How would you treat a patient with newly diagnosed prostate cancer with low volume bone metastases and extensive lung metastases with a very low PSA (< 5) and no neuroendocrine differentiation on pathology?
In addition to ADT, would you treat with abiraterone, enzalutamide or docetaxel? Or other treatment - platinum/taxane?
Answer from: Medical Oncologist at Community Practice
Generally, I would treat such a patient with ADT plus abiraterone (or enzalutamide). A recent paper from our group suggested that patients who present with pulmonary mets, without concurrent liver mets, usually have a great prognosis with hormonal therapies. Another interesting phenomenon is that pa...
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Answer from: Medical Oncologist at Academic Institution
This is a good question. The first consideration would be neuro-endocrine differentiation which you have already stated as absent and no other indication that this is anything other than prostate cancer despite the low PSA. In this case then, the presence of lung metatstases qualify these as viscera...
Answer from: Medical Oncologist at Academic Institution
Patients with lung metastases without liver metastases have a prognosis similar to that of men with bone metastases; thus would not necessarily portend a worse outcome or need for docetaxel. Recent data from LATITUDE, PEACE1 (NCT01957436), supported by our subgroup workgroup in ARCHES, suggests thes...