NCCN Guidelines Insights: Prostate Cancer, Version 1.2021.

Published on Feb 2, 2021in Journal of The National Comprehensive Cancer Network9.316
· DOI :10.6004/JNCCN.2021.0008
Edward M. Schaeffer59
Estimated H-index: 59
(NU: Northwestern University),
Sandy Srinivas50
Estimated H-index: 50
(Stanford University)
+ 29 AuthorsDeborah A. Freedman-Cass27
Estimated H-index: 27
(National Comprehensive Cancer Network)
The NCCN Guidelines for Prostate Cancer address staging and risk assessment after a prostate cancer diagnosis and include management options for localized, regional, and metastatic disease. Recommendations for disease monitoring and treatment of recurrent disease are also included. The NCCN Prostate Cancer Panel meets annually to reevaluate and update their recommendations based on new clinical data and input from within NCCN Member Institutions and from external entities. This article summarizes the panel's discussions for the 2021 update of the guidelines with regard to systemic therapy for metastatic castration-resistant prostate cancer.
#1Laura A. Sena (JHUSOM: Johns Hopkins University School of Medicine)H-Index: 1
#1Laura A. Sena (JHUSOM: Johns Hopkins University School of Medicine)H-Index: 2
Last. Emmanuel S. Antonarakis (JHUSOM: Johns Hopkins University School of Medicine)H-Index: 63
view all 20 authors...
Background Genomic biomarkers that predict response to anti-PD1 therapy in prostate cancer are needed. Frameshift mutations are predicted to generate more neoantigens than missense mutations; therefore, we hypothesized that the number or proportion of tumor frameshift mutations would correlate with response to anti-PD1 therapy in prostate cancer. Methods To enrich for response to anti-PD1 therapy, we assembled a multicenter cohort of 65 men with mismatch repair-deficient (dMMR) prostate cancer. ...
3 CitationsSource
#1Matthew R. Smith (Harvard University)H-Index: 102
#2Fred Saad (UdeM: Université de Montréal)H-Index: 98
Last. Eric J. Small (UCSF: University of California, San Francisco)H-Index: 106
view all 18 authors...
Abstract Background The phase 3 SPARTAN study evaluated apalutamide versus placebo in patients with nonmetastatic castration-resistant prostate cancer (nmCRPC) and prostate-specific antigen doubling time of ≤10 mo. At primary analysis, apalutamide improved median metastasis-free survival (MFS) by 2 yr and overall survival (OS) data were immature. Objective We report the prespecified event-driven final analysis for OS. Design, setting, and participants A total of 1207 patients with nmCRPC (diagno...
17 CitationsSource
#1Karim Fizazi (Institut Gustave Roussy)H-Index: 103
#2Gero Kramer (Medical University of Vienna)H-Index: 33
Last. Ronald de Wit (EUR: Erasmus University Rotterdam)H-Index: 49
view all 23 authors...
Summary Background In the CARD study, cabazitaxel significantly improved radiographic progression-free survival and overall survival versus abiraterone or enzalutamide in patients with metastatic castration-resistant prostate cancer previously treated with docetaxel and the alternative androgen signalling-targeted inhibitor. Here, we report the quality-of-life outcomes from the CARD study. Methods CARD was a randomised, multicentre, open-label, phase 4 study involving 62 clinical sites across 13...
6 CitationsSource
Abstract Background We previously reported that olaparib led to significantly longer imaging-based progression-free survival than the physician’s choice of enzalutamide or abiraterone among men wit...
38 CitationsSource
Abstract Background Darolutamide is a structurally distinct androgen-receptor inhibitor that is approved for the treatment of nonmetastatic, castration-resistant prostate cancer. In the planned pri...
26 CitationsSource
#1Mark C. Markowski (Johns Hopkins University)H-Index: 12
#2Emmanuel S. Antonarakis (Johns Hopkins University)H-Index: 63
5 CitationsSource
#1Wassim Abida (MSK: Memorial Sloan Kettering Cancer Center)H-Index: 24
#2Akash Patnaik (U of C: University of Chicago)H-Index: 13
Last. Triton investigatorsH-Index: 1
view all 28 authors...
PURPOSEBRCA1 or BRCA2 (BRCA) alterations are common in men with metastatic castration-resistant prostate cancer (mCRPC) and may confer sensitivity to poly(ADP-ribose) polymerase inhibitors. We pres...
38 CitationsSource
#1Wassim Abida (MSK: Memorial Sloan Kettering Cancer Center)H-Index: 24
#2David Campbell (Barwon Health)H-Index: 36
Last. Simon Chowdhury (Sarah Cannon Research Institute)H-Index: 11
view all 27 authors...
Purpose: Genomic alterations in DNA damage repair (DDR) genes other than BRCA may confer synthetic lethality with PARP inhibition in metastatic castration-resistant prostate cancer (mCRPC). To test this hypothesis, the phase 2 TRITON2 study of rucaparib included patients with mCRPC and deleterious non-BRCA DDR gene alterations. Patients and Methods:TRITON2 enrolled patients who had progressed on 1 to 2 lines of next-generation androgen receptor (AR)-directed therapy and 1 taxane-based chemothera...
67 CitationsSource
#1Cora N. Sternberg (Cornell University)H-Index: 98
#2Karim Fizazi (Université Paris-Saclay)H-Index: 103
Last. Maha HussainH-Index: 13
view all 18 authors...
Abstract Background Preliminary trial results showed that enzalutamide significantly improved metastasis-free survival among men who had nonmetastatic, castration-resistant prostate cancer and rapi...
47 CitationsSource
#1Laura S. Graham (UW: University of Washington)H-Index: 1
#2Bruce Montgomery (UW: University of Washington)H-Index: 34
Last. Michael T. Schweizer (UW: University of Washington)H-Index: 25
view all 9 authors...
