Novel androgen axis systemic therapies for metastatic hormone-sensitive prostate cancer.

PURPOSE OF REVIEW: Upfront docetaxel and androgen deprivation therapy (ADT) has improved outcomes over ADT alone in men with metastatic hormone-sensitive prostate cancer (mHSPC). Here in, we review the emerging role of novel androgen axis inhibitors in the treatment of men with mHSPC.

RECENT FINDINGS: Recently two studies, LATITUDE and STAMPEDE arm G, showed improved survival with addition of abiraterone acetate with prednisone or prednisolone to ADT in men with hormone-naïve advanced prostate cancer.

SUMMARY: Upfront docetaxel in addition to ADT has been shown to improve survival outcomes in men with high-volume mHSPC. Recently, abiraterone acetate and prednisone or prednisolone and ADT have been shown to improve survival outcomes compared with ADT alone in men with mHSPC. Multiple other novel androgen axis inhibitors are being investigated in this setting, and expected to garner regulatory approval in the near future. Biomarkers predicting response to these agents are urgently needed to optimize treatment selection, not only to improve outcomes but to also minimize cost and toxicities.