Castration-resistant prostate cancer: AUA guideline

Michael S. Cookson, Bruce J. Roth, Philipp Dahm, Christine Engstrom, Stephen J. Freedland, Maha Hussain, Daniel W. Lin, William T. Lowrance, Mohammad Hassan Murad, William K. Oh, David F. Penson, Adam S. Kibel

Research output: Contribution to journalArticle

171 Scopus citations

Abstract

Purpose: This Guideline is intended to provide a rational basis for the management of patients with castration-resistant prostate cancer based on currently available published data. Materials and Methods: A systematic review and meta-analysis of the published literature was conducted using controlled vocabulary supplemented with keywords relating to the relevant concepts of prostate cancer and castration resistance. The search strategy was developed and executed by reference librarians and methodologists to create an evidence report limited to English-language, published peer-reviewed literature. This review yielded 303 articles published from 1996 through 2013 that were used to form a majority of the guideline statements. Clinical Principles and Expert Opinions were used for guideline statements lacking sufficient evidence-based data. Results: Guideline statements were created to inform clinicians on the appropriate use of observation, androgen-deprivation and antiandrogen therapy, androgen synthesis inhibitors, immunotherapy, radionuclide therapy, systemic chemotherapy, palliative care and bone health. These were based on six index patients developed to represent the most common scenarios encountered in clinical practice. Conclusions: As a direct result of the significant increase in FDA-approved therapeutic agents for use in patients with metastatic CRPC, clinicians are challenged with a multitude of treatment options and potential sequencing of these agents that, consequently, make clinical decision-making more complex. Given the rapidly evolving nature of this field, this guideline should be used in conjunction with recent systematic literature reviews and an understanding of the individual patient's treatment goals. In all cases, patients' preferences and personal goals should be considered when choosing management strategies.

Original languageEnglish (US)
Pages (from-to)429-438
Number of pages10
JournalJournal of Urology
Volume190
Issue number2
DOIs
StatePublished - Aug 1 2013

Keywords

  • androgen antagonists
  • drug therapy
  • immunotherapy
  • prostatic neoplasms

ASJC Scopus subject areas

  • Urology

Fingerprint Dive into the research topics of 'Castration-resistant prostate cancer: AUA guideline'. Together they form a unique fingerprint.

Cite this