Panel to explore new guideline for prostate cancer salvage therapy
Better technology and expanding data drive the creation of a new guideline that will help clinicians and patients make evidence-based treatment decisions.
The AUA and partner organizations published a new guideline on salvage therapy for prostate cancer earlier this year. Rather than update existing guidance, the multidisciplinary group of urologic oncologists, medical oncologists, radiation oncologists, nuclear medicine specialists and patient advocates created a new consensus guideline from the ground up.
“The science and evidence around prostate cancer and salvage therapy for prostate cancer have advanced dramatically since the last guideline on adjuvant and salvage radiotherapy after prostatectomy was published in 2013,” said 2024 guideline committee chair Todd Morgan, MD, chief of urologic oncology and the Jack Lapides, MD, Research Professor at the University of Michigan in Ann Arbor. “As an example, we had no recourse to PET imaging 5 years ago, and this advanced molecular imaging now plays an important role in the new guideline we developed with ASTRO (the American Society for Radiation Oncology) and the SUO (Society of Urologic Oncology).”
Dr. Morgan will lead “New AUA Guideline (2024): Salvage Therapy for Prostate Cancer,” an instructional course* scheduled 10 a.m.-noon, Saturday, May 4, in Room 214C of the Henry B. González Convention Center in San Antonio. Speakers include Stephen Boorjian, MD, Carl Rosen professor and chair of urology at Mayo Clinic Rochester; Sophia Kamran, MD, assistant professor of radiation oncology at Harvard Medical School in Boston; and Scott Tagawa, MD, MS, FACP, FASCO, professor of medicine and urology and medical director of the Genitourinary Oncology Research Program at Weill Cornell Medicine in New York. The four will focus on new evidence and new tools to facilitate care decisions and help clinicians care for patients who have evidence of biochemical recurrence following prior curative-intent treatment.
Expanding data supporting clinical and molecular parameters for risk stratification and decision making, novel approaches to lymphadenectomy or nodal radiation in the absence of regional disease and other recent developments have transformed the management landscape for prostate cancer patients with BCR.
Between 20% and 80% of patients experience BCR following prostatectomy or other curative treatment, depending on their initial risk factors, Dr. Morgan noted. As more lower-risk patients opt for active surveillance, the proportion of higher-risk patients undergoing definitive treatment is increasing, as is the proportion of patients with BCR.
“The guideline is a valuable new tool to help guide clinicians and patients to make evidence-based treatment decisions, including optimal use of salvage radiation therapy and combination radiation and hormonal therapy,” he said. “Indications for adjuvant therapy are now infrequent, so it is more important than ever for salvage therapy to be implemented appropriately and adapted based on individual patient factors and preferences.”
A cure is still possible for many patients with BCR, he added.
Understanding the evaluation and appropriate use of salvage therapies for patients with BCR has become a critical part of prostate cancer care as novel PET, CT and MRI modalities can now identify regional and distant recurrences that were previously undetectable. Evidence-based and evidence-driven prognostic markers are critical to improving oncologic outcomes and maintaining quality of life for patients.
“This guideline is a major step in advancing care for prostate cancer patients with BCR,” Dr. Morgan said. “We want to share the latest evidence in salvage therapy to help clinicians improve outcomes for all of their patients.”
To learn more about the new guideline on salvage therapy for prostate cancer, be sure to attend the plenary session on Friday morning, May 3, when Dr. Morgan will describe it in more detail from 10-10:15 a.m. in the Stars at Night Ballroom.
AUA/ASTRO/SUO guideline part I.
AUA/ASTRO/SUO guideline part II.
AUA/ASTRO/SUO guideline part III.
* Instructional courses are available to those attendees who purchase an Instructional Course Pass or Individual Course Tickets.