Metastatic prostate cancer, where the cancer has spread beyond the prostate to other parts of the body, presents significant challenges in treatment. According to Bilal Siddiqui, M.D., a genitourinary medical oncologist at MD Anderson, the focus is on improving treatment strategies to enhance patient outcomes. This article explores current treatments, survival rates, and recent advances in managing metastatic prostate cancer.
Common Sites and Treatment Approaches
Prostate cancer frequently metastasizes to the bones and lymph nodes, particularly in the pelvis, spine, and ribs. Treatment strategies for metastatic prostate cancer typically involve a multidisciplinary approach.
"At MD Anderson, we work together as a team of specialists to treat stage IV prostate cancer," says Dr. Siddiqui. Treatment modalities include:
- Hormone Therapy: Antiandrogens are used to block testosterone production or its interaction with cancer cells, given the hormone-driven nature of prostate cancer.
- Chemotherapy: This is employed to destroy cancer cells throughout the body.
- Radiation Therapy: Targeted radiation is used to alleviate pain from bone metastases.
- Supportive Care: Managing pain and providing comprehensive support are integral to patient care.
Survival Rates and Disease Progression
The average survival after a metastatic prostate cancer diagnosis is approximately 5 to 6 years. This is divided into two phases:
- Hormone-Sensitive Phase: Treatments targeting testosterone are effective in controlling cancer growth.
- Hormone-Refractory (Castration-Resistant) Phase: The cancer adapts to grow independently of testosterone. On average, the transition to castration-resistant prostate cancer occurs within 2 to 3 years, with survival in this phase averaging another 2 to 3 years.
Latest Advances in Treatment
Significant research is underway to identify biomarkers that can guide treatment selection. A notable advancement is the FDA approval of lutetium Lu 177 vipivotide tetraxetan (Pluvicto) in 2022. This targeted nuclear medicine therapy is designed for prostate-specific membrane antigen (PSMA) metastatic castration-resistant prostate cancer.
Lutetium Lu 177 vipivotide tetraxetan targets the PSMA protein, delivering radiation directly to cancer cells. A Phase III clinical trial demonstrated that patients receiving this therapy lived longer than those in the control arm. "We have a new treatment option to offer patients," notes Dr. Siddiqui. Eligible patients receive the treatment via infusion every six weeks.
Ongoing Research and Clinical Trials
MD Anderson is actively involved in clinical trials exploring the potential of immunotherapy in treating prostate cancer. While prostate cancer has historically been less responsive to immunotherapy compared to cancers like melanoma or lung cancer, ongoing research aims to improve outcomes.
Dr. Siddiqui advises patients diagnosed with metastatic prostate cancer to inquire about clinical trial opportunities. "Ask them, ‘What’s new in the pipeline? What other options beyond the standard treatment do we potentially have?’"
While a cure for metastatic prostate cancer remains elusive, advancements in targeted therapies and immunotherapy offer hope for extending survival and improving the quality of life for patients.
