Management and Monitoring of Adverse Events in mCRPC
An expert highlights that safety considerations in metastatic castration-resistant prostate cancer (mCRPC) treatment depend on prior therapies and disease status, emphasizing early combination therapy for better control, vigilant bone health management with bone-modifying agents, proactive adverse effect mitigation, and the importance of exercise, nutrition, and cardiovascular monitoring to optimize patient outcomes and quality of life.
When selecting therapies for metastatic castration-resistant prostate cancer (MCRPC)mCRPC, safety considerations are crucial and depend largely on the patient’s treatment history and disease status. Newly diagnosed patients may benefit most from combination therapies, as early treatment offers the best chance for disease control before progression leads to poorer outcomes. For example, patients with homologous recombination repair(HRR) mutations often receive combinations like such as androgen receptor pathway inhibitors (ARPIs) plus PARP inhibitors. For those progressing on ARPIs, treatment choices vary based on factors such as prostate-specific membrane antigen PSMA PET positivity, symptom severity, and bone involvement, including options like such as chemotherapy, radium, or novel radioligand therapies.
Bone health is a top priority due to the high risk of fractures and skeletal complications, which significantly affect quality of life and survival. All patients with metastatic mCRPC should receive bone-modifying agents such as bisphosphonates or denosumab, along with vitamin D and calcium supplementation, unless contraindicated. Side Adverse effects from cancer therapies are common and include anemia, nausea, fatigue, weight loss, and muscle wasting. For instance, anemia frequently occurs with PARP inhibitors, requiring early dose adjustments or treatment breaks to maintain tolerability. Preventive anti-nausea medications are also important, particularly with agents like such as olaparib.
Maintaining overall health through exercise, nutrition, and cardiovascular monitoring is vital, especially as patients live longer. Resistance training and physical activity can help preserve muscle mass and reduce fatigue, while tailored dietary guidance helps manage metabolic changes. Cardiovascular health requires close attention, with routine cardiac evaluations such as echocardiograms and EKGs ECGs for those with symptoms or risk factors. Early recognition and proactive management of side adverse effects enable patients to continue treatment safely and improve their quality of life during therapy for MmCRPC.
