Published on March 23, 2018
What factors determine the route a metastatic prostate cancer patient’s treatment journey will take? What treatment options are available? Prostate cancer expert Dr. Tomasz Beer from OHSU Knight Cancer Center explains how treatment plans are typically sequenced. Dr. Beer also describes which therapy is used as an initial treatment, how to tell if a patient is likely to be hormone-resistant or hormone-responsive, and shares other options suitable for different stages of the disease. Watch now to learn more about choosing the right treatment option for your prostate cancer condition.
This is a Patient Empowerment Network program produced by Patient Power in partnership with Seattle Cancer Care Alliance. We thank Astellas and Sanofi for their support.
Transcript | Hormone-Resistant vs. Hormone-Responsive Metastatic Prostate Cancer: How Does the Approach to Treatment Vary?
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So, Dr. Beer, “How is metastatic prostate cancer treated differently between hormone-resistant and nonresistant?”
Sure. When a patient has metastatic prostate cancer that is not hormone-resistant, sometimes we call that hormone-responsive or hormone-naïve if the cancer hasn’t been treated yet. The backbone of therapy is primary hormonal therapy, most often given through one of these injectable agents like leuprolide (Lupron), goserelin (Zoladex), and so forth. In very recent times, we’ve learned that adding either chemotherapy with docetaxel (Taxotere) or stronger hormonal therapy with abiraterone (Zytiga) appears to yield better survival, at least in men with multiple metastases and more advanced disease.
So, that’s the initial treatment for hormone-responsive or -sensitive prostate cancer. In the hormone-resistant setting, that’s where all the different chemotherapeutics—both docetaxel and cabazitaxel (Jevtana)—all the different second-generation anti-androgens like enzalutamide (Xtandi) and abiraterone, radium, come into place—Sipuleucel-T and, potentially, a lot of investigational therapies. So, we tend to treat patients sequentially, first with standard initial therapy, and then with a series of therapies. And, each treatment there is individualized—how you sequence those.