VIDEO: Androgen receptor pathway inhibitors ‘have transformed’ prostate cancer management

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We have different types of drugs that have different mechanisms of action. Obviously, the first treatment for advanced mCRPC that improve survival was in fact chemotherapy. And we still use chemotherapy. Chemotherapy still has a role. While I think that we're trying to get smarter about how to use chemotherapy, particularly around antibody drug conjugates that may deliver the chemo more accurately for now, drugs like docetaxel and cabazitaxel still have an important role because they work.

Even though they have side effects, we've learned how to manage those side effects over the years. Hormonal therapy, namely targeting androgen signaling, has continued to be the mainstay of treatment for advanced prostate cancer, going all the way back to the 1940s when we first started using androgen deprivation therapy. But of course, the last few years, really the last decade to decade and a half, has been the advent of what we call, now call ARPIs, or androgen receptor pathway inhibitors. And these are really much more potent androgen signaling blockers.

Drugs like enzalutamide, abiraterone, now darolutamide, and also apalutamide, these drugs have actually really transformed the management to prostate cancer because they're much more potent than what we had before. And so I think those are almost always gonna be the first things that we start with. And then finally, there are targeted therapies. I talked about radioligand therapies with PSMA, and I think there are gonna be more to come. PSMA is a very promising target, but there are other targets that are being developed in advanced prostate cancer.