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What advances to expect in prostate cancer treatment in coming years?
My PSA is still undetectable as I approach the one-year mark. Given my high-risk pathology and biology, however, I realize that biochemical recurrence (BCR) is still possible sometime in the future, despite my efforts to reduce that risk through exercise, better sleep, and an “anti-cancer” diet.
Hopefully, these efforts will help prevent BCR—or, if it does occur, perhaps delay it long enough for imaging and treatments to improve substantially.
With that in mind, we are just learning that Moderna and Merck announced that a personalized mRNA cancer vaccine reduced the risk of melanoma recurrence and spread in a late-stage trial. It makes me wonder: Could similar personalized treatments become available for prostate cancer recurrence relatively soon?
What other advances might we realistically expect in the coming years, particularly in:
* Hormone therapy, including treatments that are more effective and/or have fewer side effects
* Radiation therapy: treatments with real-time targeting, and smaller margins
* Imaging, especially since current scans often cannot detect small amounts of recurrent prostate cancer unless PSA has risen to a higher level
* Personalized or immune-based treatments such as cancer vaccines
I’d really appreciate it if anyone who has researched these developments could share what you have found. I think it would be helpful for all of us to stay informed—not only so we understand what may be coming, but also so we know what questions to ask our doctors and, hopefully, have some things to look forward to.
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Well, this seems to be less than brand new technology. It also isn’t being used in many places yet, it seems to be a step up in capability.
Mayo Clinic installs 1st Quadra PET/CT scanner in North America
https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-installs-1st-quadra-pet-ct-scanner-in-north-america/
Then there are Immunotherapy Solutions for prostate cancer VIR-5500 and others
https://www.theguardian.com/society/2026/feb/28/researchers-praise-stunning-results-of-new-prostate-cancer-treatment
https://www.sciencealert.com/new-experimental-drug-shrinks-tumors-in-prostate-cancer-clinical-trial
https://online.flippingbook.com/link/677451/10/
There is one group trying to find a way to detect dormant prostate cancer cells, That would be a big step in preventing BCR.
There are a lot of other clinical trials I have read about
The study focused on men with metastatic castration-resistant prostate cancer – an aggressive form of the disease that has spread and no longer responds to hormone-blocking treatments.
https://www.news-medical.net/news/20260515/Multi-institutional-trial-explores-new-lifeline-for-advanced-prostate-patients.aspx
Developing effective therapies for prostate cancer bone metastasis—a final stage of prostate cancer progression without any effective treatments—is a medical priority,”
https://www.masseycancercenter.org/news/2026/innovative-targeted-therapy-halts-prostate-cancer-spread-to-the-bone/
promising antitumor activity with combination of pasritamig and docetaxel in advanced prostate cancer
https://www.jnj.com/media-center/press-releases/early-study-results-from-johnson-johnson-show-promising-antitumor-activity-with-combination-of-pasritamig-and-docetaxel-in-advanced-prostate-cancer
Experimental treatment kills prostate tumor cells while reawakening antitumor immunity
https://news.cornell.edu/stories/2026/06/experimental-treatment-kills-prostate-tumor-cells-while-reawakening-antitumor
Early study results from Johnson & Johnson show promising antitumor activity with combination of pasritamig and docetaxel in advanced prostate cancer
https://www.jnj.com/media-center/press-releases/early-study-results-from-johnson-johnson-show-promising-antitumor-activity-with-combination-of-pasritamig-and-docetaxel-in-advanced-prostate-cancer
Roswell Park Study: Inhibiting Regulator Protein Can Make Aggressive Prostate Cancers More Vulnerable.
BCL2 inhibitors in combination with a lutamide
https://physicianresources.roswellpark.org/news/roswell-park-study-inhibiting-regulator-protein-can-make-aggressive-prostate-cancers-more-vulnerable
Tiny silica particles wiped out aggressive prostate cancer in mice
https://www.sciencedaily.com/releases/2026/07/260708022158.htm
Researchers Uncover a Promising New Way To Stop Prostate Cancer From Spreading
https://scitechdaily.com/researchers-uncover-a-promising-new-way-to-stop-prostate-cancer-from-spreading/
I attended a presentation yesterday of an extremely interesting treatment for prostate cancer that is in phase 2 trials. It involves using a probe they put directly into a metastasis and it freezes the center, and then they put in a drug that spreads throughout the body and kills all metastasis. It’s been very successful in trials, they are using three different doses right now and trying to figure out which two should be part of the third phase of the trial.
you can find out more information about this trial and maybe even sign up for it at this website
https://legion100trial.com
The result: vitamin E supplementation increased prostate cancer risk by 17%.
New antibody drug stops aggressive prostate cancer from
spreading
https://www.sciencedaily.com/releases/2026/07/260718010151.htm
Optimizing Care for Patients With Metastatic Castration-Resistant Prostate Cancer
https://ascopubs.org/doi/10.1200/EDBK-26-516658
Scientists have developed a fully human antibody that halted the growth and spread of aggressive prostate cancer in preclinical research. Although more testing is needed, the drug’s unusual mechanism could open the door to a safer new treatment for advanced cancer.”
https://share.google/YPmWiFGdpeszVq511
CRISPR technology could augment treatment of immune cold cancers that don’t respond to immunotherapy. Can change prostate cancer cold metastasis so they can be treated.
https://www.urmc.rochester.edu/news/story/improving-immune-therapy-in-prostate-cancer
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23 Reactions@jeffmarc
Jeff: thanks a million for sharing this extensive list of emerging prostate cancer detection and treatment approaches at various stages of development, clinical trials, and implementation.
