPC patients with bony metastases to prevent skeletal-related events. (Moderate Recommendation; Evidence Level: Grade B)

• #64 Attacking metastatic prostate cancer early with combination treatment approach improves outcomes in preliminary study | UCLA Health

  https://www.uclahealth.org/news/release/attacking-metastatic-prostate-cancer-early-with-combination

  A team of UCLA Health Jonsson Comprehensive Cancer Center investigators has shown the combination of a short course of powerful and intense hormonal therapy with targeted radiation is safe and effective in treating people with prostate cancer that has come back and has spread to other parts of the body. […] In the small study, researchers found that 50% of the patients who were treated with the combination therapy had no signs of the cancer and remained free of recurrence six months after their treatment, with less than a quarter experiencing severe side effects from the treatment. […] These results suggest a substantial improvement and strongly suggest there can be a meaningful impact namely, delaying the need for hormonal therapy and thus without the significant side effects of it by attacking metastatic prostate cancer early.

• #65 What to know about metastatic prostate cancer | MD Anderson Cancer Center

  https://www.mdanderson.org/cancerwise/what-to-know-about-metastatic-prostate-cancer.h00-159703068.html

  At MD Anderson, we’re also conducting clinical trials to study how immunotherapy can help treat prostate cancer. […] If you have been diagnosed with prostate cancer, specifically metastatic prostate cancer, I strongly encourage you to ask your oncologist about clinical trials. […] We haven’t cured metastatic prostate cancer yet. But we’re moving in the right direction.

• #66 Metastatic Prostate Cancer—A Review of Current Treatment Options and Promising New Approaches

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9856730/

  Overall, PSMA RLT showed improved efficacy and lower risk of grade 34 adverse events when compared to Cabazitaxel. […] The most advanced bispecific T-cell engager in the therapy of prostate cancer is PSMA Bite. […] Overall, bispecific T-cell engager is a promising new therapy option with early signs of clinical activity.

• #67 Novel Drugs May Introduce ‘New Era’ of Metastatic Prostate Cancer Treatment

  https://www.cancernetwork.com/view/novel-drugs-may-introduce-new-era-of-metastatic-prostate-cancer-treatment

  I remain optimistic about many options that are going to be approved for patients with prostate cancer in the very near future. […] Some of the therapies I would like to highlight, which I think are close to being approved, include AR-targeted therapies novel ways to target AR. […] I also remain optimistic about immunotherapy beyond immune checkpoint inhibitors such as CAR T cells and bispecific T cells that are being developed by different companies. […] We also know that the 177Lu-PSMA-617 [Pluvicto] approval was just the start of delivering radionuclide therapy in precise fashion in the prostate cancer cells. […] We are also waiting for the results from the phase 3 TALAPRO-3 trial and the phase 3 AMPLITUDE trial, which are using the combination of AR-targeting with PARP inhibitors. […] It is great to see these phase 3 trials leading to the approval of new drugs and combinations for our patients.

• #68 New drug could treat prostate cancer that stops responding to hormone therapy | Prostate Cancer UK

  https://prostatecanceruk.org/about-us/news-and-views/2025/01/new-drug-could-treat-prostate-cancer-that-stops-responding-to-hormone-therapy/

  Research into a new treatment already being tested in other cancers could give men with advanced prostate cancer more options if hormone therapy fails. […] A new drug currently being trialled in ovarian cancer could also help men with advanced prostate cancer, according to research you helped to fund. […] The discovery could be a game-changer for men whose cancer has stopped responding to hormone therapy, as they currently have few treatment options open to them. […] A team at The Institute of Cancer Research, London (ICR), found that the drug slowed the growth of prostate cancer, including in cells that had become resistant to the hormone therapy enzalutamide. […] Although hormone therapies like enzalutamide and abiraterone transform the lives of thousands of men with advanced prostate cancer every year, most will eventually find their cancer stops responding to these treatments.

