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GU Cancers 2019 | Metastatic prostate cancer treatment: a paradigm shift

Bridget Koontz, MD, of the Duke University Medical Center, Durham, NC, explains how the treatment of metastatic prostate cancer has evolved at the 2019 Genitourinary Cancers Symposium, held in San Francisco, CA.

Transcript (edited for clarity)

I think not many years ago, we really thought about metastatic prostate cancer as being completely in the realm of systemic therapies. If it was out of the box, it was out of the box and if there was one cell that we knew about that was metastatic, they were sure to be many others. So all of our treatments were really focused on medications that could go body wide.

I think what’s changed in the role of prostate cancers are realizing that there are different biologies and that for some cancers you can actually have sort of a more of a stepwise spread and that offers us an opportunity where we can stop the spread even when it has metastasized to a few spots.

This is actually a really big paradigm shift and it’s happening in different parts of the world. So I think Australia and in mainland Europe, that was sort of a big switch. I think in the US it’s really starting to pick up and there’s a lot more interest.

I actually talked to some colleagues from the UK and they said it doesn’t happen very much at all yet, but I think it’s, we’re going to see a change as we learn more about the science of prostate cancer, and so I think there’s going to be more and more research.

At Duke, we’re actually, I think really trying to push the envelope there and are really looking at advancing with some novel clinical trials and combination agents with radiation to see what we can do to change the natural history for metastatic prostate cancer.