What’s on the horizon for patients with advanced prostate cancer?

In this video, Prof Dr Karim Fizazi, medical oncologist at the Institut Gustave Roussy in Villejuif, France, shares the highlights of an educational session at ESMO 2024 dedicated to emerging therapeutic targets for patients with advanced prostate cancer (PCa).

For the last two decades the most prominent therapeutic target in prostate cancer has been the androgen receptor (AR) signaling pathway. Nowadays, second generation AR antagonists such as abiraterone, enzalutamide, or apalutamide have become an essential part of the therapeutic arsenal for patients with prostate cancer. More recently, third generation AR inhibitors have emerged, and these agents are currently under evaluation in clinical trials. Other targets that have gained importance in recent years consist of PSMA, and the DNA repair mechanism (i.e., PARP inhibition). In addition to this, clinical trials are underway to assess the potential of agents targeting STIP1 or CALR. Other emerging therapies to keep an eye on in the prostate cancer field include inhibitors of B7-H3, agents interfering with epigenetic modulation (e.g., anti EZH2) and T-cell engagers.

In his overview, Prof Fizazi specifically addressed prostate cancer with neuroendocrine differentiation. This continues to be a very challenging disease entity for which little to no effective treatments are available. More recently, however, increased insights into the biology of these cancers identified several potential therapeutic targets. In this respect, early clinical trials with agents targeting DLR3 have yielded promising results.