• #69 A Promising New Targeted Therapy for Patients with Metastatic Prostate Cancer with Therapy-resistant Mutations < Yale School of Medicine

  https://medicine.yale.edu/news-article/a-promising-new-targeted-therapy-for-patients-with-metastatic-prostate-cancer-with-therapy-resistant-mutations/

  Metastatic prostate cancer is treated by reducing levels of testosterone, and despite initial responses to treatment, nearly all patients become resistant to androgen deprivation therapy. […] A phase 1/2 clinical study led by Yale Cancer Center (YCC) researchers at Yale School of Medicine has revealed promising results for ARV-766 or Proteolysis-targeting chimera (PROTAC), which is a new type of therapy designed to combat metastatic castration-resistant prostate cancer (mCRPC) by targeting protein degradation of the androgen receptor. […] The study demonstrated that ARV-766 has significant antitumor activity, with 43% of patients demonstrating a prostate-specific antigen (PSA) decline of at least 50% in the subgroup of patients with tumors that have AR LBD mutations. […] Our data demonstrate that ARV-766 has promising clinical activity in patients with ligand binding mutations and this represents a potential new type of targeted therapy for prostate cancer, warranting further development in resistant-disease, said Dr. Petrylak. Phase III studies are justified by this data.

• #70 Novel Drugs May Introduce ‘New Era’ of Metastatic Prostate Cancer Treatment

  https://www.cancernetwork.com/view/novel-drugs-may-introduce-new-era-of-metastatic-prostate-cancer-treatment

  I remain optimistic about many options that are going to be approved for patients with prostate cancer in the very near future. […] Some of the therapies I would like to highlight, which I think are close to being approved, include AR-targeted therapies novel ways to target AR. […] I also remain optimistic about immunotherapy beyond immune checkpoint inhibitors such as CAR T cells and bispecific T cells that are being developed by different companies. […] We also know that the 177Lu-PSMA-617 [Pluvicto] approval was just the start of delivering radionuclide therapy in precise fashion in the prostate cancer cells. […] We are also waiting for the results from the phase 3 TALAPRO-3 trial and the phase 3 AMPLITUDE trial, which are using the combination of AR-targeting with PARP inhibitors. […] It is great to see these phase 3 trials leading to the approval of new drugs and combinations for our patients.

• #71 Breakthrough nuclear medicine treatment helps patients with advanced prostate cancer – Medical Update

  https://medicalupdate.pennstatehealth.org/urology-surgery/novartis-pluvicto/

  This allows for the individualization of therapeutic management. […] The majority of patients experience little discomfort and few side effects, Tulchinsky said. The side effect profile is relatively well tolerated. Not only is Pluvicto effective where other treatments have failed, but its also much less burdensome and allows most patients to maintain their well-being through the treatment course. […] Two phase 3 trials are investigating how Pluvicto could potentially benefit more patients at earlier stages of prostate cancer. […] Tulchinsky is excited about investigating the potential of Pluvicto to treat prostate cancer at much earlier stages. […] I hope other physicians will recognize Pluvicto as a pivotal therapy that not only has a relatively low burden of side effects and patient inconvenience but also improves lives despite an advanced prostate cancer diagnosis.

• #72 What to know about metastatic prostate cancer | MD Anderson Cancer Center

  https://www.mdanderson.org/cancerwise/what-to-know-about-metastatic-prostate-cancer.h00-159703068.html

  At MD Anderson, we’re also conducting clinical trials to study how immunotherapy can help treat prostate cancer. […] If you have been diagnosed with prostate cancer, specifically metastatic prostate cancer, I strongly encourage you to ask your oncologist about clinical trials. […] We haven’t cured metastatic prostate cancer yet. But we’re moving in the right direction.

• #73 New Treatment Options for Men with Metastatic Prostate Cancer | Medical School

  https://med.umn.edu/news/new-treatment-options-men-metastatic-prostate-cancer

  Men with newly diagnosed prostate cancer already have docetaxel chemotherapy, abiraterone hormonal therapy, and ADT as treatment options. Enzalutamide and apalutamide will give the doctors and patients more choices for this crucial decision. Most of these new treatments block the function of testosterone in cancer cells, but eventually, the cancer cells escape this restriction and the treatments stop working. […] We have a number of novel clinical trials of immunotherapies and targeted therapies to help Minnesotans with prostate cancer in need of newer and better treatments. Many of these trials have already shown promising early results.

