Welcome

Within 10 years of diagnosis, many individuals with prostate cancer develop castration-resistant prostate cancer (CRPC), which can advance to metastatic CRPC (mCRPC)^1-9. Historically, mean overall survival for mCRPC is approximately 16–18 months¹⁰. The disease has no cure.

Unmet needs in metastatic castration-resistant prostate cancer include no curative treatment, and insufficient understanding of treatment selection, sequencing, or intensification^11-16.

This Learning Zone offers an up-to-date look at mCRPC treatment, including emerging treatment strategies to address unmet needs and the latest data from international conferences.

Expert faculty, Professors Axel Merseburger, Karim Fizazi and Neeraj Agarwal, give their view of the opportunities and challenges in this evolving field.

References

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2. Parker C, Castro E, Fizazi K, Heidenreich A, Ost P, Procopio G, et al. Prostate cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2020;31:1119–1134.
3. Mohler JL, Antonarakis ES, Armstrong AJ, D’Amico AV, Davis BJ, Dorff T, et al. Prostate Cancer, Version 2.2019, NCCN Clinical Practice Guidelines in Oncology. J NCCN. 2019;17(5):479–505.
4. Mottet N, Bellmunt J, Bolla M, Briers E, Cumberbatch MG, De Santis M, et al. EAU-ESTRO-SIOG guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent. Euro Urol. 2017;71(4):618–629.
5. Rozet F, Mongiat-Artus P, Hennequin C, Beauval JB, Beuzeboc P, Cormier L, et al. French CCAFU guidelines-update 2020-2022: prostate cancer. J L'ass Franc D'urol Soc Franc D'urol. 2020;30:S136–251.
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7. AIOM. Linee Guida: Carcinoma Della Prostata. 2020. Available at: https://www.aiom.it/wp-content/uploads/2020/12/2020_LG_AIOM_Carcinoma_Prostata.pdf.
8. González Del Alba A, Méndez-Vidal MJ, Vazquez S, Castro E, Climent MA, Gallardo E, et al. SEOM clinical guidelines for the treatment of advanced prostate cancer. Clin Translat Oncol. 2021;23(5):969–979.
9. NICE. Metastatic prostate cancer guidelines. 2022. Available at: https://www.nice.org.uk/search?q=metastatic+prostate+cancer.
10. Karantanos T, Corn PG, Thompson TC. Prostate cancer progression after androgen deprivation therapy: mechanisms of castrate resistance and novel therapeutic approaches. Oncogene. 2013;32(49):5501–5511.
11. Vennemann M, Ruland V, Kruse JP, Harloff C, Trübel H, Gielen-Haertwig H. Future unmet medical need as a guiding principle for pharmaceutical R&D. Drug Disc Today. 2019;24(9):1924–1929.
12. Boye M, Ribbands A, Leith A, Clayton E, Butcher J, Rybowski S. Real-world health-related quality of life and caregiver need in patients with metastatic hormone-sensitive and metastatic castration-resistant prostate cancer. J Clin Oncol. 2022;40:54.
13. Nussbaum N, Dorff T, Abernethy A, Dolan C, Flanders S, Oestreicher N, et al. Health-related quality of life in metastatic castration-resistant prostate cancer: a critical literature review. Val Health. 2015;18(3):A211.
14. Drudge-Coates L, Oh WK, Tombal B, Delacruz A, Tomlinson B, Ripley AV. Recognizing symptom burden in advanced prostate cancer: a global patient and caregiver survey. Clin Genitour Canc. 2018;16(2):e411–419.
15. Fallowfield L, Payne H, Jenkins V. Patient-reported outcomes in metastatic castration-resistant prostate cancer. Nat Revs Oncol. 2016;13(10):643–650.
16. Connor MJ, Genie MG, Burns D, Bass EJ, Gonzalez MC, Sarwar N, et al. A systematic review of patients’ values, preferences, and expectations for the treatment of metastatic prostate cancer. Euro Urol Open Sci. 2022;36:9–18.