Prostate cancer requires a multidisciplinary treatment approach that incorporates surgery, radiotherapy, hormonal therapy, chemotherapy, bone-metastases-targeted therapy, and, in the United States, immunotherapy. Both urologists and oncologists are involved in the management and treatment of prostate cancer patients. Physicians categorize patients as having localized, locally advanced, or metastatic disease, and the choice of therapy closely reflects the risk of biochemical recurrence (for patients with localized and locally advanced disease) and responsiveness to hormonal treatments (i.e., hormone-sensitive or castrate-resistant). The drug treatment of prostate cancer has evolved rapidly over the last few years. In particular, the mCRPC setting has become crowded and competitive following the launch of five efficacious therapies since 2010, and the hormonal agents Zytiga (Johnson & Johnson/ Janssen Biotech/Janssen-Cilag/AstraZeneca’s abiraterone) and Xtandi (Medivation/Astellas Pharma’s enzalutamide), which compete fiercely in this setting. Despite the availability of Zytiga and Xtandi, chemotherapy continues to play an essential role in mCRPC treatment. This analysis provides insight into current use of approved therapies for prostate cancer in the United States and factors driving physicians prescribing decisions.


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