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An Orthotopic Murine Model of Human Prostate Cancer Metastasis
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Management algorithms for metastatic prostate cancer.

Shawn Malone1, Bobby Shayegan2, Naveen S Basappa3

  • 1The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.

Canadian Urological Association Journal = Journal De L'Association Des Urologues Du Canada
|May 1, 2019
PubMed
Summary

Canadian experts developed new treatment guidelines for metastatic prostate cancer (mPCa). These algorithms offer updated recommendations for managing both castration-sensitive (mCSPC) and castration-resistant (mCRPC) stages of the disease.

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Area of Science:

  • Urology
  • Medical Oncology
  • Clinical Practice Guidelines

Background:

  • Prostate cancer (PCa) presents a significant lifetime risk for Canadian men.
  • Current clinical guidance for metastatic prostate cancer (mPCa) management is lacking up-to-date information.
  • The Canadian Genitourinary Research Consortium (GURC) identified the need for updated mPCa management guidance.

Purpose of the Study:

  • To develop updated clinical guidance for the management of metastatic prostate cancer (mPCa).
  • To create evidence-based treatment algorithms for mPCa based on recent guidelines and trials.
  • To provide recommendations for multidisciplinary teams managing mPCa.

Main Methods:

  • A comprehensive review of the latest guidelines, consensus statements, and phase 3 trials was conducted.
  • A multidisciplinary genitourinary oncology panel developed treatment algorithms for mPCa.
  • Algorithms were created for newly diagnosed metastatic castration-sensitive prostate cancer (mCSPC) and metastatic castration-resistant prostate cancer (mCRPC).

Main Results:

  • Two distinct treatment algorithms for mPCa management were developed.
  • For mCSPC with high-volume/high-risk disease, docetaxel or abiraterone acetate and prednisone (AAP) with androgen-deprivation therapy (ADT) is recommended.
  • For first-line mCRPC, androgen receptor-axis-targeted (ARAT) therapy is recommended, with various sequencing options for later lines.

Conclusions:

  • Two practical treatment algorithms for mPCa management have been established.
  • These algorithms can assist multidisciplinary specialist teams in guiding patient treatment.
  • The developed algorithms represent an updated approach to mPCa care in Canada.