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dc.contributor.authorMateo, J
dc.contributor.authorFizazi, K
dc.contributor.authorGillessen, S
dc.contributor.authorHeidenreich, A
dc.contributor.authorPerez-Lopez, R
dc.contributor.authorOyen, WJG
dc.contributor.authorShore, N
dc.contributor.authorSmith, M
dc.contributor.authorSweeney, C
dc.contributor.authorTombal, B
dc.contributor.authorTomlins, SA
dc.contributor.authorde Bono, JS
dc.date.accessioned2020-06-11T12:18:14Z
dc.date.issued2019-02
dc.identifier.citationEuropean urology, 2019, 75 (2), pp. 285 - 293
dc.identifier.issn0302-2838
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/3722
dc.identifier.eissn1873-7560
dc.identifier.doi10.1016/j.eururo.2018.07.035
dc.description.abstractCONTEXT:Patients with nonmetastatic castration-resistant prostate cancer (nmCRPC) have rising prostate-specific antigen (PSA) and castrate testosterone levels, with no radiological findings of metastatic disease on computed tomography and bone scan. Given recent drug approvals for nmCRPC, with many other therapeutics and imaging modalities being developed, management of nmCRPC is a rapidly evolving field that merits detailed investigation. OBJECTIVE:To review current nmCRPC management practices and identify opportunities for improving care of nmCRPC patients. EVIDENCE ACQUISITION:A literature search up to July 2018 was conducted, including clinical trials and clinical practice guidelines (National Comprehensive Cancer Network, European Society for Medical Oncology, European Association of Urology, Prostate Cancer Clinical Trials Working Group, Prostate Cancer Radiographic Assessments for Detection of Advanced Recurrence). Keywords included prostate cancer, nonmetastatic, castration resistance, rising PSA, and biochemical relapse. EVIDENCE SYNTHESIS:Recommendations regarding indications for, and frequency of, imaging and PSA testing, as well as for initiating systemic therapy in nmCRPC are based on PSA rise kinetics and symptoms. Both enzalutamide and apalutamide have been shown to significantly increase metastasis-free survival in phase III placebo-controlled randomised trials in nmCRPC patients with PSA doubling time (DT) ≤10 mo. The expected impact of new imaging techniques in the assessment of nmCRPC is also reviewed. CONCLUSIONS:nmCRPC is a heterogeneous disease; while observation may be an option for some patients, enzalutamide and apalutamide may be appropriate to treat nmCRPC patients with PSA-DT ≤10 mo. The emergence of more accurate imaging modalities as well as circulating tumour biomarker assays will likely redefine the assessment of nmCRPC in the near future. PATIENT SUMMARY:Herein, we review key literature and clinical practice guidelines to summarise the optimal management of patients with prostate cancer and rising prostate-specific antigen despite castrate testosterone levels, but with no evidence of distant metastasis on traditional imaging. New drugs are being developed for this disease setting; novel imaging and tumour biomarker blood tests are likely to define this disease state more accurately.
dc.formatPrint-Electronic
dc.format.extent285 - 293
dc.languageeng
dc.language.isoeng
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.subjectHumans
dc.subjectAndrogen Antagonists
dc.subjectKallikreins
dc.subjectProstate-Specific Antigen
dc.subjectAntineoplastic Agents
dc.subjectTomography, X-Ray Computed
dc.subjectMagnetic Resonance Imaging
dc.subjectTreatment Outcome
dc.subjectPredictive Value of Tests
dc.subjectMale
dc.subjectWhole Body Imaging
dc.subjectProstatic Neoplasms, Castration-Resistant
dc.subjectPositron Emission Tomography Computed Tomography
dc.titleManaging Nonmetastatic Castration-resistant Prostate Cancer.
dc.typeJournal Article
dcterms.dateAccepted2018-07-26
rioxxterms.versionofrecord10.1016/j.eururo.2018.07.035
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by/4.0
rioxxterms.licenseref.startdate2019-02
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfEuropean urology
pubs.issue2
pubs.notesNot known
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Prostate Cancer Targeted Therapy Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Translational Molecular Imaging
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Prostate Cancer Targeted Therapy Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Translational Molecular Imaging
pubs.publication-statusPublished
pubs.volume75
pubs.embargo.termsNot known
icr.researchteamProstate Cancer Targeted Therapy Groupen_US
icr.researchteamTranslational Molecular Imagingen_US
dc.contributor.icrauthorOyen, Willemen
dc.contributor.icrauthorDe Bono, Johannen


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