The treatment landscape for advanced prostate cancer is rapidly evolving. In metastatic hormone-sensitive prostate cancer (mHSPC), the CHAARTED trial showed that androgen-deprivation therapy (ADT) plus docetaxel increased overall survival (OS) compared with ADT alone. Most recently, the STAMPEDE arm G and LATITUDE clinical trials demonstrated that ADT plus abiraterone acetate (abiraterone hereafter) significantly improved outcomes in mHSPC compared with ADT alone. Furthermore, clinical trials of ADT plus multiple other androgen-axis inhibitors are ongoing, and the number of therapies available to clinicians is expected to markedly increase in the coming years. However, no biomarkers are routinely used in the clinic to predict response to these agents and personalize treatment selection. The most immediate need is for a biomarker to help select men for treatment with abiraterone vs docetaxel in the setting of newly diagnosed mHSPC.
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