Going towards a precise definition of the therapeutic management of de-novo metastatic castration sensitive prostate cancer patients: How prognostic classification impact treatment decisions

Roberto Iacovelli, Chiara Ciccarese, Giovanni Schinzari, Brigida Anna Maiorano, Ernesto Rossi, Francesco Pierconti, Pier Francesco Bassi, Emilio Bria, Giampaolo Tortora

Research output: Contribution to journalReview article


De-novo metastatic castration sensitive prostate cancer (mCSPC) is a subgroup of prostate cancer associated with poor prognosis. Recently, the treatment of mCSPC has been enriched by new life-prolonging options, including the combination of docetaxel or abiraterone acetate with androgen deprivation therapy (ADT). Of note, the advantage of chemohormonal therapy was more relevant in the subgroup of high-volume disease compared to low-volume, while the survival prolongation of abiraterone was observed only in high-risk patients. Choosing the most appropriate therapy is one of the most debated issues. This review describes the latest news on de-novo mCSPC to better outline patients' management. At the ESMO 2018 Congress two novel studies focused on this setting have been presented, trying to define the role of radiotherapy to the primary tumour and the efficacy of abiraterone acetate in the subset of low-risk patients. We have analysed these results in light of the evidence already available.

Original languageEnglish
Pages (from-to)83-86
Number of pages4
JournalCritical Reviews in Oncology/Hematology
Publication statusPublished - Jul 2019



  • Combined Modality Therapy
  • Disease Management
  • Humans
  • Male
  • Patient Selection
  • Prognosis
  • Prostatic Neoplasms, Castration-Resistant/classification

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