• #74 Metastatic Prostate Cancer: Treatment Options – PubMed

  https://pubmed.ncbi.nlm.nih.gov/34781285/

  Metastatic prostate cancer (PCa) is associated with considerable diminished overall survival (OS). Standard treatment for metastatic PCa has long been androgen deprivation therapy alone, with patients initially responding to this treatment and then progressing to a castration-resistant phase. […] The advent of novel therapeutic agents has changed this paradigm, with high-level evidence that upfront combination therapy with either docetaxel or new hormonal agents results in improved OS for patients with metastatic hormone-sensitive PCa. […] In the absence of a comprehensive clinical trial investigating the comparative efficacy and safety of all agents, clinicians are responsible for choosing the most appropriate therapy in close coordination with patients. […] Furthermore, the same therapeutic agents are also efficient in the castration-resistant phase, leading to the issue of the best therapeutic sequence.

• #75 Metastatic Prostate Cancer: Treatment Options – PubMed

  https://pubmed.ncbi.nlm.nih.gov/34781285/

  Finally, along with systemic therapy and molecular imaging advancements, radiotherapy was investigated in the oligometastatic setting, whether it is to treat the primary tumour or metastases. […] In this complex landscape, where providers have multiple effective therapeutic options to treat metastatic PCa patients, priority must be given to determine which treatment combination and sequence is best suited to a particular patient, given his comorbidities and preferences.

• #76 Prostate Cancer Treatment Challenge: Which Drugs to Use First

  https://www.renalandurologynews.com/features/prostate-cancer-treatment/

  In practice, it is a moot point because no patient wants chemo. Consequently, first-line therapy for patients who have not received prior treatment for mCPRC is an ARPI, and a meta-analysis will not change this approach given the tolerability and side effect issues with chemotherapy. […] Moreover, with ARPIs being used more and more prior to mCRPC, chemotherapy is likely to be used increasingly as first- or second-line mCRPC therapy. […] Studies that provide potentially useful information that can inform drug sequencing is not limited to RCTs or other large studies. […] Some trends offer the promise of greater clarity about which drugs to use and when to use them. One is growing use of genomic and other biomarkers that can predict prostate cancer aggressiveness and response to therapy.

• #77 Advanced Prostate Cancer: AUA/SUO Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/advanced-prostate-cancer

  8. In mCRPC patients without PSA progression or new symptoms, clinicians should perform imaging at least annually. (Expert Opinion) […] […] 9. In mCRPC patients with disease progression (PSA or radiographic progression or new disease-related symptoms) having previously received docetaxel and androgen pathway inhibitor, who are considering 177Lu-PSMA-617, clinicians should order PSMA PET imaging. (Expert Opinion) […] […] 10. Clinicians should offer germline (if not already performed) and somatic genetic testing to identify DNA repair deficiency, MSI status, tumor mutational burden, and other potential mutations that may inform prognosis and familial cancer risk as well as direct potential targeted therapies. (Clinical Principle) […] […] 11. In newly diagnosed mCRPC patients, who have not received prior androgen receptor pathway inhibitors, clinicians should offer continued ADT with abiraterone acetate plus prednisone, docetaxel, or enzalutamide. (Strong Recommendation; Evidence Level: Grade A [abiraterone acetate plus prednisone and enzalutamide]/Grade B [docetaxel]) […]

• #78 What to know about metastatic prostate cancer | MD Anderson Cancer Center

  https://www.mdanderson.org/cancerwise/what-to-know-about-metastatic-prostate-cancer.h00-159703068.html

  Metastatic prostate cancer is prostate cancer that has spread outside of the prostate to other parts of the body. This is also known as stage IV disease. […] A lot of our research is focused on how we can better treat metastatic prostate cancer to improve patients results. […] At MD Anderson, we work together as a team of specialists to treat stage IV prostate cancer. Patients may receive: […] Antiandrogens are medications that block the production of testosterone or stop their interaction with cancer cells. […] Chemotherapy is often used to treat metastatic prostate cancer by destroying cancer cells. […] Patients who have painful metastases in their bones may receive targeted radiation therapy to those areas. […] The average length of survival after a new, metastatic prostate cancer diagnosis is about 5 to 6 years.

