Harnessing the potential of multimodal radiotherapy in prostate cancer

Abstract

in combinaNon with androgen deprivaNon therapy (ADT) is a standard treatment opNon for men with localized and locally advanced prostate cancer. However, emerging clinical evidence suggests that radiotherapy could be incorporated into mulNmodality therapy regimens beyond ADT, in combinaNons that include chemotherapy, radiosensiNzing agents, immunotherapy, and surgery for localized and locally advanced prostate cancer, as well as in paNents with oligometastaNc disease where the low metastaNc burden in parNcular may be treatable with these combinaNons. This mulNmodal approach is increasingly recognized to offer considerable clinical benefit, such as increased anN-tumour effects and survival benefits. Thus, radiotherapy is becoming a key component of mulNmodal therapy for many stages of prostate cancer, parNcularly for paNents with oligometastaNc disease. Key points-Radiotherapy combined with androgen deprivaNon therapy (ADT) is a common treatment opNon for men with prostate cancer.

Prostate Cancer Peripheral Blood NK Cells Show Enhanced CD9, CD49a, CXCR4, CXCL8, MMP-9 Production and Secrete Monocyte-Recruiting and Polarizing Factors

“…Prostate carcinoma (PCa) is the one of most commonly diagnosed cancer in males worldwide ( 1 ). Surgery and radiation therapy ( 2 ) are still important treatment options, as well as chemotherapy ( 3 ) and hormonal therapy ( 4 ). Recently, immunotherapy came of age as a possible effective strategy for PCa therapy ( 5 ).…”

Tumour irradiation combined with vascular-targeted photodynamic therapy enhances antitumour effects in pre-clinical prostate cancer

“…There is increasing interest in the role of multimodality therapy for PCa. 35 To date, PCa is one of few solid organ malignancies where immunotherapy is not part of the standard of care, potentially due to the immunosuppressive tumour microenvironment and/or its low mutational burden. 36 , 37 Other treatment combinations beyond the inclusion of immunotherapy may be necessary to improve PCa tumour control and reduce treatment toxicity.…”

“… 48 , 51 It is important for future clinical translation to consider these aspects of FRT delivery. Hypofractionated RT is increasingly used clinically, 35 and it would be feasible to use FRT schedules that are likely to induce ‘vascular normalisation’ changes ahead of VTP in a multimodality approach.…”

Tumor irradiation combined with vascular-targeted photodynamic therapy enhances anti-tumor effects in preclinical prostate cancer

“…However, around a third of patients develop disease recurrence, and treatments lead to significant side effects on urinary, sexual and bowel function, as well as loss of quality of life in long-term survivors. There is an increasing interest in the role of multimodality therapy for PCa (37). To date PCa is one of few malignancies where immunotherapy is not part of standard of care (38), potentially due to the immunosuppressive tumor microenvironment (39) and/or its low mutational burden (40,41).…”

“…It is important for future clinical translation to consider these aspects of FRT delivery. Hypofractionated RT is increasingly used clinically (37), and it would be entirely feasible to use FRT schedules that are likely to induce vascular normalization ahead of VTP in a multimodality approach.…”