Given my situation and my substantial pathological and biological risk of BCR, I am particularly interested in developments that could provide earlier molecular detection of recurrence, much more sensitive imaging at lower PSA levels, increasingly precise local treatments that minimize collateral damage to healthy tissues, and more selective systemic therapies.
I’ll review the materials in detail and will ask questions or add comments as I learn more. This is exactly the kind of information I was hoping we could share in this group so that we can all stay informed about what may be coming.
@soli
I try to keep up with the latest trials related to castrate resistance people, Since it keeps coming back, I know, I will need something when what I’m on now stops working. I want something better than a PARP inhibitor.
I keep adding new things to my list. I’m glad it helps people that are looking for the latest new developments.
If anybody find something new and interesting that I didn’t list, please put in a link to it.
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3 Reactions@jeffmarc
You are doing the right thing and helping so many people who are in the same boat. The more informed we are about the latest developments and trends, the better prepared we are to ask the right questions of our doctors—and the better positioned we are to make informed decisions and receive the best possible diagnosis and treatment.
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2 ReactionsI'd keep an eye on mRNA research. It was originally aimed at cancer treatment before the fast pivot to COVID vaccines in 2021, but the work continues.
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4 ReactionsMe too, for sure.
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1 ReactionGiven I am on BCR watch, I am paying the closest attention to the development and adoption of Quadra PET/CT systems for early detection and localization of BCR.
From what I have learned so far, it is an extended-field-of-view digital PET/CT system that can collect substantially more signal than conventional PET scanners. The practical question is therefore whether that extra sensitivity translates into finding prostate cancer at very low PSA levels.
From what I have I learned so far, the answer is: yes, there is encouraging evidence that it does. A study of the first 300 patients undergoing PSMA PET/CT on a Quadra scanner found a 67% positivity rate even when PSA was <0.2 ng/mL. Among the patients with positive scans in that PSA range, 63% had disease confined to the prostate bed and another 31% had pelvic nodal disease without local recurrence. Only 6% had distant metastases.
That’s pretty remarkable compared with conventional PSMA PET performance.
But there is an important caveat: 67% positive does not mean that Quadra can reliably rule out microscopic disease when the scan is negative. A negative scan at PSA 0.15, for example, would not necessarily mean there is no cancer. It could mean the disease wasn’t detectable with that particular scan.
For me, that distinction is crucial. If my PSA eventually begins rising, the ideal future scenario would be:
slightly elevated PSA → highly sensitive PSMA PET → identify exactly where the recurrence is → target that area rather than treating in the blind a much larger volume.
That could potentially reduce collateral damage to the bladder, rectum and surrounding pelvic tissues.
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4 Reactions@northoftheborder
Yes- that is the area where the true "cure" will eventually happen or at least very, very long remissions. Just yesterday this was in the news :
https://www.cnbc.com/2026/08/19/moderna-merck-cancer-vaccine-shows-initial-late-stage-melanoma-data.html
I really hope that such treatments will be available for PC in very near future. 🍀
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4 Reactions@soli There is promising research into how to more accurately predict which patients will find that their cancers metastasize. The researchers feel their new classification system will eventually replace the Gleason grading system in importance. So far they have validated their system using the extensive pathology available from prostate glands that have been removed, by analyzing the long term outcomes that result after surgery. They are hoping to be able to do as well with biopsy pathology. .
UCSF has a recording of the webinar they hosted:
https://www.urotoday.com/video-lectures/a-journal-club-for-patients-with-prostate-cancer/video/mediaitem/4452-unfavorable-histology-classification-aims-to-reduce-unnecessary-treatment-journal-club-jesse-mckenney-jane-nguyen-cornelia-ding.html
A Q&A afterward was recorded as well: https://www.urotoday.com/video-lectures/a-journal-club-for-patients-with-prostate-cancer/video/mediaitem/4453-unfavorable-histology-classification-aims-to-reduce-unnecessary-treatment-discussion.html
Their published research: https://pubmed.ncbi.nlm.nih.gov/38828674/
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3 ReactionsI think the important thing about this thread is that there's a *lot* going on.
In ye olden days (like, 2006 or even in some ways, 2016) once you had a stage-4 prostate cancer diagnosis, the goal was just to keep you comfortable with palliative treatments until your inevitable death in a few years or months. Aggressive treatments were considered almost unethical, because they'd just degrade your quality of life in your short remaining time.
These days, we have far more effective drugs, like the lutamides; we have better guidance for when aggressive treatments like radiation, chemo, or radioligands make a difference; and even an extra year or two is worth fighting hard for, because by then there could be a treatment that will carry you through another year or two (or 20).
For prostate cancer, the traditional stage-4 cancer-treatment medical wisdom has done a somersault and ended up in a handstand. 🙂