• #79 What Is Metastatic Prostate Cancer?

  https://www.webmd.com/prostate-cancer/metastatic-prostate-cancer

  The 5-year survival rate for metastatic prostate cancer is 32%. The earlier you’re diagnosed, the more likely you’ll be disease-free with treatment, as 99% of localized and regional metastatic prostate cancer (earlier stages) cases have a 5-year survival rate. […] Chemotherapy works for metastatic prostate cancer to improve your symptoms and help you live longer, whether or not your cancer is still responding to hormone therapy.

• #80 What to know about metastatic prostate cancer | MD Anderson Cancer Center

  https://www.mdanderson.org/cancerwise/what-to-know-about-metastatic-prostate-cancer.h00-159703068.html

  During this phase, treatments directed toward the testosterone hormones are working well to keep the cancer from growing. […] Prostate cancer is smart, and eventually, it learns how to grow without testosterone. […] On average, metastatic prostate cancer takes 2 to 3 years to become castration-resistant, but it could be longer or shorter depending on the features of the cancer. […] In 2022, the Food and Drug Administration (FDA) approved a targeted nuclear medicine therapy called lutetium Lu 177 vipivotide tetraxetan to treat prostate-specific membrane antigen (PSMA) metastatic castration-resistant prostate cancer. […] A Phase III clinical trial showed that patients who received lutetium Lu 177 vipivotide tetraxetan lived longer than those in the control arm who received a different treatment.

• #81 Metastatic Prostate Cancer: Treatment Options & Prognosis | ZERO Prostate Cancer

  https://zerocancer.org/stages-and-grades/metastatic-prostate-cancer

  Bisphosphonates prevent the thinning of the bone, help make them stronger, and help relieve bone pain. […] There are several types of radiation therapies that can be used to treat and manage the cancer and the pain it can cause when it grows in the bones. […] If several areas of the skeletal system are affected by cancer then radiation, in the form of radiopharmaceuticals, can be administered via IV injection into the blood stream through a vein. […] When facing a metastatic prostate cancer diagnosis, many patients want to get a better understanding of their prognosis and survival rates in hope that this will help them make informed decisions about their treatment and care. […] Survival rates for metastatic prostate cancer can vary widely depending on individual factors. […] Remember, while metastatic prostate cancer is a serious diagnosis, many patients can live for several years with appropriate treatment and support.

• #82 Treatment for Metastatic Prostate Cancer Often Suboptimal – NCI

  https://www.cancer.gov/news-events/cancer-currents-blog/2025/metastatic-prostate-cancer-combination-treatments

  Previous studies from Dr. Agarwal’s team and others have found that, despite clinical trials demonstrating the superiority of more intensified treatment with combination therapies in clinical trials, these findings were largely not changing real-world practice. […] Multiple clinical trials have shown that people who receive combination therapy when their disease is still hormone sensitive live longer than those who get it later, after their disease becomes hormone resistant. […] So the message here is: Don’t wait for disease progression, he said.

• #83 Promising New Options for Treating Aggressive Prostate Cancer

  https://www.cedars-sinai.org/newsroom/promising-new-options-for-treating-aggressive-prostate-cancer/

  New treatment options studied by Cedars-Sinai investigators improved metastasis-free survival while preserving quality of life for men with aggressive prostate cancer. […] Cedars-Sinai Cancer investigators have identified two promising new treatment options for men with recurrent prostate cancer both of which helped patients live longer without their disease progressing than the current standard treatment. […] In the study, both of these new options improved metastasis-free survival while preserving quality of life. […] Investigators found that the combination of ADT plus enzalutamide reduced the risk of metastasis or death by 58% over ADT alone. […] They found that enzalutamide alone reduced the risk of metastasis or death by 37% over ADT alone. […] Both treatments maintained quality of life relative to the ADT alone. […] The results of this trial point the way to two options which the study showed were more effective than current standard of care, giving these patients and their providers the opportunity to choose a potentially improved course of therapy that best meets their needs.

