Episode 2 - Variability in Disease Course and Treatment Approach

Because each patient with castration-resistant prostate cancer (CRPC) experiences a different disease course, clinicians need to evaluate several factors when making treatment decisions, explains Christopher Sweeney, MBBS.

As an example, Dr Sweeney describes 2 patient cases and discusses the criteria he uses to determine whether to recommend hormonal therapy (eg, with agents such as abiraterone or enzalutamide) or nonhormonal therapy (ie, chemotherapy).

Based on the variability of disease course in patients with CRPC, research on tumor heterogeneity is being conducted. An area that is currently being investigated is a variation in the androgen receptor that allows tumor cells to grow despite testosterone blockade and androgen receptor blockade. Dr Sweeney remarks that this variation of the androgen receptor holds promise as a biomarker to help determine whether or not a patient would respond to hormonal therapy.

Watch our related Peer Exchange, Oncology Stakeholder Summit 2014: Evidence-Based Decisions to Improve Quality and Regulate Costs