Metastatic Disease Resistant to Testosterone-Reducing Therapy
In some men, prostate cancer continues to spread after therapy is administered to lower the level of testosterone in the blood. These tumors differ on a molecular level from other metastatic prostate tumors.
Treatments for this group of patients can include additional hormonal therapies, chemotherapy, or, for those who are eligible, investigational approaches available through clinical trials. Treatments are tailored to the individual based on the aggressiveness of his cancer and the predicted molecular profile of his disease. Our basic scientists and clinicians are at the forefront of developing new drugs for these patients. These efforts have resulted in new generations of hormonal therapies, the testing of new biologic therapies and bone-directed treatments, and novel methods of identifying patients' unique biology through molecular imaging and detection of circulating tumor cells. (To learn more about our research efforts, visit the lab pages of Dr. Charles Sawyer and Dr. Neal Rosen.)
Therapies for patients with metastatic disease who do not respond to hormonal treatments are not curative, but are designed to slow, control, or reverse progression of the disease, as well as to promote quality of life.
Patients whose disease is resistant to testosterone-reducing therapy fall into two groups:
- Men who may not need chemotherapy; who might not have yet received it; or having received it are not resistant to it
- Men who have received but are no longer responsive to active chemotherapy
The needs, risks, and disease manifestations of the members of each of these groups differ. Our approach, both in terms of treating the cancer and supportive care, is tailored accordingly. For patients for whom chemotherapy may not be appropriate, we are developing new hormonal therapies and other non-chemotherapeutic approaches. For those who require chemotherapy, we are developing more potent chemotherapy combinations. For those resistant to chemotherapy, we are developing drugs that treat the disease by methods that are based on the newest scientific research in prostate cancer biology. We are focused on finding new therapies for these patients that both extend and improve life. [LINK to Trials] Because prostate cancer can be slow-growing and have a prolonged natural history, many patients in this clinical state live a long life.
In addition, our medical oncologists, psychiatrists, pain and palliative care specialists, surgeons, and radiation oncologists work together as a team to treat the physical and psychological effects of disease among these patients.