Dr. Zhang on Therapeutic Advancements in Prostate Cancer

Jingsong Zhang, MD, PhD, discusses the advancements for patients with metastatic castration-resistant prostate cancer (mCRPC) that have occurred over the last decade.

Since 2010, there have been 6 drugs approved for treating stage IV disease when patients no longer respond to hormonal therapy, such as androgen-deprivation therapy (ADT) and leuprolide acetate for depot suspension (Lupron). Five of these agents are based on an improvement of overall survival, Zhang says.

Researchers are investigating how to best sequence these agents and how they may benefit patients in combination. The CHAARTED trial, for example, demonstrated that upfront chemotherapy should be administered when patients start ADT, as it has a survival benefit here.

Regarding tumor markers, there is AR-V7, which is a predictive marker in terms of response to newer androgen-deprivation agents such as abiraterone acetate (Zytiga) and enzalutamide (Xtandi). Ongoing phase III trials are targeting this patient population, but they have positive AR-V7 in their circulating tumor cells.