Breaking Down the Prostate Cancer Treatment Renaissance

In a recent interview with CURE, Dr. Kai Tsao broke down current treatment advancements for patients with prostate cancer.

Tsao was appointed earlier this year by Northwell Cancer Institute as system chief of solid tumor oncology, and he is also medical director of the R.J. Zuckerberg Cancer Center and director of Northwell's medical oncology prostate cancer program.

Transcript

Prostate cancer care has changed a lot in recent years. Which treatment advancements are most promising today and how might they change the patient experience?

Given our advances in understanding of cancer genetics, biology and many other factors, we have witnessed this renaissance in terms of development of different therapeutics for prostate cancer, and we've seen that translate to better outcomes for patients.

I think on the screening side, there is a lot of work to understand how to best screen patients for prostate cancer. The PSA screening guidelines have changed over the years, but I do think right now, we're entering a time where we're using personalized risk factors to better stratify who needs to be screened and how often. So certainly that's really important.

From the localized disease side, we've made many advancements, particularly understanding who can be watched in a method called active surveillance and who should be treated. There is also currently molecular testing that's available to guide doctors and clinicians in how to approach a patient's prostate cancer. So certainly, that is a very personalized approach that patients can benefit from.

In terms of advanced disease, we now have many different treatment options. I remember when I became an oncologist. Initially, we really only had chemotherapy and hormone therapy as our main stage of treatment, but now we have separate classes of immunotherapy. We have targeted therapy. We also have different types of chemotherapy and radio ligand therapy. There are many breakthroughs in this field that are becoming more and more significant as we see their clinical development.

I think one specific area is immunotherapy. There is now development of targeted immunotherapies, where we're bringing the immunotherapy to the cancer cells and activating it against the cancer. We now have targeted chemotherapy, where instead of giving chemotherapy that could affect all cells in the body, these targeted therapies bring the chemotherapy to the cancer cells and precisely divert them to the cancer cells.

We have PROTACs, and this is a class of medication, they are pills and they could adhere to the androgen receptor on the cancer cells and degrade them and render them vulnerable to other therapies. We have radio ligand therapies with different targets, where we could bring radio isotopes right to the cancer and radiate the cancer cells very precisely. And this is just a small list of some of the more advancing and promising therapy that we have in front of us today.

Transcript has been edited for clarity and conciseness.

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