Evolving Treatment Paradigm and NCCN Guideline Updates

Author(s):

Stephen J. Freedland, MD,Eleni Efstathiou, MD, PhD

Key opinion leaders examine the treatment landscape for castration-sensitive prostate cancer, highlighting prevalent first-line approaches and discussing the role of androgen deprivation therapy in the treatment paradigm.

EP: 1.Testing Principes and Benefits of Early Intervention in Castration-Sensitive Prostate Cancer

EP: 2.Risk Stratification and Prognostic Markers in castration-sensitive prostate cancer

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EP: 3.Evolving Treatment Paradigm and NCCN Guideline Updates

EP: 4.The EMBARK trial investigating enzalutamide in NM CSPC

EP: 5.The Role of PSA Doubling Time in Risk Assessment

EP: 6.Patient Case 1: Non-Metastatic CSPC with Rapidly Doubling PSA

EP: 7.Patient Case 2: Metastatic CSPC

EP: 8.Final Thoughts on CSPC

Dr. Freedland asks Dr. Efstathiou: Please review the current treatment landscape for CSPC. What are the main therapeutic approaches typically utilized for these patients?
1. What role does androgen deprivation therapy alone play, and in what settings?
2. When are chemotherapy and novel hormonal agents like enzalutamide considered?
3. How do you sequence or combine these different modalities in your practice?
Dr. Efstathiou asks Dr. Freedland:The NCCN guidelines were recently updated to include enzalutamide as a treatment option for high-risk non-metastatic CSPC and metastatic CSPC, as well as metastatic and nonmetastatic CRPC. Can you summarize the significance of these updates?
1. How do you see these guideline changes impacting clinical practice patterns?