M0CRPC overview of management options

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Though prostate cancer usually responds to androgen deprivation therapy (ADT) in the beginning, the majority of prostate cancers will develop castration resistance over time. The androgen receptor (AR) pathway is often found to be activated in castration resistant prostate cancer (CRPC). Thus, AR signalling remains a therapeutic target upon the development of CRPC. The term M0CRPC is used when ADT leads to castration resistance and there are no metastases detectable by means of conventional imaging. Until recently, there was no therapeutic standard for this group of patients. With the PROSPER-, SPARTAN- and ARAMIS-studies three large placebo-controlled phase III trials have been published lately that showed a significant benefit in metastasis-free survival in men with M0CRPC and short PSA doubling time (PSADT). The efficacy data are very similar in these studies, meaning that the drugs’ safety profiles, final analyses of overall survival and their availability will be more important to help clinicians decide which of these three drugs they use for their patients with M0CRPC.

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Author information

YH-B project development, data management, manuscript writing. BH project development, manuscript writing/editing. JH project development, data management, manuscript writing/editing.

Correspondence to J. Hess.

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Y. Hess-Busch reports non-financial support from Roche and BMS. J. Hess reports grants and personal fees and non-financial support from Boston Scientific and personal fees and non-financial support from Bayer, Janssen and MSD. B. Hadaschik reports grants, personal fees and non-financial support from Janssen, personal fees and non-financial support from Astellas, AstraZeneca, Bayer, BMS, Lightpoint Medical, and Uromed.

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Hess-Busch, Y., Hadaschik, B. & Hess, J. M0CRPC overview of management options. World J Urol (2019).

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  • M0CRPC
  • nmCRPC
  • Prostate cancer
  • Enzalutamide
  • Apalutamide
  • Darolutamide