Initial Management of Noncastrate Advanced, Recurrent, or Metastatic Prostate Cancer: ASCO Guideline Update.
Katherine S VirgoR Bryan RumbleRonald de WitDavid S MendelsonThomas J SmithMary-Ellen TaplinJames L WadeCharles L BennettHoward I ScherPaul L NguyenMartin GleaveScott C MorganAndrew LoblawSean SachdevDavid L GrahamNeha VapiwalaAmy M SionVirgil H SimonsJames A TalcottPublished in: Journal of clinical oncology : official journal of the American Society of Clinical Oncology (2021)
Docetaxel, abiraterone, enzalutamide, or apalutamide, each when administered with androgen deprivation therapy (ADT), represent four separate standards of care for noncastrate metastatic prostate cancer. Currently, the use of any of these agents in any particular combination or series cannot be recommended. ADT plus docetaxel, abiraterone, enzalutamide, or apalutamide should be offered to men with metastatic noncastrate prostate cancer, including those who received prior therapies, but have not yet progressed. The combination of ADT plus abiraterone and prednisolone should be considered for men with noncastrate locally advanced nonmetastatic prostate cancer who have undergone radiotherapy, rather than castration monotherapy. Immediate ADT may be offered to men who initially present with noncastrate locally advanced nonmetastatic disease who have not undergone previous local treatment and are unwilling or unable to undergo radiotherapy. Intermittent ADT may be offered to men with high-risk biochemically recurrent nonmetastatic prostate cancer. Active surveillance may be offered to men with low-risk biochemically recurrent nonmetastatic prostate cancer. The panel does not support use of either micronized abiraterone acetate or the 250 mg dose of abiraterone with a low-fat breakfast in the noncastrate setting at this time.Additional information is available at www.asco.org/genitourinary-cancer-guidelines.
Keyphrases
- prostate cancer
- locally advanced
- radical prostatectomy
- squamous cell carcinoma
- rectal cancer
- neoadjuvant chemotherapy
- radiation therapy
- small cell lung cancer
- middle aged
- early stage
- healthcare
- clinical trial
- palliative care
- combination therapy
- lymph node
- stem cells
- open label
- mesenchymal stem cells
- quality improvement
- clinical practice
- health insurance