Metastatic castration-resistant prostate cancer (mCRPC) is known as a cancer that more often than not metastasizes to the bone. Less often it moves to nonosseous sites (soft tissue sites like lymph nodes, liver and lung).

The last few years has seen the development of new drugs that extend the survival of men. Because of these new treatments and their relative success in extending life it has been hypothesized that the pattern of metastases is changing.

To evaluate these possible changing trends the pattern of metastatic disease was evaluated in men with mCRPC. The evaluation was prepared by looking at all phase 2 and 3 therapeutic studies in men with mCRPC in PubMed and American Society of Clinical Oncology abstracts from 1990 to 2012 over two decades.

The study included a total of 290 different trials involving a total of 19,110 men.

They found that the rate of nonosseous metastasis (not bone) increased significantly at 1.6% per year (P?<?.0001), whereas the rate of osseous metastasis (bone) decreased at 0.5% per year (P?<?.0001). The rate of lymph node metastasis increased at 1.4% per year (P?<?.0001), but the rate of liver and lung metastasis remained relatively stable.

The researchers concluded that there has been a significant change in the patterns of metastatic development in prostate cancer. These changes will have important implications in treatment and prognosis of more and more men with advanced prostate cancer.

There needs to be more drug development and clinical trials that focus on these soft tissue metastases.
Reference: Cancer. 2014 Mar 15;120(6):833-9. 
doi: 10.1002/cncr.28494; SMT sao CK, Godbold JH, Galsky MD, Oh WK
PMID: 25302607


Joel T. Nowak, M.A., M.S.W.