Zoledronic acid and denosumab can be used in men with mCRPC and osseous metastases to prevent skeletal-related complications .
PATIENT SUMMARY In men with a rise in their PSA levels after prior local treatment for prostate cancer only , it is important to balance overtreatment against further progression of the disease since survival and quality of life may never be affected in many of these patients .
OBJECTIVE To present a summary of the 2016 version of the European Association of Urology ( EAU ) - European Society for Radiotherapy & Oncology ( ESTRO ) - International Society of Geriatric Oncology ( SIOG ) Guidelines on the treatment of relapsing , metastatic , and castration-resistant prostate cancer ( CRPC ) .
EVIDENCE SYNTHESIS Relapse after local therapy is defined by a rising prostate-specific antigen ( PSA ) level > 0.2ng/ml following radical prostatectomy ( RP ) and > 2ng/ml above the nadir after radiation therapy ( RT ) .
And rogen deprivation therapy ( ADT ) remains the basis for treatment of men with metastatic prostate cancer ( PCa ) .
Level 1 evidence for the treatment of metastatic CRPC ( mCRPC ) includes , abiraterone acetate plus prednisone ( AA/P ) , enzalutamide , radium 223 ( Ra 223 ) , docetaxel at 75 mg/m2 every 3 wk and sipuleucel-T. Cabazitaxel , AA/P , enzalutamide , and radium are approved for second-line treatment of CRPC following docetaxel .
CONCLUSIONS The knowledge in the field of advanced and metastatic PCa and CRPC is changing rapidly .
Effects of continued androgen-deprivation therapy and other prognostic factors on response and survival in phase II chemotherapy trials for hormone-refractory prostate cancer: a Southwest Oncology Group report.
PURPOSE To assess the impact of prognostic factors , including continued ( orchiectomy ) versus discontinued and rogen-suppression ( nonorchiectomy ) therapy , on  chemotherapy response and survival of patients with hormone-refractory prostate cancer . METHODS Analysis of five consecutive Southwest Oncology Group ( SWOG ) phase II chemotherapy trials was undertaken . RESULTS Two hundred five hormone-refractory patients were evaluated . Eighty-four percent had been orchiectomized . The median survival duration s for the nonorchiectomy and orchiectomy patients were 6 and 7 months , respectively ( P = .73 ) . In a univariate analysis , orchiectomy patients had a significantly longer median time from diagnosis to first hormone therapy  ( 1.1 v 0.1 years , P = .003 ) , were more likely to have had chemotherapy initiated > or = 2 years from diagnosis ( 75 % v 56 % , P = .03 ) , had a lower incidence of liver metastases ( 16 % v 30 % , P = .05 ) , and had lower likelihood of being black ( 8 % v 18 % , P = .05 ) when compared with the nonorchiectomy group . Orchiectomy patients had a marginally significant longer median time from initial hormone treatment , more prior endocrine manipulations , lower median baseline alkaline phosphatase levels , and a lower likelihood of response to chemotherapy when compared with the nonorchiectomy group . Absence of liver metastases ( P = .004 ) , hemoglobin level > or = 10 g/dL ( P < .001 ) , acid phosphatase level > or = 1.2 IU/L ( P = .05 ) , response to chemotherapy ( P = .001 ) , and > or = 2 years from initial hormone treatment ( P = .01 ) are important factors for survival . CONCLUSION This study failed to show obvious advantages in response to chemotherapy or survival for patients with continued gonadal suppression . A prospect i ve r and omized trial is suggested to evaluate the effect of this factor on progression-free and overall survival of patients with hormone-refractory prostate cancer receiving chemotherapy
Zoledronic acid and denosumab can be used in men with mCRPC and osseous metastases to prevent skeletal-related complications .
PATIENT SUMMARY In men with a rise in their PSA levels after prior local treatment for prostate cancer only , it is important to balance overtreatment against further progression of the disease since survival and quality of life may never be affected in many of these patients .
OBJECTIVE To present a summary of the 2016 version of the European Association of Urology ( EAU ) - European Society for Radiotherapy & Oncology ( ESTRO ) - International Society of Geriatric Oncology ( SIOG ) Guidelines on the treatment of relapsing , metastatic , and castration-resistant prostate cancer ( CRPC ) .
EVIDENCE SYNTHESIS Relapse after local therapy is defined by a rising prostate-specific antigen ( PSA ) level > 0.2ng/ml following radical prostatectomy ( RP ) and > 2ng/ml above the nadir after radiation therapy ( RT ) .
And rogen deprivation therapy ( ADT ) remains the basis for treatment of men with metastatic prostate cancer ( PCa ) .
Level 1 evidence for the treatment of metastatic CRPC ( mCRPC ) includes , abiraterone acetate plus prednisone ( AA/P ) , enzalutamide , radium 223 ( Ra 223 ) , docetaxel at 75 mg/m2 every 3 wk and sipuleucel-T. Cabazitaxel , AA/P , enzalutamide , and radium are approved for second-line treatment of CRPC following docetaxel .
CONCLUSIONS The knowledge in the field of advanced and metastatic PCa and CRPC is changing rapidly .