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The Spanish Genitourinary Oncology Group (SOGUG) has highlighted the importance of early molecular diagnosis in patients with prostate cancer, which allows personalizing treatment and optimizing its sequencing.
“PARP inhibitors are targeted treatments against specific mutations, mainly BRCA1 and BRCA2, which confer a worse prognosis, but also a better response when targeted therapies are used,” said the president of SOGUG, Aránzazu González del Albawho added that these drugs have been shown to improve survival in castration-resistant prostate cancer and, in combination with androgen deprivation, prolong the time to progression.
In this context, experts highlight the role of genetic testing early. “The sooner we can perform a genetic test and have molecular determinations that are targets for treatment, the better we will be able to sequence the different therapeutic options available,” indicated the general secretary of SOGUG, Francisco Zambrana.
This has been one of the points that have been addressed during the I Multidisciplinary Conference on Prostate Cancer of SOGUGwho has analyzed the role of molecular diagnosisprecision oncology and theragnosis in current clinical practice.
The management of prostate cancer, one of the most common tumors in men, has undergone profound evolution in the last decade, driven by the incorporation of new diagnostic tools and the expansion of the therapeutic arsenal, which has allowed an increase in cure rates in localized stages and significantly improve survival in advanced disease.
Among the main drivers of this change are the improvements in imaging techniques, such as multiparametric MRI and the PET with different radiotracers, as well as the arrival of new targeted treatments and radiopharmaceuticals. “These new diagnostic tools allow us to detect the disease that previously went unnoticed and better adjust therapeutic decisions,” said González.
So, theragnosis It has established itself as one of the most relevant advances in advanced prostate cancer. The recently funded Lutetium-PSMA represents a paradigm shift: “We use PET with a diagnostic radiotracer to identify cells that express PSMA, present in more than 80% of cases of metastatic disease, and subsequently a radiopharmaceutical directed against those same cells,” González pointed out.
This treatment has shown improve survival and pain control in patients who have progressed after multiple therapeutic lines.
Quality of life, a new challenge
The improvement in survival has placed quality of life as one of the emerging clinical challenges. “Osteoporosis, metabolic disorders and increased cardiovascular risk are relevant adverse effects that require de-escalation strategies to be considered in certain patients,” explained González, who stressed that these strategies should be explored. “without compromising overall survival, with the aim of reducing toxicity and improving well-being”.
The day has also incorporated the patient’s perspective, with the participation of the Spanish Association Against Cancer (AECC), ANCAP and GEPAC. “None of what we do makes sense if we do not incorporate the patient’s perspective in every advance and in every therapeutic decision,” concluded Aránzazu.
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