Resolution of the Expert Council on the new approach to drug therapy for non-metastatic castration-resistant prostate cancer
D.R. KAIDAROVA1, O.V. SHATKOVSKAYA1, Z.D. DUSHIMOVA1, B.T. ONGARBAYEV1
1.Kazakh Institute of Oncology and Radiology, Almaty, the Republic of Kazakhstan
Год: 2021 выпуск: 59 номер: 1 страницы: 8-11
Relevance: Prostate cancer (PC) is one of the most common malignant neoplasms in the male population. The widespread introduction of modern diagnostic methods and the determination of prostate-specific antigen (PSA) levels have increased the number of detected cases of localized and locally advanced PC forms. However, in some patients treated with radical methods and long-term androgen deprivation therapy (ADT), the disease continues to progress in the form of an increase in PSA levels with castration testosterone values and with no distant metastases. Such a course of the disease is referred to as non-metastatic castration-resistant prostate cancer (nmCRPC).
Purpose: The article reports the results of a meeting of the Expert Council arranged by the Kazakh Research Institute of Oncology and Radiology on December 25, 2020, on non-metastatic castration-resistant prostate cancer diagnostics and treatment.
Results: Large clinical studies highlight the critical importance of controlling the PSA doubling time as the main prognostic factor for an unfavorable outcome to increase patient survival and prevent the development of distant metastases.
Based on the results of large randomized studies, experts recommended using new-generation androgen receptor antagonists in combination with ongoing ADT to improve the clinical outcomes in nmCRPC patients at high risk of metastatic progression. The Expert Council was presented with the data of a registration clinical study on darolutamide efficacy and safety.
The advantages of introducing this drug into clinical practice to expand the choice of therapeutic options were identified.
Personalized adjustment of a treatment regimen will increase the treatment efficacy and ensure higher survival in this category of patients.
Conclusion: Increasing survival as the main objective in treating nmCRPC patients requires improved diagnostics through regular controlling of testosterone and PSA levels, calculation of PSA doubling time, and the use of radiological diagnostic methods to rule out distant metastases. The choice of therapy in patients at high risk of metastasis shall consider the patient’s status and the treatment efficacy and safety balance.
Ключевые слова: non-metastatic castration-resistant prostate cancer (nmCRPC), selective androgen receptor blocker, combination therapy, darolutamide.
Ссылка: D.R. Kaidarova, O.V. Shatkovskaya, Z.D. Dushimova, B.T. Ongarbayev. Resolution of the Expert Council on the new approach to drug therapy for non-metastatic castration-resistant prostate cancer. Oncology and Radiology of Kazakhstan, 2021, 59 (1), 8-11.