Personalizing Approaches to the Management of Metastatic Hormone Sensitive Prostate Cancer: Role of Advanced Imaging, Genetics and Therapeutics

Given the expanding role of novel treatments and diagnostic modalities, the management of metastatic hormone sensitive prostate cancer (mHSPC) has become increasingly personalized. In this review article, we highlight the wideninge array of diagnostic imaging techniques and treatments available in the management of mHSPC including the recently endorsed PSMA-PET imaging Ga-68 or F-18 pifluofolastat PSMA.

Germline genetic testing and somatic tumor testing have also expanded in the last decade and may help educate patients on prognosis and help select for novel targeted therapeutics. Ongoing trials are investigating synergistic therapies such as docetaxel doublet and triplet therapies. The roles of metastasis directed therapy as well as local therapy including cytoreductive prostatectomy are also being evaluated. Ultimately, management considerations are based on the individual patient including the treatment side effects, disease progression and health related quality of life.

Written by: Soum D. Lokeshwar, Ankur U. Choksi, Daniel Haltstuch, Syed N. Rahman, Benjamin H. Press, Jamil Syed, Michael E. Hurwitz, Isaac Y. Kim, Michael S. Leapman

Department of Urology, Yale University School of Medicine, New Haven, CT

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