Multidisciplinary approach: key in new treatment options for metastatic castration resistant PCa

An effective multidisciplinary approach with urologists taking the active lead role is crucial in dealing with the advent of emerging drugs for the treatment of metastatic castration resistant prostate cancer (mCRPC), says a cancer expert during the EAU 7th South Eastern European Meeting (SEEM) held in Skopje."With the entry of emerging drugs there is a need to link up with other specialists in prostate cancer treatment since this requires a concerted approach. Urologists are certainly on board in this multi-disciplinary team and we can do a lot more in defining an effective strategy for our patients," said Prof. Gero Kramer of the Department of Urology, Medical University Vienna.

Kramer lectured in the concluding plenary session of the 7th SEEM on the topic "Castration Resistant Prostate Cancer, New Therapeutic Options," and gave an overview on the current emerging approaches such as cabazitaxel, a next-generation taxane.

"Preclinical data shows activity against tumour cells and tumour models that are resistant to, or not sensitive to currently available taxanes," said Kramer adding that cabazitaxel is as potent as docetaxel against sensitive cell lines and tumour models.

He also focused on the need for identifying the proper sequencing on these new drugs saying that specialists should be on the lookout for adverse events.

"Another concern is the high costs of these drugs. For patients to really benefit, the costs of treatment should go down," Kramer said adding that at current prices in the US the cost of using cabazitaxel for a patient averages at around $48,000, and in the case of the FDA-approved Sipuleucel-T, costs could run up to as high as $93,000 for a complete regimen.

Asked on what could be the most beneficial for patients with mCRPC, Kramer said it would be difficult to say at this point but immunotherapy presents the most promising potential with a significant impact on survival, very low incidence of adverse events and a short treatment duration.