The Oncology Committee of the French Urology Association is proposing updated recommendations for the management of recurrent and/or metastatic prostate cancer (PCa).
A systematic review of the literature from 2022 to 2024 was conducted by the CCAFU on the therapeutic management of recurrent PCa following local or metastatic treatment, assessing the references based on their level of evidence.
Molecular imaging is the standard approach for assessing recurrence after local treatment and should not delay early salvage treatment. Androgen deprivation therapy (ADT) is the primary treatment option for metastatic PCa. Intensification of ADT, now cononsidered standard care for metastatic PCa, involves incorporating at least one new-generation hormone therapy (ARPI). For patients with high-volume metastatic disease at diagnosis, adding docetaxel to ADT+ARPI may be considered for eligible patients. In castration-resistant PCa (CRPC) patients, poly(ADP) ribose polymerase (PARP) inhibitors and PSMA radioligand therapy are new treatment options. The combination and sequencing of treatmentsare influenced by several factors, including patient and disease characteristics, prior therapies, genomic status, and molecular imaging findings.
This update of French recommendations should help to improve the management recurrent or metastatic PCa patients.
The French journal of urology. 2024 Nov [Epub]
Guillaume Ploussard, Charles Dariane, Romain Mathieu, Michaël Baboudjian, Eric Barret, Laurent Brureau, Gaëlle Fiard, Gaëlle Fromont, Jonathan Olivier, François Rozet, Arthur Peyrottes, Raphaële Renard-Penna, Paul Sargos, Stéphane Supiot, Léa Turpin, Guilhem Roubaud, Morgan Rouprêt, Comité de Cancérologie de l’Association Française d’Urologie, Groupe Prostate, Maison de l’Urologie
Department of Urology, La Croix du Sud Hospital, Quint-Fonsegrives, France. Electronic address: ., Department of Urology, Hôpital européen Georges-Pompidou, AP-HP, Paris, France; Paris University, U1151 Inserm-INEM, Necker, Paris, France., Department of Urology, CHU de Rennes, Rennes, France., Department of Urology, Hopital Nord, AP-HM, Marseille, France., Department of Urology, Institut Mutualiste Montsouris, Paris, France., Department of Urology, CHU de Pointe-à-Pitre, University of Antilles, University of Rennes, Inserm, EHESP, Institut de Recherche en Santé, Environnement et Travail (Irset), UMR_S 1085, 97110 Pointe-à-Pitre, Guadeloupe., Department of Urology, Grenoble Alpes University Hospital, Université Grenoble Alpes, CNRS, Grenoble INP, TIMC-IMAG, Grenoble, France., Department of Pathology, CHRU, 37000 Tours, France., Department of Urology, CHRU de Lille, Lille, France., Department of Urology, CHU Saint-Louis, Paris, France., Sorbonne University, AP-HP, Radiology, Pitié-Salpêtrière Hospital, 75013 Paris, France., Department of Radiotherapy, Institut Bergonié, 33000 Bordeaux, France., Radiotherapy Department, Institut de Cancérologie de l'Ouest, Saint-Herblain, France., Nuclear Medicine Department, Hôpital Foch, Suresnes, France., Department of Medical Oncology, Institut Bergonié, 33000 Bordeaux, France., Sorbonne University, GRC 5 Predictive Onco-Uro, AP-HP, Urology, Pitié-Salpêtrière Hospital, 75013 Paris, France., 11, rue Viète, 75017 Paris, France.