Multimodality Therapies for Localized Prostate Cancer

• Published in: Current oncology reports Vol. 25; no. 3; pp. 221 - 229
• Main Authors: Valle, Luca F., Jiang, Tommy, Weiner, Adam B., Reiter, Robert E., Rettig, Matthew B., Shen, John, Chang, Albert J., Nickols, Nicholas G., Steinberg, Michael L., Kishan, Amar U.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-03-2023; Springer Nature B.V
• Subjects: Androgen Antagonists; Antiandrogens; Brachytherapy; Cancer surgery; Cancer therapies; Combined Modality Therapy; Decision making; Genitourinary Cancers (Dp Petrylak and Jw Kim; Humans; Male; Medicine; Medicine & Public Health; Oncology; Prostate cancer; Prostatectomy; Prostatic Neoplasms - therapy; Radiation; Radiation therapy; Section Editors; Topical Collection on Genitourinary Cancers; Urological surgery; ADT; Radical prostatectomy; Hormone therapy; Surgery; Genomics; Radiation; SBRT; Localized prostate cancer; Radiotherapy
• ISSN: 1523-3790; 1534-6269; 1534-6269
• DOI: 10.1007/s11912-023-01374-9

Purpose of Review
Multimodality therapy including radical prostatectomy, radiation therapy, and hormone therapy are frequently deployed in the management of localized prostate cancer. We sought to perform a critical appraisal of the most contemporary literature focusing on the multimodality management of localized prostate cancer.
Recent Findings
Men who are ideal candidates for multimodality therapy include those with unfavorable intermediate-risk disease, high-risk disease, and very high-risk disease. Enhancements in both systemic agents (including second-generation antiandrogens) as well as localized therapies (such as stereotactic body radiotherapy and brachytherapy) are refining the optimal balance between the use of systemic and local therapies for localized prostate cancer. Genomic predictors are emerging as critical tools for more precisely allocating treatment intensification with multimodality therapies as well as treatment de-intensification.
Summary
Close collaboration among medical oncologists, surgeons, and radiation oncologists will be critical for coordinating evidence-based multimodality therapies when clearly indicated and for supporting shared decision-making in areas where the evidence is mixed.