Dr Lowentritt on the Exploration of Active Surveillance in Prostate Cancer

Benjamin H. Lowentritt, MD, FACS, director, Minimally Invasive Surgery and Robotics, Chesapeake Urology, discusses the exploration of active surveillance in patients with prostate cancer.

The exploration of which biomarkers might influence patient adherence to active surveillance and understanding the need for diverse monitoring approaches remains an ongoing, evolving process, Lowentritt begins. Although various prognostic tests are available to aid in identifying potentially aggressive diseases, they don't outright disqualify a patient from candidacy for active surveillance but rather assist in determining the required level of monitoring that patient should receive, he explains. As these tests progress, a question emerges regarding whetheralterations in these markers suggest a shift in behavior necessitating a transition from activesurveillance to treatment or vice versa, Lowentritt says. The best methods and frequency for utilizing these tests are still largely unknown, presenting unresolved queries, he adds. Regardless, ongoing revelations and data are expected to provide valuable guidance in the future, Lowentritt notes.

In the overall field of prostate cancer, emerging trends revolve around defining specific diseasecategories and stratifying patients, he expands. A growing discourse surrounds intensifying treatment for some patients and de-escalating treatment for super-responsive or certain disease-patterned patients, he says. Delving into genomics and understanding metastatic patterns, coupled with the advent of novel treatments, allows for the identification of patient subsets that respond favorably to distinct therapies, Lowentritt emphasizes. This research is focused on discerning which patients might respond best to which treatments, and this approach extends to identifying patients who might not require aggressive treatment, he states.

Achieving this level of precision will take time, likely defining the next decade or two in prostate cancer research, Lowentritt continues. The emphasis of this research is on uncovering significant successes based largely on genomics and targeting specific disease aspects to improve patient outcomes, he explains. Although there's enthusiasm around targeting prostate-specific membrane antigen and using various emerging treatment approaches, the future appears to be increasingly specialized in tailoring more precise treatments for patients with prostate cancer, Lowentritt concludes.