Background While response rates to anti-PD1 therapy are low in unselected metastatic castration resistant prostate cancer (mCRPC) patients, those with inactivating mutations in mismatch repair (MMR) genes (i.e. MMR deficiency; MMRd) or microsatellite instability (MSI) are thought likely to respond favorably. To date, there is limited published data on this biologically distinct and clinically relevant subgroup’s natural history and response to treatment. Methods We retrospectively identified pat...
11 CitationsSource
Cited By2
#1Shoshana Adler Jaffe (UNM: University of New Mexico)H-Index: 2
#2D. Guest (UNM: University of New Mexico)H-Index: 70
Last. Jean A. McDougall (UNM: University of New Mexico)H-Index: 8
view all 0 authors...
Cancer treatment often leads to work disruptions including loss of income, resulting in long-term financial instability for cancer survivors and their informal caregivers. In this sequential explanatory study, we conducted a cross-sectional survey of employment experiences among ethnically diverse, working-age individuals diagnosed with breast, colorectal, or prostate cancer. Following the survey, we conducted semi-structured interviews with cancer survivors and informal caregivers to explore ch...
#1Doo Yong Chung (Inha University)H-Index: 9
Non-metastatic castration-resistant prostate cancer (nmCRPC) is defined by a progressively rising prostate-specific antigen level, despite a castrate level of testosterone, in the absence of obvious radiologic evidence of metastatic disease on conventional imaging modalities. As a significant proportion of patients with nmCRPC develop metastatic diseases, the therapeutic goals of physicians for these patients are to delay metastasis development, preserve quality of life, and increase overall sur...
#1Nieves Martinez Chanza (ULB: Université libre de Bruxelles)H-Index: 7
#2Brandon Bernard (Harvard University)H-Index: 11
Last. Thierry Roumeguere (ULB: Université libre de Bruxelles)H-Index: 22
view all 0 authors...
Background null The appropriate management of localized or metastatic hormone-sensitive prostate cancer (HSPC) patients harboring tumor BRCA mutations (tBRCAm) is not well-characterized. We sought to evaluate the prevalence and clinical outcomes of patients with tBRCAm and localized or de novo metastatic HSPC. null Methods null We performed a multicenter, international, retrospective cohort study of localized (cohort 1) and de novo metastatic (cohort 2) HSPC patients who underwent tumor BRCA1 an...
#1Alessia Cimadamore (Marche Polytechnic University)H-Index: 17
#2Liang Cheng (IUPUI: Indiana University – Purdue University Indianapolis)H-Index: 132
Last. Rodolfo Montironi (Marche Polytechnic University)H-Index: 96
view all 10 authors...
Approximately 23% of metastatic castration-resistant prostate cancers (mCRPC) harbor deleterious aberrations in DNA repair genes. Poly (ADP-ribose) polymerase (PARP) inhibitors (PARPi) therapy has shown improvements in overall survival in patients with mCRPC who harbor somatic and/or germline alterations of homology recombination repair (HRR) genes. Peripheral blood samples are typically used for the germline mutation analysis test using the DNA extracted from peripheral blood leucocytes. Somati...
view all 4 authors...
BACKGROUND Cancer care during the Covid-19 pandemic has been challenging especially in a developing country such as the Philippines. Oncologists were advised to prioritize chemotherapy based on the absolute benefit that the patient may receive, which outbalances the risks of Covid-19 infection. The results of this study will allow re-examination of how to approach cancer care during the pandemic and ultimately, help optimize treatment recommendations during this crisis. AIM This study described ...
#1Paolo GandelliniH-Index: 25
Last. Nadia ZaffaroniH-Index: 66
view all 16 authors...
Active surveillance (AS) has evolved as a strategy alternative to radical treatments for very low risk and low-risk prostate cancer (PCa). However, current criteria for selecting AS patients are still suboptimal. Here, we performed an unprecedented analysis of the circulating miRNome to investigate whether specific miRNAs associated with disease reclassification can provide risk refinement to standard clinicopathological features for improving patient selection. The global miRNA expression profi...
#1Giuseppe CanaveseH-Index: 18
#2Corrado TinterriH-Index: 13
Last. Beatrice DozinH-Index: 23
view all 10 authors...
Abstract Background Whether the extent of residual disease in the sentinel lymph node (SLN) after neoadjuvant chemotherapy (NAC) influences the prognosis in clinically node-positive breast cancer (BC) patients remains to be ascertained. Methods One hundred and thirty-four consecutive cN+/BC-patients received NAC followed by SLN biopsy and axillary lymph node dissection. Cumulative incidence of overall (OS) and disease-free (DFS) survival, BC-related recurrences and death from BC were assessed us...
#1Devin Patel (UCSD: University of California, San Diego)H-Index: 9
#2Lawrence KarshH-Index: 23
Last. Timothy J. Daskivich (Cedars-Sinai Medical Center)H-Index: 10
view all 3 authors...
#1Dawid Sigorski (Ministry of Interior (Bahrain))H-Index: 4
#1Dawid Sigorski (Ministry of Interior (Bahrain))
Last. Lubomir Bodnar (Ministry of Interior (Bahrain))H-Index: 15
view all 3 authors...
Genomic instability is one of the hallmarks of cancer. The incidence of genetic alterations in homologous recombination repair genes increases during cancer progression, and 20% of prostate cancers (PCas) have defects in DNA repair genes. Several somatic and germline gene alterations drive prostate cancer tumorigenesis, and the most important of these are BRCA2, BRCA1, ATM and CHEK2. There is a group of BRCAness tumours that share phenotypic and genotypic properties with classical BRCA-mutated t...
3 CitationsSource