Onkologie. 2026:20(3):130-135 | DOI: 10.36290/xon.2026.024

Individualization of systemic treatment for advanced prostate cancer

Jana Katolická
Onkologicko-chirurgické oddělení, FN u svaté Anny, Brno

Advanced prostate cancer represents a heterogeneous disease with diverse biological characteristics, clinical course, and treatment responses. In recent years, there has been a significant expansion of therapeutic options, which places increased demands on the individualization of treatment strategies. The aim of this article is to summarize the current options for systemic therapy of advanced prostate cancer and to emphasize the importance of a personalized approach based on clinical, laboratory, imaging, and molecular-genetic characteristics of both the patient and the tumor.

Keywords: prostate cancer, treatment individualization, hormonal therapy, targeted therapy, radioligand therapy.

Accepted: June 15, 2026; Published: July 1, 2026  Show citation

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Katolická J. Individualization of systemic treatment for advanced prostate cancer. Onkologie. 2026;20(3):130-135. doi: 10.36290/xon.2026.024.
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References

  1. Matsukawa A, Litterio G, Cormio A, et al. An Updated Systematic Review and Network Meta-Analysis of First-Line Triplet vs. Doublet Therapies for Metastatic Hormone-Sensitive Prostate Cancer. Cancers. 2025;17:205. https://doi.org/10.3390/cancers17020205. Go to original source... Go to PubMed...
  2. Hellman S, Weichselbaum RR. Oligometastases. J Clin Oncol. 1995;13:8-10. Go to original source...
  3. Xiaolei Shi, Jarey H. Wang, Brian F. Chapin et al. Integrating systemic therapy and metastasis-directed therapy in oligometastatic hormone-sensitive prostate cancer. Prostate Cancer and Prostatic Diseases. https://doi.org/10.1038/s41391-025-01041-z. Go to original source... Go to PubMed...
  4. Sutera P, Phillips RM, Deek M, et al. The promise of metastasis-directed therapy for oligometastatic prostate cancer: going beneath the surface with molecular Imaging. J Nucl Med. 2022;63:339-41. Go to original source...
  5. Gillespie EF, Yang JC, Mathis NJ, et al. Prophylactic radiation therapy versus standard of care for patients with high-risk asymptomatic bone metastases: a multicenter, randomized phase II clinical trial. J Clin Oncol. 2024;42:38-46. Go to original source...
  6. Chowdhury S, Bjartell A, Lumen N, et al. Real-world outcomes in first-line treatment of metastatic castration-resistant prostate cancer: The prostate cancer registry. Target Oncol. 2020;15(3):301-315. Go to original source...
  7. Davis MI, Bennett MJ, Thomas LM, et al. Crystal structure of prostate-specific membrane antigen, a tumor marker and peptidase. Proc Natl Acad Sci U S A. 2005;102(17):5981-5986. Go to original source...
  8. Sartor O, de Bono J, Chi KN, et al. Lutetium-177-PSMA-617 for Metastatic Castration-Resistant Prostate Cancer. N Engl J Med. 2021;385(12):1091-103. Go to original source...
  9. Available from: https://www.sukl.gov.cz/.
  10. Morris MJ, Castellano D, Herrmann K, et al. Lu-PSMA-617 versus a change of androgen receptor pathway inhibitor therapy for taxane-naive patients with progressive metastatic castration-resistant prostate cancer (PSMAfore): a phase 3, randomised, controlled trial. The Lancet. 2024;404(10459):1227-1239. Go to original source...
  11. Parker C, Nilsson S, Heinrich D, et al.Alpha-emitter radium-223 and survival in metastatic prostate cancer. N Engl J Med. 2013;369(3):213-223. doi: 10.1056/NEJMoa1213755. Go to original source... Go to PubMed...
  12. Smith M, Parker C, Saad F, et al. Addition of radium-223 to abiraterone acetate and prednisone or prednisolone in patients with castration-resistant prostate cancer and bone metastases (ERA-223): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Oncol. 2019;20(3):408-419. doi: 10.1016/S1470-2045(18)30860-X. PMID: 30738780. Go to original source... Go to PubMed...
  13. Taylor AK, Kosoff D, Emamekhoo H, et al. PARP inhibitors in metastatic prostate cancer. Front Oncol. 2023;13:1159557. Go to original source...
  14. Grewal k,Dorff TB, Mukhida SS, et al. Advances in Targeted Therapy for Metastatic Prostate Cancer. Current Treatment Options in Oncology. 2025;26:465-475. https://doi.org/10.1007/s11864-025-01323-7. Go to original source... Go to PubMed...
  15. Available from: www.linkos.cz.Fizazi K, Clarke NW, De Santis M, et al. Capivasertib plus abiraterone in PTEN-deficient metastatic hormone-sensitive prostate cancer: CAPItello-281 Phase III study. ESMO 2025: A Phase III Study of Capivasertib + Abiraterone versus Placebo + Abiraterone in Patients with PTEN-deficient De Novo Metastatic Hormone-sensitive Prostate Cancer (mHSPC): CAPItello-281. http://www.ncbi.nlm.nih.gov/pubmed/41120017.
  16. Cattrini C, Caffo O, et al.Apalutamide, Darolutamide and Enzalutamide for Nonmetastatic Castration-Resistant Prostate Cancer (nmCRPC): A Critical Review Cancers. 2022;14(7):1792. Go to original source...
  17. Fizazi K, Shore N, Tammela TL, et al. Darolutamide in Nonmetastatic, Castration-Resistant Prostate Cancer. N. Engl. J. Med. 2019;380:1235-1246. Go to original source...
  18. Hussain M, Fizazi K, Saad F, et al. Enzalutamide in Men with Nonmetastatic, Castration-Resistant Prostate Cancer. N. Engl. J. Med. 2018;378:2465-2474. Go to original source...
  19. Smith MR, Saad F, Chowdhury S, et al. Apalutamide Treatment and Metastasis-free Survival in Prostate Cancer. N. Engl. J. Med. 2018;378:1408-1418. Go to original source...
  20. Lockwood GT, Steven EC, Xianglin LD. Review of major adverse effects of androgen-deprivation therapy in men with prostate cancer. Cancer. 2009;115(11):2388-2399.doi: 10.1002/cncr.24283. Go to original source... Go to PubMed...
  21. Cao B, Kim M, Reizine NM, et al. Adverse Events and Androgen Receptor Signaling Inhibitors in the Treatment of Prostate Cancer: A Systematic Review and Multivariate Network Meta-analysis. EurUrolOncol 2023;6(3):237-250. doi: 10.1016/j.euo.2023.01.001. Epub 2023 Jan 20. Go to original source... Go to PubMed...




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