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Master of Public Health

Prostate Cancer, Version 4.2023, NCCN Clinical Practice Guidelines in Oncology

AUTHORS

Schaeffer EM , Srinivas S , Adra N , An Y , Barocas D , Bitting R , Bryce A , Chapin B , Cheng HH , D'Amico AV , Desai N , Dorff T , Eastham JA , Farrington TA , Gao X , Gupta S , Guzzo T , Ippolito JE , Kuettel MR , Lang JM , Lotan T , McKay RR , Morgan T , Netto G , Pow-Sang JM , Reiter R , Roach M , Robin T , Rosenfeld S , Shabsigh A , Spratt D , Teply BA , Tward J , Valicenti R , Wong JK , Shead DA , Snedeker J , Freedman-Cass DA , . Journal of the National Comprehensive Cancer Network : JNCCN. ; 21(10). 1067-1096

ABSTRACT

The NCCN Guidelines for Prostate Cancer provide a framework on which to base decisions regarding the workup of patients with prostate cancer, risk stratification and management of localized disease, post-treatment monitoring, and treatment of recurrence and advanced disease. The Guidelines sections included in this article focus on the management of metastatic castration-sensitive disease, nonmetastatic castration-resistant prostate cancer (CRPC), and metastatic CRPC (mCRPC). Androgen deprivation therapy (ADT) with treatment intensification is strongly recommended for patients with metastatic castration-sensitive prostate cancer. For patients with nonmetastatic CRPC, ADT is continued with or without the addition of certain secondary hormone therapies depending on prostate-specific antigen doubling time. In the mCRPC setting, ADT is continued with the sequential addition of certain secondary hormone therapies, chemotherapies, immunotherapies, radiopharmaceuticals, and/or targeted therapies. The NCCN Prostate Cancer Panel emphasizes a shared decision-making approach in all disease settings based on patient preferences, prior treatment exposures, the presence or absence of visceral disease, symptoms, and potential side effects.

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