AUA Updates Castration-Resistant Prostate Cancer Clinical Guideline

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The update includes 2 treatments, apalutamide and enzalutamide, that have shown benefit in this patient population
The update includes 2 treatments, apalutamide and enzalutamide, that have shown benefit in this patient population

The American Urological Association (AUA) released an update to its Castration-Resistant Prostate Cancer (CRPC) clinical guideline. 

The updated guideline includes recent literature related to the treatment of patients with CRPC to help physicians with clinical decision-making. While the initial guidelines from 2013 included the 6 most common patient scenarios seen in clinical practice, the 2018 modifications provide new evidence regarding treatment of patients with asymptomatic or non-metastatic CRPC, 1 of the index patients represented in the previous guideline.

The 2018 amendment includes the addition of 2 treatments, apalutamide and enzalutamide, that have shown benefit in this patient population. Apalutamide, a nonsteroidal anti-androgen, was the first FDA-approved treatment in 2018 for patients with non-metastatic disease. Enzalutamide, an androgen receptor signaling inhibitor, has also shown benefit in metastatic patients. The Statement now reads as follows:

  • Statement 1: Clinicians should offer apalutamide or enzalutamide with continued androgen deprivation to patients with non-metastatic CRPC at high risk for developing metastatic disease. (Standard; Evidence Level Grade A [apalutamide] / B [enzalutamide])

Additional supportive text and a description of ongoing research have also been include in the amended guideline. Michael Cookson, MD, chair of the original 2013 guideline panel and member of the 2018 amendment panel, stated, "We are confident this guideline is fully aligned with the latest science on treatments for patients with non-metastatic and metastatic CRPC."   

The full guideline is now available here.

For more information visit AUAnet.org.

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