SEOM clinical guidelines for the treatment of advanced prostate cancer (2020)
González-del-Alba, Aránzazu (Hospital Universitario Puerta de Hierro Majadahonda (Madrid))
Méndez-Vidal, M. J. (Hospital Universitario Reina Sofía (Còrdova, Espanya))
Vazquez, S. (Hospital Universitario Lucus Augusti (Lugo))
Castro, E. (Hospital Universitario Virgen de la Victoria (Màlaga, Andalusia))
Climent, Miguel Ángel (Fundació Institut Valencià d'Oncologia)
Gallardo, Eduard (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Gonzalez-Billalabeitia, Enrique (Universidad Católica San Antonio de Murcia)
Lorente, D. (Consorci Hospitalari Provincial de Castelló)
Maroto Rey, Pablo. (Institut d'Investigació Biomèdica Sant Pau)
Arranz Alija, Jose Ángel (Hospital General Universitario Gregorio Marañón)
Universitat Autònoma de Barcelona

Date:	2021
Abstract:	The treatment of advanced prostate cancer has evolved due to recent advances in molecular research and new drug development. Dynamic aberrations in the androgen receptor, DNA repair genes, PTEN-PI3K, and other pathways drive the behavior of advanced prostate cancer allowing a better selection of therapies in each patient. Tumor testing for BRCA1 and BRCA2 is recommended for patients with metastatic prostate cancer, also considering a broad panel to guide decisions and genetic counseling. In symptomatic metastatic patients, castration should be stared to palliate symptoms and prolong survival. In high-risk or high-volume metastatic hormone-naïve patients, castration should be combined with docetaxel, abiraterone, enzalutamide or apalutamide. Radiotherapy to the primary tumor combined with systemic therapy is recommended in low-volume mHNPC patients. In patients with non-metastatic castration-resistant tumors, risk stratification can define the frequency of imaging. Adding enzalutamide, darolutamide or apalutamide to these patients prolongs metastasis-free and overall survival, but potential adverse events need to be taken into consideration. The choice of docetaxel, abiraterone or enzalutamide for treating metastatic castration-resistant patients depends on previous therapies, with cabazitaxel being also recommended after docetaxel. Olaparib is recommended in BRCA1/BRCA2 mutated castration-resistant patients after progression on at least one new hormonal therapy. Aggressive variants of prostate cancer respond to platinum-based chemotherapy. To optimize treatment efficiency, oncologists should incorporate all of these advances into an overall therapeutic strategy.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Androgen ; Castration ; Molecular ; Biomarkers ; Research
Published in:	Clinical & translational oncology, Vol. 23 (february 2021) , p. 969-979, ISSN 1699-3055

DOI: 10.1007/s12094-021-02561-5
PMID: 33625671

11 p, 805.4 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Parc Taulí Research and Innovation Institute (I3PT
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
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Articles > Published articles