Treatment of Veterans With Metastatic Hormone-Sensitive Prostate Cancer

July 24, 2023 - Oncologists discuss the treatment of veterans with metastatic hormone-sensitive prostate cancer. The panelists report that advances in systemic and local therapy are helping clinicians improve survival rates. They examine the evolution of treatment options, including chemotherapy, next-generation androgen receptor (AR) blockers, and radiation therapy. The clinicians also discuss triple therapy, and why the use of docetaxel plus an AR blocker may not be optimal treatment for every patient.

Prostate cancer is the most common malignancy among US veterans. Historically, men with metastatic disease had very poor outcomes, but significant progress has been made with chemotherapy, next-generation androgen receptor blockers, and, in the right patient, radiation therapy. All of these treatment modalities have improved survival and quality of life.

In this Roundtable discussion, Dr Bruce Montgomery, from the Fred Hutchinson Cancer Center and the VA Puget Sound in Seattle, is joined by oncologist Alexandra Sokolova, from Oregon Health and Science University, and Nicholas Nickols, the chief of radiation oncology at the VA Greater Los Angeles.

The panelists outline how these major treatment advances in metastatic hormone-sensitive prostate cancer have shaped clinical practice, beginning with the CHAARTED clinical trial results that led to the addition of docetaxel to androgen deprivation therapy as a new standard of care for select patients.

They also examine the efficacy of combination therapy using AR receptors plus chemotherapies.

Finally, the panelists discuss the role of radiation, including the combination of tumor-directed therapy and systemic therapy.

This program was created in collaboration with the Association of VA Hematology/Oncology (AVAHO) and does not represent the opinions of the US Department of Veterans Affairs.

About the Panel

Bruce Montgomery, MD Photo

Bruce Montgomery, MD

  • Professor, Attending Physician
  • Department of Medicine, Division of Oncology
  • University of Washington, Fred Hutchinson Cancer Center
  • VA Puget Sound Health Care System
  • Seattle, Washington
Alexandra O. Sokolova, MD Photo

Alexandra O. Sokolova, MD

  • Assistant Professor
  • Department of Hematology Oncology
  • Oregon Health and Science University
  • Portland, Oregon
Nicholas G. Nickols, MD, PhD  Photo

Nicholas G. Nickols, MD, PhD

  • Associate Professor
  • Department of Radiation Oncology
  • UCLA David Geffen School of Medicine
  • Chief
  • Radiation Oncology Service
  • VA Greater Los Angeles
  • Los Angeles, California

Bruce Montgomery, MD, has disclosed no relevant financial relationships.

Alexandra O. Sokolova, MD, has disclosed the following relevant financial relationships:
Travel reimbursement from: AstraZeneca

Nicholas G. Nickols, MD, PhD, has disclosed the following relevant financial relationships:
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: PrimeFour (consultant)
Received research grant from: Lantheus; Janssen; Bayer