• #84 Metastatic prostate cancer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/metastatic-prostate-cancer/diagnosis-treatment/drc-20377972

  Chemotherapy treats cancer with strong medicines. Chemotherapy medicines are sometimes used with hormone therapy medicines for metastatic prostate cancer. Chemotherapy also helps treat advanced prostate cancer when hormone therapy isn’t working. […] Targeted therapy for cancer is a treatment that uses medicines that attack the cancer cells in a specific way that causes the cells to die. […] For metastatic prostate cancer, immunotherapy treatments most often involve medicines called immune checkpoint inhibitors. These medicines help immune system cells find cancer cells. […] Radiopharmaceutical treatments are medicines that contain a radioactive substance. Radiopharmaceutical treatments used for cancer can deliver radiation to cancer cells. […] Palliative care is a special type of healthcare that helps you feel better when you have a serious illness. If you have cancer, palliative care can help relieve pain and other symptoms. […] When palliative care is used with all of the other appropriate treatments, people with cancer may feel better and live longer.

• #85 Advanced prostate cancer | Prostate Cancer UK

  https://prostatecanceruk.org/prostate-information-and-support/just-diagnosed/advanced-prostate-cancer/

  Advanced prostate cancer can cause symptoms, such as bone pain. Speak to your doctor or nurse if you have symptoms there are treatments available to help manage them. […] While it isnt possible to cure advanced prostate cancer, treatments can help keep it under control, often for several years. Treatments will also help manage any symptoms, such as pain. […] Speak to your doctor about your own situation and any questions or concerns you have.

• #86 Advanced prostate cancer | Macmillan Cancer Support

  https://www.macmillan.org.uk/cancer-information-and-support/prostate-cancer/advanced-prostate-cancer

  Treatments can help to control the cancer and relieve the symptoms. But there may be a time when the treatment has little effect on the cancer. This means you have the side effects without the benefits. […] If you decide not to have further treatment, you will be given supportive (palliative) care, with medicines to control any symptoms. Specialist nurses called palliative care nurses can provide help and support.

• #87 Treatment options | Cancer Australia

  https://www.canceraustralia.gov.au/cancer-types/prostate-cancer/treatment-options

  Prostate cancer may recur (come back) after treatment. […] If prostate cancer has come back, the type of treatment you have may depend on how your primary cancer was treated. […] Treatment to prevent prostate cancer from spreading to the bones, or to relieve symptoms associated with secondary cancer in the bones may include: bisphosphonates, which can help strengthen bones, and is also used in people who have had hormone therapy; external beam radiation therapy, which can help relieve bone pain; monoclonal antibodies such as denosumab injected under the skin to help protect bones; corticosteroids, which can relieve pain and lower PSA levels; radiopharmaceuticals (medicines that contain radioactivity) such as radium-223, which are injected into the body and settle in areas of damaged bone, where they can destroy cancer cells. […] Supportive care forms an important component of managing advanced prostate cancer.

• #88 Metastatic prostate cancer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/metastatic-prostate-cancer/diagnosis-treatment/drc-20377972

  Chemotherapy treats cancer with strong medicines. Chemotherapy medicines are sometimes used with hormone therapy medicines for metastatic prostate cancer. Chemotherapy also helps treat advanced prostate cancer when hormone therapy isn’t working. […] Targeted therapy for cancer is a treatment that uses medicines that attack the cancer cells in a specific way that causes the cells to die. […] For metastatic prostate cancer, immunotherapy treatments most often involve medicines called immune checkpoint inhibitors. These medicines help immune system cells find cancer cells. […] Radiopharmaceutical treatments are medicines that contain a radioactive substance. Radiopharmaceutical treatments used for cancer can deliver radiation to cancer cells. […] Palliative care is a special type of healthcare that helps you feel better when you have a serious illness. If you have cancer, palliative care can help relieve pain and other symptoms. […] When palliative care is used with all of the other appropriate treatments, people with cancer may feel better and live longer.

• #89 Prostate cancer – androgen deprivation therapy | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/prostate-cancer-androgen-deprivation-therapy

  A rapid and often long-term reduction in the growth of prostate cancer, as seen by a reduction in your PSA level. […] Hormone therapy can be given as medications (injections, implants or tablets) to block the production of testosterone or to block the effects of testosterone on cells. […] Testosterone production can be permanently stopped by a surgical procedure to remove the testicles (called an orchidectomy). […] All prostate cancer treatments, including hormone therapy, come with potential side effects. […] Hormone therapy can affect people differently. Some men may experience minimal or no side effects, while others may be very troubled by side effects. […] Possible side effects include: Loss of libido or sex drive, Erection problems, Hot flushes and night sweats, Fatigue (tiredness), Weight gain from increased body fat, Declining bone density (osteoporosis), Loss of muscle mass and muscle weakness, Depression or mood swings, Poor memory, concentration and physical unsteadiness, Breast swelling and breast tenderness, Increased risk of cardiovascular disease and diabetes.

