This project was an initiative of the GU research Consortium (GURC). This is a national collaboration of uro-oncologists, medical oncologists, and radiation oncologists who treat advanced PC with a common interest in research, education and best practice.
The development of this algorithm was a very rigorous process and entailed a review of all contemporary guidelines, including NCCN, ASCO AUA, EAU, and CUA. The algorithm incorporated data from the COU-301, COU-302, PREVAIL, AFFIRM, TAX 327, TROPIC, and ALSYMPCA trials. The new algorithm is demonstrated in figure 1.
Figure 1- Proposed treatment algorithm:
The algorithm was developed as a practical tool to guide therapy. Its development was informed by clinical evidence and multidisciplinary expert consensus. This algorithm should not be considered definitive or replace evidence-based clinical guidelines or consensus statements. It does not address sequencing from metastatic castrate sensitive status to mCRPC status. Importantly, since the mCRPC algorithm was developed by a national panel of multidisciplinary experts, some provinces may not have funding policies that match the algorithm.
Shayegan also mentioned that another algorithm for biochemical recurrence following radical therapy, and non-metastatic CRPC were created to provide guidance earlier in therapy. Additionally, a management algorithm for newly diagnosed metastatic hormone-sensitive prostate cancer is being finalized.
Presented by: Bobby Shayegan, MD, Associate Professor and Head, McMaster University, Hamilton, Canada
Written By: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre, @GoldbergHanan at the 73rd Canadian Urological Association Annual Meeting - June 23 - 26, 2018 - Halifax, Nova Scotia