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Systemic Therapy for Prostate Cancer

A urologic oncology fellow provides a comprehensive overview of systemic therapy options for patients with prostate cancer.

This is a synopsis of an Educated Patient Sound Bites series featuring Alicia Morgans, MD, MPH, of Dana-Farber Cancer Institute; Rashid K. Sayyid, MD, MSc, of the University of Toronto; and Reginald Tucker-Seeley, MA, ScM, ScD, of ZERO Prostate Cancer.

Dr Rashid K. Sayyid discusses chemotherapy options docetaxel and cabazitaxel, which stabilize microtubules to inhibit cancer cell proliferation. He then covers immunotherapy with programmed cell death protein 1 (PD-1) and programmed death ligand 1 (PD-L1) inhibitors, which prevent cancer cells from tricking the immune system.

The most commonly used treatment is androgen deprivation therapy, including luteinizing hormone-releasing hormone (LHRH) agonists to reduce testosterone production and gonadotropin-releasing hormone (GnRH) antagonists to immediately inhibit testosterone. Newer drugs also prevent adrenal testosterone production. Dr Sayyid explains testosterone promotes prostate cancer growth, so limiting levels fights proliferation.

Additional drug classes are then summarized, including sipuleucel-T immunotherapy whereby peripheral blood cells activate against antigens then reinject to target cancer, radium Ra 223 dichloride which emits alpha radiation to damage cancer cell DNA, and PARP inhibitors like olaparib, rucaparib, and talazoparib that prevent DNA damage repair prompting cancer cell death.

In total, Dr. Rashid K. Sayyid overviews major drug categories for treating prostate cancer - chemotherapy, immunotherapy, hormone therapy, therapeutic vaccines, alpha radiation, and PARP inhibitors.

*Video synopsis is AI-generated and reviewed by CURE editorial staff.

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