• #90 Advanced Prostate Cancer – Prostate Cancer | UCLA Health Jonsson Comprehensive Cancer Center

  https://www.uclahealth.org/cancer/cancer-services/prostate-cancer/prostate-cancer-treatment/advanced-prostate-cancer

  Advanced (Metastatic) prostate cancer occurs when a tumor that develops in the prostate gland spreads outside the prostate. Currently, no treatments can cure advanced/metastatic prostate cancer. However, there are effective ways to help slow its spread, prolong life, and control its symptoms, including immunotherapy, hormone therapy, chemotherapy, precision medicine and clinical trials. […] Provenge (sipuleucel-T) is an immunotherapy treatment that utilizes the power of the patients own immune system to identify and target prostate cancer cells. […] Hormone therapy, also known as androgen ablation or androgen-deprivation therapy, is the primary approach in the treatment of advanced prostate cancer. […] Regardless of the specific type of hormone therapy, side effects common to all these drugs include hot flashes, mood swings, loss of sex drive and erectile dysfunction, heart problems, and loss of bone density and muscle mass with long-term use.

• #91 Prostate cancer – androgen deprivation therapy | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/prostate-cancer-androgen-deprivation-therapy

  A rapid and often long-term reduction in the growth of prostate cancer, as seen by a reduction in your PSA level. […] Hormone therapy can be given as medications (injections, implants or tablets) to block the production of testosterone or to block the effects of testosterone on cells. […] Testosterone production can be permanently stopped by a surgical procedure to remove the testicles (called an orchidectomy). […] All prostate cancer treatments, including hormone therapy, come with potential side effects. […] Hormone therapy can affect people differently. Some men may experience minimal or no side effects, while others may be very troubled by side effects. […] Possible side effects include: Loss of libido or sex drive, Erection problems, Hot flushes and night sweats, Fatigue (tiredness), Weight gain from increased body fat, Declining bone density (osteoporosis), Loss of muscle mass and muscle weakness, Depression or mood swings, Poor memory, concentration and physical unsteadiness, Breast swelling and breast tenderness, Increased risk of cardiovascular disease and diabetes.

• #92

  https://www.facingourrisk.org/info/risk-management-and-treatment/cancer-treatment/by-cancer-type/prostate/targeted-and-immunotherapy

  The PARP inhibitor, Rubraca (rucaparib) may be used to treat mCRPC, in people who have an inherited mutation in BRCA1 or BRCA2 (found through genetic testing) or a tumor mutation in BRCA1 or BRCA2 (found through tumor testing or liquid biopsy). […] Akeega is a new drug that combines the PARP inhibitor, Zejula (niraparib) with the hormone therapy, Zytiga. Akeega is used with prednisone to treat mCRPC in people who have an inherited mutation or a tumor mutation in BRCA1 or BRCA2 (found through tumor testing or liquid biopsy). […] Pluvicto (lutetium Lu 177 vipivotide tetraxetan) is a type of targeted radiation used to treat mCRPC for men previously treated with hormone therapy with an androgen receptor inhibitor and taxane-based chemotherapy. […] Keytruda (pembrolizumab) may be used to treat patients with castration resistant prostate cancer that is MSI-H or dMMR and have had one line of therapy affecting the whole body.

• #93 Targeted Therapy | ZERO Prostate Cancer

  https://zerocancer.org/treatment-options/systemic-therapies/targeted-therapy

  Targeting PSMA enables treatment to focus on the prostate cancer cells rather than healthy cells in the body. This allows a precision medicine approach to treatment. PSMA treatments will likely be made available to patients who have high levels of PSMA protein detected on their cancer cells using a PSMA PET scan. […] Lutetium Lu 177 vipivotide tetraxetan (Pluvicto), also know as Lu-PSMA, is a PSMA-targeted radioligand therapy (RLT) approved by the FDA to treat mCRPC. […] Common side effects of Lutetium Lu 177 include fatigue, dry mouth, nausea, decreased appetite, constipation, and diarrhea. There are some potentially serious side effects, including bone marrow problems and kidney problems.

