ESMO 2023 | Time for treatment de-escalation for mHSPC?

Bertrand Tombal, MD, PhD, Université catholique de Louvain in Ottignies-Louvain-la-Neuve, Belgium, explores the evolving strategies in metastatic hormone-sensitive prostate cancer (mHSPC), focusing on the potential for treatment de-escalation. He reflects on the historical shift from intermittent androgen deprivation therapy (ADT) to continuous ADT following combination trial results like the Phase III CHAARTED (NCT00309985) trial. Prof. Tombal discusses the extended survival benefits but highlights increased toxicity risks, including cardiovascular issues, falls, fractures, and cognitive decline. He poses the crucial question of whether patients with extensive PSA responses can safely discontinue treatment and advocates for clinical trials like EORTC-2238 GUCG (De-Escalate) to evaluate the risk-benefit profile. This interview was conducted at the PROSCA/BLADDR 2023 conference in Malaga, Spain.

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