Novel Agents Are Changing the Prostate Cancer Treatment Landscape


The addition of novel agents in the prostate cancer treatment landscape could create a shift in the way patients with advanced disease are treated, said Dr. Daniel George.

The addition of novel agents in the prostate cancer treatment landscape could create a shift in the way patients with advanced disease are treated, said Dr. Daniel George.

In an interview with CURE, George, a medical oncologist and the director of genitourinary oncology at Duke Cancer Institute, explained how patients can be treated earlier with new drugs that could prolong their lives.


Prostate cancer is really in a dynamic state right now, and it’s an exciting time for patients, caregivers and physicians alike. For the past probably 70 years, we’ve focused primarily on hormonal therapy, androgen deprivation therapy, particularly for patients with metastatic advanced prostate cancer.

Over the last few years, that landscape has changed with the approval of and the data showing clinical benefit associated with upfront use of docetaxel and then [Zytiga (abiraterone)], and most recently, with androgen receptor antagonists such as [Erleada (apalutamide)] and [Xtandi (enzalutamide)] in this landscape of patients with metastatic, hormone-sensitive prostate cancer.

And the repercussions of that are being felt downstream, so now we’re seeing patients enter into the castration-resistant prostate cancer setting having been exposed to these drugs, and I think we’re going to have an opportunity to treat earlier with some novel agents that are going to show promise in that post-(androgen receptor), post-chemotherapy setting, or with other cytotoxic agents that are maybe novel in the field and targeting the disease through radiopharmaceuticals like radium, also docetaxel or [(Jevtana (cabazitaxel)], as well as novel agents coming in that may be other ways of targeting, say, PSA [prostate specific antigens] and other strategies.

So, this is opening up room for clinical trials. Patients are going to live longer and have more time to go on those studies, which is exciting. We’re going to have an opportunity to treat patients earlier in the disease with life-prolonging therapies. And I think we’re going to begin to see some of these things translate into the curative setting, that’s probably one of the most exciting changes in the field that are coming, where we move from our investigational agents in the late stage all the way to the early stage, and this change in the landscape. It’s really a paradigm shift in how we think about managing our patients with advanced prostate cancer.

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