Research Topic

Interaction between modern radiotherapy and novel drugs in prostate cancer: future perspectives

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Prostate cancer (PCa) is one of the most common malignancies and main causes of cancer death in Western countries. Metastatic castration resistant prostate cancer (mCRPC) causes approximately 258,400 deaths annually worldwide. The death of patients with this condition, which typically occurs within 24 to 48 ...

Prostate cancer (PCa) is one of the most common malignancies and main causes of cancer death in Western countries. Metastatic castration resistant prostate cancer (mCRPC) causes approximately 258,400 deaths annually worldwide. The death of patients with this condition, which typically occurs within 24 to 48 months after the onset of castration resistance, is commonly preceded by a sequence of landmark events associated with deterioration of overall health and worsening symptoms. In the presence of metastatic disease, systemic treatment remains the main clinical option. However, irradiation of metastatic foci could improve the clinical outcome in patients with limited burden of disease.

Implementing next-generation ARTA (androgen receptor-targeted agents) or chemotherapy with docetaxel could aid treatment intensification in the localized high risk or locally advanced settings. ARTA have demonstrated clinical efficacy in more advanced clinical settings and because there is preclinical evidence of their radiosensitizing effects, their combination with radiotherapy is the next step for treatment intensification in patients with high-risk.

Moreover data in literature demonstrated the emerging role of metastasis directed therapy (surgery or radiotherapy) in the management of oligometastatic prostate cancer. In particular, stereotactic body radiotherapy (SBRT) seems to be a safe and effective treatment, and has a positive impact on progression free survival. In oligometastatic prostate cancer, the use of SBRT may lead to an improvement of clinical benefit of systemic therapy. Oligometastatic disease is described in the literature as an intermediate state between local and widespread metastatic dissemination. The use of SBRT directed against all active lesions has been suggested as a possible salvage treatment, especially with integration with ARTA in the setting of mCRPC.

The main objective of the collection is to evaluate the benefit of combination of docetaxel chemo or the new drugs (ARTA/ immunotherapy) and primary radiation therapy in patients with intermediate and high-risk, localized or locally advanced prostate cancer and the benefit of metastasis directed therapy and combination with the new drugs in a population of prostate cancer patients in different setting (de novo mHSPC, MDT for oligorecurrent or oligoprogressive, mCRPC).


Keywords: prostate cancer, ablative radiotherapy, androgen receptor targeted agents, stereotactic radiotherapy, castration resistant prostate cancer


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