Dr. George on the Changing Treatment Landscape in Prostate Cancer

Daniel J. George, MD, professor of medicine and surgery, and member, Duke Cancer Institute, discusses the changing treatment landscape in prostate cancer.

Within the past decade, hormonal therapy, particularly androgen deprivation therapy, has been the focus of treatment for patients with metastatic prostate cancer. Over the past few years, that landscape has changed, with data showing the clinical benefit of docetaxel, abiraterone acetate (Zytiga), apalutamide (Erleada), and enzalutamide (Xtandi) upfront in the metastatic hormone-sensitive setting.

These findings have opened the door to explore additional cytotoxic approaches with radiopharmaceuticals, such as radium-223 dichloride (Xofigo), docetaxel, and cabazitaxel, or other targeted approaches, such as prostate-specific membrane antigen (PSMA)—directed therapy in the post-androgen receptor and -chemotherapy settings. Some of these approaches could end up being used in the curative setting, which would result in a paradigm shift in the advanced setting, concludes George.