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Reply to: PCWG4: A Missed Opportunity to Make Bone-Protective Agents Mandatory for Patients With Bone Metastatic Castration-Resistant Prostate Cancer.

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Updated: Nov 18, 2025

A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound
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NCCN Guidelines Insights: Prostate Cancer, Version 1.2021.

Edward Schaeffer1, Sandy Srinivas2, Emmanuel S Antonarakis3

  • 11Robert H. Lurie Comprehensive Cancer Center of Northwestern University.

Journal of the National Comprehensive Cancer Network : JNCCN
|February 5, 2021
PubMed
Summary

The National Comprehensive Cancer Network (NCCN) updated its 2021 prostate cancer guidelines, focusing on systemic therapy for metastatic castration-resistant prostate cancer. These updates guide treatment decisions for advanced prostate cancer patients.

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Area of Science:

  • Oncology
  • Urology
  • Clinical Practice Guidelines

Background:

  • The NCCN Guidelines for Prostate Cancer provide comprehensive management strategies.
  • Guidelines cover staging, risk assessment, and treatment for localized, regional, and metastatic prostate cancer.
  • Annual updates ensure recommendations reflect the latest clinical data.

Purpose of the Study:

  • To summarize the NCCN Prostate Cancer Panel's discussions for the 2021 guideline update.
  • To focus specifically on systemic therapy recommendations for metastatic castration-resistant prostate cancer (mCRPC).

Main Methods:

  • Review of annual NCCN Prostate Cancer Panel discussions.
  • Incorporation of new clinical data and expert input.
  • Focus on systemic treatment strategies for mCRPC.

Main Results:

  • The article details the panel's deliberations on systemic therapy for mCRPC.
  • Key updates and considerations for treating recurrent prostate cancer are highlighted.
  • Recommendations are based on current evidence and expert consensus.

Conclusions:

  • The 2021 NCCN Guidelines offer updated recommendations for managing metastatic castration-resistant prostate cancer.
  • These guidelines are crucial for oncologists and urologists in optimizing patient care.
  • Continuous reevaluation ensures evidence-based treatment for advanced prostate cancer.