A Urologic Oncology Roundtable Discussion: The Role of Disease Monitoring in Treatment Decision-Making for Patients With Metastatic Castration-Resistant Prostate Cancer

Abstract

A recent Elsevier survey of 200 urologists and oncologists who treat patients with castration-resistant prostate cancer (CRPC) identified a lack of physician confidence in understanding and using current clinical practices regarding the identification, treatment, and management of patients with CRPC. In response to this knowledge gap, a urologic oncology physician roundtable discussion was convened and a companion summary article created to provide a knowledge-based perspective for optimizing the identification, monitoring, and treatment of patients with metastatic CRPC (http://prostatecancer.urologiconcology.org/). Leading urology experts were selected to discuss how CRPC is defined and monitored, and to elaborate (through the presentation of 2 different cases) on considerations of how the currently approved chemotherapeutics, immunotherapy, and oral androgen inhibition agents can be used in the treatment of metastatic CRPC.

Increased resource use in men with metastatic prostate cancer does not result in improved survival or quality of care at the end of life

“…1 Screening for progression of disease is valuable because it may influence the course of therapy a patient undergoes. 2 There exists level 1 evidence regarding how treatments for mPCa may delay radiographic progression of disease, thereby modifying the therapeutic course a provider selects. 3 Furthermore, defining castration-resistant PCa requires both the demonstration of castrate serum testosterone levels as well as either evidence of biochemical disease progression or radiographic disease progression.…”