Analysis of innovative clinical developments in the field of therapy for metastatic prostate cancer: bright results of the ASCO Congress-2022

Introduction. Prostate cancer (PC), according to the results for 2019, is the second most frequently diagnosed malignant tumor in men living in the Russian Federation. There is a significant proportion of patients with advanced (III-IV stages) of prostate cancer - up to 50 %, while metastatic cancer accounts for up to 18.1 % of patients. Popularization in the Moscow City Healthcare clinical practice of innovative technologies for managing patients with metastatic castration-resistant prostate cancer (mCRPC) directly meets the goals and objectives of the Federal project aimed at increasing the life expectancy of cancer patients. Materials and methods. The article reviews the results of clinical developments in the field of mCRPC treatment presented at The ASCO Annual Meeting, June 3-7, 2022: VISION sub-studies, TheraP study, study of the prognostic role of circulating tumor DNA (ctDNA) in the early choice of a strategy for the use of abiraterone or enzalutamide in patients with initial mCRPC - treatment naïve - status. Results and discussion. The volume of clinical information on the results of theranostic antitumor radiation technologies implemented with the participation of prostate-specific membrane antigen (hereinafter referred to as PSMA) is growing rapidly. PSMA - mediated radio-imaging is considered as a potentially effective tool for selecting patients who are sensitive to specific therapy. When studying radionuclide therapy mediated by a ligand to PSMA (PSMA-L), the main efforts are focused on determining the optimal regimens for its clinical application. The possibility of expanding the current indications for prescribing 177Lu-PSMA-617 to patients with prostate cancer at an earlier stage is also being studied. Until final results are obtained from clinical trials that provide clear answers to open questions regarding various aspects of the application of innovative PSMA - mediated theranostic technologies, it remains very important to reach an expert consensus, within the framework of an exchange of opinions, re arding their appropriate use in various clinical situations.