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World Journal of Urology

Erschienen in:

17.03.2016 | Invited Review

Non-metastatic castrate-resistant prostate cancer: a call for improved guidance on clinical management

verfasst von: Francois Rozet, Thierry Roumeguère, Martin Spahn, Dirk Beyersdorff, Peter Hammerer

Erschienen in: World Journal of Urology | Ausgabe 11/2016

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Abstract

Background

Guidelines on the clinical management of non-metastatic castrate-resistant prostate cancer (nmCRPC) generally focus on the need to continue androgen deprivation therapy and enrol patients into clinical trials of investigational agents. This guidance reflects the lack of clinical trial data with established agents in the nmCRPC patient population and the need for trials of new agents.

Aim

To review the evidence base and consider ways of improving the management of nmCRPC.

Conclusion

Upon the development of castrate resistance, it is essential to rule out the presence of metastases or micrometastases by optimising the use of bone scans and possibly newer procedures and techniques. When nmCRPC is established, management decisions should be individualised according to risk, but risk stratification in this diverse population is poorly defined. Currently, prostate-specific antigen (PSA) levels and PSA doubling time remain the best method of assessing the risk of progression and response to treatment in nmCRPC. However, optimising imaging protocols can also help assess the changing metastatic burden in patients with CRPC. Clinical trials of novel agents in nmCRPC are limited and have problems with enrolment, and therefore, improved risk stratification and imaging may be crucial to the improved management. The statements presented in this paper, reflecting the views of the authors, provide a discussion of the most recent evidence in nmCRPC and provide some advice on how to ensure these patients receive the best management available. However, there is an urgent need for more data on the management of nmCRPC.

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Titel: Non-metastatic castrate-resistant prostate cancer: a call for improved guidance on clinical management
verfasst von: Francois Rozet
Thierry Roumeguère
Martin Spahn
Dirk Beyersdorff
Peter Hammerer
Publikationsdatum: 17.03.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 11/2016
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-016-1803-9

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