Fast Five Quiz: Advanced and Metastatic Prostate Cancer Treatment

Daniel S. Schwartz, MD, MBA


May 02, 2022

Adjuvant bisphosphonates may reduce fractures and related skeletal events in patients with advanced or metastatic prostate cancer. However, a 2019 analysis showed that adjuvant bisphosphonate therapy did not significantly improve overall survival in patients with prostate cancer, with the exception of the castration-sensitive metastatic prostate cancer subgroup.

GnRH analogues suppress ovarian and testicular steroidogenesis by decreasing luteinizing hormone (LH) and follicle stimulating hormone (FSH) levels, whereas GnRH antagonists lower serum testosterone levels by suppressing LH and FSH.

Antiandrogens are frequently used as combination agents to treat prostate cancer. Data suggest that the use of nonsteroidal antiandrogen monotherapy for advanced prostate cancer results in decreased overall survival and increased clinical progression, treatment failure, and treatment discontinuation due to adverse events compared with medical or surgical castration monotherapy.

Efficacy of abiraterone with prednisone for the treatment of metastatic high-risk castration-sensitive prostate cancer was shown in the LATITUDE trial. In that trial, the addition of abiraterone acetate and prednisone to ADT significantly increased overall survival and radiographic progression-free survival in men with newly diagnosed metastatic castration-sensitive prostate cancer. Abiraterone may be an option for patients who are chemotherapy naïve with metastatic castration-resistant prostate cancer as well as those with castration-sensitive prostate cancer.

Learn more about the management of advanced and metastatic prostate cancer.


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