• #94 Advanced prostate cancer | Prostate Cancer UK

  https://prostatecanceruk.org/prostate-information-and-support/just-diagnosed/advanced-prostate-cancer/

  Advanced prostate cancer can cause symptoms, such as bone pain. Speak to your doctor or nurse if you have symptoms there are treatments available to help manage them. […] While it isnt possible to cure advanced prostate cancer, treatments can help keep it under control, often for several years. Treatments will also help manage any symptoms, such as pain. […] Speak to your doctor about your own situation and any questions or concerns you have.

• #95 Advanced prostate cancer | Macmillan Cancer Support

  https://www.macmillan.org.uk/cancer-information-and-support/prostate-cancer/advanced-prostate-cancer

  Treatments can help to control the cancer and relieve the symptoms. But there may be a time when the treatment has little effect on the cancer. This means you have the side effects without the benefits. […] If you decide not to have further treatment, you will be given supportive (palliative) care, with medicines to control any symptoms. Specialist nurses called palliative care nurses can provide help and support.

• #96 Treatments for prostate cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/prostate/treatment

  If you have prostate cancer, your healthcare team will create a treatment plan just for you. It will be based on your health and specific information about the cancer. […] Prostate cancer treatments can seriously affect your quality of life and cause side effects such as erectile dysfunction (problems getting or keeping an erection) and incontinence (loss of bladder control). Many prostate cancers grow slowly and cause no symptoms or problems. […] Metastatic castration-sensitive prostate cancer (CSPC) can be treated with hormone therapy, radiation therapy and chemotherapy. […] Castration-resistant prostate cancer (CRPC) can be treated with hormone therapy, chemotherapy, targeted therapy and radiation therapy.

• #97 Patient education: Treatment for advanced prostate cancer (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/treatment-for-advanced-prostate-cancer-beyond-the-basics

  Patient education: Treatment for advanced prostate cancer (Beyond the Basics) […] Advanced prostate cancer is usually treated with a combination of different approaches, which may include hormone therapy, chemotherapy, immunotherapy, or radiation. […] Although metastatic prostate cancer is not curable, treatment can often help to control the cancer for prolonged periods of time. This can help to reduce symptoms and improve the quality of life. […] STAGE IV (METASTATIC) PROSTATE CANCER TREATMENT […] Options for initial treatment […] Androgen deprivation therapy — Male hormones (androgens, the most common of which is testosterone) fuel the growth of prostate cancer. Treatments that decrease the body’s levels of androgens can also decrease the size of the cancer in the prostate as well as other areas (metastases). These treatments are called „androgen deprivation therapy” or „ADT.”

• #98 New Treatment Options for Men Presenting With De Novo Metastatic Prostate Cancer – American Urological Association

  https://auanews.net/issues/articles/2024/january-extra-2024/new-treatment-options-for-men-presenting-with-de-novo-metastatic-prostate-cancer

  Newly presenting or de novo metastatic hormone-sensitive prostate cancer (mHSPC) accounts for 5% to 10% of all prostate cancer (PC) diagnoses, but it is responsible for nearly 50% of PC-related deaths. […] However, the prognosis of mHSPC has improved due to the introduction of new hormonal agents and chemotherapy, combined with standard androgen deprivation therapy (ADT) in the first-line setting. […] Advanced PC guidelines recommend the use of combination therapy rather than ADT alone for patients with mHSPC. […] This chemohormonal therapy approach was validated in several additional phase 3 trials including STAMPEDE and GETUG-AFU15. […] More recently, the need for treatment intensification was expanded by employing so-called “triplet therapy” in patients with high-risk mHSPC. […] Both ARASENS and PEACE-1 show that upfront treatment intensification with the combination of ADT, docetaxel, and an ASI for de novo mHSPC improved survival outcomes with an acceptable safety profile.

