Expert Perspectives on Controversies in Metastatic Castration-Resistant Prostate Cancer Management: Narrative Review...

Area of Science:

• Oncology
• Urology

Background:

• Management of metastatic castration-resistant prostate cancer (mCRPC) is evolving rapidly with new imaging and therapies.
• Clinicians face complex cases with limited established guidance.

Purpose of the Study:

• To summarize expert consensus and controversies in mCRPC management from the US Prostate Cancer Conference (USPCC).
• To identify key areas for future clinical trials in mCRPC.

Main Methods:

• A narrative review of expert discussions and perspectives from the first annual USPCC meeting.
• Included expert presentations, panel discussions, and Q&A sessions.

Main Results:

• Consensus reached on poly (ADP-ribose) polymerase (PARP) inhibitors for BRCA1/2-mutated mCRPC and radioligand therapy for PSMA-positive mCRPC.
• Areas of controversy include PARP inhibitor use in non-BRCA mutations, PSMA positivity definition, and NEPC/AVPC treatment post-platinum therapy.

Conclusions:

• The USPCC highlighted significant controversies in mCRPC management, emphasizing the need for targeted clinical trials.
• Future research should focus on treatment selection and sequencing for this heterogeneous disease.