SEOM clinical guidelines for the treatment of advanced prostate cancer (2020)

• A. González del Alba ^[6] ; M. J. Méndez-Vidal ^[1] ; S. Vazquez ^[2] ; E. Castro ^[3] ; M. A. Climent ^[4] ; E. Gallardo ^[7] ; E. Gonzalez-Billalabeitia ^[8] ; D. Lorente ^[9] ; J. P. Maroto ^[10] ; J. A. Arranz ^[5]
  1. [1] Hospital Universitario Reina Sofia

     Hospital Universitario Reina Sofia

     Cordoba, España

     
  2. [2] Hospital Universitario Lucus Augusti

     Hospital Universitario Lucus Augusti

     Lugo, España

     
  3. [3] Hospital Universitario Virgen de la Victoria

     Hospital Universitario Virgen de la Victoria

     Málaga, España

     
  4. [4] Instituto Valenciano de Oncologia

     Instituto Valenciano de Oncologia

     Valencia, España

     
  5. [5] Hospital General Universitario Gregorio Marañón

     Hospital General Universitario Gregorio Marañón

     Madrid, España

     
  6. [6] Hospital Universitario Puerta de Hierro-Majadahonda
  7. [7] Parc Taulí Hospital Universitari
  8. [8] Hospital Universitario Doce de Octubre
  9. [9] Hospital Provincial de Castellón
  10. [10] Hospital Universitari Santa Creu i San Pau

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 23, Nº. 5 (May), 2021 (Ejemplar dedicado a: SEOM clinical guidelines 2020), págs. 969-979
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • The treatment of advanced prostate cancer has evolved due to recent advances in molecular research and new drug development. Dynamic aberrations in the androgen receptor, DNA repair genes, PTEN-PI3K, and other pathways drive the behavior of advanced prostate cancer allowing a better selection of therapies in each patient. Tumor testing for BRCA1 and BRCA2 is recommended for patients with metastatic prostate cancer, also considering a broad panel to guide decisions and genetic counseling. In symptomatic metastatic patients, castration should be stared to palliate symptoms and prolong survival. In high-risk or high-volume metastatic hormone-naïve patients, castration should be combined with docetaxel, abiraterone, enzalutamide or apalutamide. Radiotherapy to the primary tumor combined with systemic therapy is recommended in low-volume mHNPC patients. In patients with non-metastatic castration-resistant tumors, risk stratification can define the frequency of imaging. Adding enzalutamide, darolutamide or apalutamide to these patients prolongs metastasis-free and overall survival, but potential adverse events need to be taken into consideration. The choice of docetaxel, abiraterone or enzalutamide for treating metastatic castration-resistant patients depends on previous therapies, with cabazitaxel being also recommended after docetaxel. Olaparib is recommended in BRCA1/BRCA2 mutated castration-resistant patients after progression on at least one new hormonal therapy. Aggressive variants of prostate cancer respond to platinum-based chemotherapy. To optimize treatment efficiency, oncologists should incorporate all of these advances into an overall therapeutic strategy.