Treatment of primary cancer in metastatic hormone-sensitive prostate cancer

Purpose of review Recently, there has been emerging interest in the treatment of primary tumours in metastatic prostate cancer based on major trials that have provided evidence for radiation therapy and cytoreductive radical prostatectomy. Preclinical studies have further established the molecular features of metastatic disease that provide a rationale for primary treatment. Recent findings Several randomised controlled trials and other prospective studies have demonstrated a benefit in overall survival, predominantly in low-volume disease. Advancements in precision medicine also offer insight into improving selection, staging and monitoring. Summary In this review, the authors highlight and review recent data on emerging and established treatment options and shift towards personalised medicine for hormone-sensitive metastatic prostate cancer. Keywords cytoreductive prostatectomy, metastatic hormone-sensitive prostate cancer, personalised medicine, primary treatment, radiation therapy