Managing advanced prostate cancer : breakthroughs in hormone therapy and beyond

Abstract

Over the course of the past decade, the therapeutic panorama for the management of advanced prostate cancer has expanded significantly and attracted much attention. Advanced prostate cancer is defined from the perspective of metastatic hormone-sensitive prostate cancer (mHSPC), metastatic castration-resistant prostate cancer (mCRPC), and certain localized diseases with high-risk characteristics. In this context, the landscape of hormone therapy (commonly referred to as androgen deprivation therapy (ADT)) in advanced prostate cancer continues to evolve, with a focus on maximizing treatment efficacy, minimizing side effects, and tailoring approaches to the unique characteristics of each patient’s cancer. Hormone therapy has been a cornerstone in the treatment of prostate cancer for many years. It aims to reduce the levels of male hormones (androgens), such as testosterone, which fuel the growth of prostate cancer cells. Significant breakthroughs and innovations in hormone therapy for advanced prostate cancer have been reported over the years, enhancing its effectiveness and expanding treatment options, particularly in Africa where several setbacks and challenges marred advanced prostate cancer management. The chapter focuses on the breakthroughs in hormone therapy and emerging treatment options in advanced prostate cancer, primarily in the African context. It explores the development of novel hormone therapies, such as androgen receptor antagonists and CYP17 inhibitors, which have shown efficacy in improving outcomes for patients with advanced or castration-resistant disease. Additionally, the chapter delves into emerging treatment approaches beyond hormone therapy, including targeted therapies and immunotherapies, which hold promise in managing advanced stages of prostate cancer in Africa.