• #99 Prostate Cancer Treatment Challenge: Which Drugs to Use First

  https://www.renalandurologynews.com/features/prostate-cancer-treatment/

  American Society of Clinical Oncology guidelines recommend triplet therapy consisting of either darolutamide or abiraterone combined with docetaxel and ADT for patients with metastatic hormone-sensitive prostate cancer (mHSPC). […] Triplet therapy with docetaxel plus an ARPI and ADT has become a widely accepted first-line treatment for patients with high-volume synchronous mHSPC especially for those with visceral metastases and who can tolerate chemotherapy. […] Trial data support ADT/ARPI doublet therapy and radiation to the primary tumor (and possibly metastasis-directed radiation) for patients with synchronous low-volume disease. […] In a network meta-analysis that included 10 RCTs with 11,043 patients with mHSPC, investigators found that triplet therapies of darolutamide plus docetaxel and ADT and abiraterone plus docetaxel and ADT are significantly associated with 32% and 25% lower risks for death, respectively, compared with docetaxel plus ADT doublet therapy.

• #100 What to know about metastatic prostate cancer | MD Anderson Cancer Center

  https://www.mdanderson.org/cancerwise/what-to-know-about-metastatic-prostate-cancer.h00-159703068.html

  At MD Anderson, we’re also conducting clinical trials to study how immunotherapy can help treat prostate cancer. […] If you have been diagnosed with prostate cancer, specifically metastatic prostate cancer, I strongly encourage you to ask your oncologist about clinical trials. […] We haven’t cured metastatic prostate cancer yet. But we’re moving in the right direction.

• #101 New Drug Hope for Prostate Cancer Patients | Prostate Cancer Foundation

  https://www.pcf.org/c/new-drug-hope-for-prostate-cancer-patients/

  In the lab, theresearchersfound thatNXP800slowedthe growth of prostate cancer cells even forcells which were resistant to the hormone therapy enzalutamide. […] Inmice withhormone therapy-resistant prostate cancers, NXP800 significantly slowed tumour growth. […] The researchersfrom the ICR, which is both a research institute and a charity,hope these findings willlead to trials of NXP800 for advanced prostate cancer, to provide patients with alternative treatments when hormone therapies have stopped working. […] While hormone therapies have extended the lives of lots of men with advanced prostate cancer, drug resistance is inevitable. […] With this research, weve shown that targeting the heat shock response pathway a pathway responsible for enabling tumours to withstand stress and keep growing is a potential new avenue for treating advanced prostate cancer.

• #102 Advanced prostate cancer | Macmillan Cancer Support

  https://www.macmillan.org.uk/cancer-information-and-support/prostate-cancer/advanced-prostate-cancer

  Advanced prostate cancer is when the cancer cells have spread from the prostate to other parts of the body. It is not possible to cure advanced prostate cancer. But there are treatments that can help to keep control it. […] Although advanced prostate cancer cannot be cured, it can be controlled with treatment, sometimes for several years. Treatments can also help relieve symptoms and improve your quality of life. […] A multidisciplinary team (MDT) will meet to discuss the best possible treatment options for you. This will depend on different factors, like your general health. Your cancer doctor will talk to you about the advantages and disadvantages of these treatments. […] The main treatments are: Hormonal therapy is recommended for most people with advanced prostate cancer. Hormonal therapies reduce the amount of testosterone in the body. This may slow the growth of the cancer, or stop it growing for a while.

• #103 Metastatic prostate cancer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/metastatic-prostate-cancer/diagnosis-treatment/drc-20377972

  Chemotherapy treats cancer with strong medicines. Chemotherapy medicines are sometimes used with hormone therapy medicines for metastatic prostate cancer. Chemotherapy also helps treat advanced prostate cancer when hormone therapy isn’t working. […] Targeted therapy for cancer is a treatment that uses medicines that attack the cancer cells in a specific way that causes the cells to die. […] For metastatic prostate cancer, immunotherapy treatments most often involve medicines called immune checkpoint inhibitors. These medicines help immune system cells find cancer cells. […] Radiopharmaceutical treatments are medicines that contain a radioactive substance. Radiopharmaceutical treatments used for cancer can deliver radiation to cancer cells. […] Palliative care is a special type of healthcare that helps you feel better when you have a serious illness. If you have cancer, palliative care can help relieve pain and other symptoms. […] When palliative care is used with all of the other appropriate treatments, people with cancer may feel better and live longer.

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