Therapeutic Options in Metastatic Castration-Resistant Prostate Cancer
Therapeutic Options in Metastatic Castration-Resistant Prostate Cancer
Although PSA is easy and inexpensive to obtain, it must be used prudently for clinical decision making in prostate cancer. In mCRPC, using the information provided by PSA levels in clinical practice is more clearly defined than in the past. PSA should not be used as a sole criterion to discontinue treatment for a patient. Studies have shown that PSA secretion is a poor marker of disease progression and should be treated as such. The PCWG2 has recommendations for the design and endpoints of clinical trials for patients with mCRPC that include definition of progression of disease and radiographic assessments. Although significant strides have been made during the past several years in terms of treatment options for patients with mCRPC, there remain areas in which further elucidation is required, and the role of PSA is one of them. For now, effort needs to be placed in exploring suitable biomarkers to determine the efficacy of treatments (cytotoxic and noncytotoxic). This also will have added importance as the horizon of immunotherapeutic agents continues to evolve.
Future Perspectives
Although PSA is easy and inexpensive to obtain, it must be used prudently for clinical decision making in prostate cancer. In mCRPC, using the information provided by PSA levels in clinical practice is more clearly defined than in the past. PSA should not be used as a sole criterion to discontinue treatment for a patient. Studies have shown that PSA secretion is a poor marker of disease progression and should be treated as such. The PCWG2 has recommendations for the design and endpoints of clinical trials for patients with mCRPC that include definition of progression of disease and radiographic assessments. Although significant strides have been made during the past several years in terms of treatment options for patients with mCRPC, there remain areas in which further elucidation is required, and the role of PSA is one of them. For now, effort needs to be placed in exploring suitable biomarkers to determine the efficacy of treatments (cytotoxic and noncytotoxic). This also will have added importance as the horizon of immunotherapeutic agents continues to evolve.
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