TY - JOUR
T1 - Castration-resistant prostate cancer
T2 - AUA guideline
AU - Cookson, Michael S.
AU - Roth, Bruce J.
AU - Dahm, Philipp
AU - Engstrom, Christine
AU - Freedland, Stephen J.
AU - Hussain, Maha
AU - Lin, Daniel W.
AU - Lowrance, William T.
AU - Murad, Mohammad Hassan
AU - Oh, William K.
AU - Penson, David F.
AU - Kibel, Adam S.
PY - 2013/8
Y1 - 2013/8
N2 - Purpose: This Guideline is intended to provide a rational basis for the management of patients with castration-resistant prostate cancer based on currently available published data. Materials and Methods: A systematic review and meta-analysis of the published literature was conducted using controlled vocabulary supplemented with keywords relating to the relevant concepts of prostate cancer and castration resistance. The search strategy was developed and executed by reference librarians and methodologists to create an evidence report limited to English-language, published peer-reviewed literature. This review yielded 303 articles published from 1996 through 2013 that were used to form a majority of the guideline statements. Clinical Principles and Expert Opinions were used for guideline statements lacking sufficient evidence-based data. Results: Guideline statements were created to inform clinicians on the appropriate use of observation, androgen-deprivation and antiandrogen therapy, androgen synthesis inhibitors, immunotherapy, radionuclide therapy, systemic chemotherapy, palliative care and bone health. These were based on six index patients developed to represent the most common scenarios encountered in clinical practice. Conclusions: As a direct result of the significant increase in FDA-approved therapeutic agents for use in patients with metastatic CRPC, clinicians are challenged with a multitude of treatment options and potential sequencing of these agents that, consequently, make clinical decision-making more complex. Given the rapidly evolving nature of this field, this guideline should be used in conjunction with recent systematic literature reviews and an understanding of the individual patient's treatment goals. In all cases, patients' preferences and personal goals should be considered when choosing management strategies.
AB - Purpose: This Guideline is intended to provide a rational basis for the management of patients with castration-resistant prostate cancer based on currently available published data. Materials and Methods: A systematic review and meta-analysis of the published literature was conducted using controlled vocabulary supplemented with keywords relating to the relevant concepts of prostate cancer and castration resistance. The search strategy was developed and executed by reference librarians and methodologists to create an evidence report limited to English-language, published peer-reviewed literature. This review yielded 303 articles published from 1996 through 2013 that were used to form a majority of the guideline statements. Clinical Principles and Expert Opinions were used for guideline statements lacking sufficient evidence-based data. Results: Guideline statements were created to inform clinicians on the appropriate use of observation, androgen-deprivation and antiandrogen therapy, androgen synthesis inhibitors, immunotherapy, radionuclide therapy, systemic chemotherapy, palliative care and bone health. These were based on six index patients developed to represent the most common scenarios encountered in clinical practice. Conclusions: As a direct result of the significant increase in FDA-approved therapeutic agents for use in patients with metastatic CRPC, clinicians are challenged with a multitude of treatment options and potential sequencing of these agents that, consequently, make clinical decision-making more complex. Given the rapidly evolving nature of this field, this guideline should be used in conjunction with recent systematic literature reviews and an understanding of the individual patient's treatment goals. In all cases, patients' preferences and personal goals should be considered when choosing management strategies.
KW - androgen antagonists
KW - drug therapy
KW - immunotherapy
KW - prostatic neoplasms
UR - http://www.scopus.com/inward/record.url?scp=84880009495&partnerID=8YFLogxK
U2 - 10.1016/j.juro.2013.05.005
DO - 10.1016/j.juro.2013.05.005
M3 - Article
C2 - 23665272
AN - SCOPUS:84880009495
SN - 0022-5347
VL - 190
SP - 429
EP - 438
JO - Journal of Urology
JF - Journal of Urology
IS - 2
ER -