Dr. Hwang on the State of Treatment in Metastatic Prostate Cancer

Clara Hwang, MD, a medical oncologist with Henry Ford Health System, discusses the state of treatment in metastatic prostate cancer.

In metastatic castration-sensitive prostate cancer, multiple agents have been shown to improve survival, including docetaxel, abiraterone acetate (Zytiga), enzalutamide (Xtandi), and apalutamide (Erleada). As such, patients should be offered 1 of those agents, says Hwang. As time goes on, more data are going to emerge with combination treatments which may help answer the question of whether patients need docetaxel and a novel hormonal agent, adds Hwang.

In metastatic castration-resistant prostate cancer, olaparib (Lynparza) should be considered for use in patients with homologous recombination repair defects. Right now, the agent would be used off-label in anticipation of an approval, says Hwang. Patients with bone metastases should be given bone-protecting agents, says Hwang. Additionally, radium-223 dichloride (Xofigo) plus abiraterone is not recommended in this patient population, concludes Hwang.