ASCO GUIDELINES Bundle

Metastatic Non-castrate Prostate Cancer

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Key Points ➤ Prostate cancer is the most commonly diagnosed cancer in men, representing 19% of all newly reported cancer cases. ➤ It is responsible for 8% of all cancer deaths in men. ➤ Patients who have newly diagnosed radiographically evident metastatic disease, either as a de novo diagnosis of prostate cancer or as a manifestation of disease progression through earlier clinical disease states, are termed as having "metastatic non-castrate" prostate cancer. ➤ Historically, standard treatment for metastatic non-castrate disease has been androgen deprivation therapy (ADT) until progression, at which time patients are described as having metastatic castration-resistant prostate cancer (mCRPC), and then ADT is continued with additional treatments offered. Treatment ADT + Docetaxel ➤ For men with metastatic non-castrate prostate cancer with high volume disease per CHAARTED who are candidates for treatment with chemotherapy, the addition of docetaxel to ADT should be offered. (Strong Recommendation for high volume disease patients as per CHAARTED; EB-H) ➤ For patients with low volume disease per CHAARTED who are candidates for chemotherapy, docetaxel plus ADT may be offered. (Moderate Recommendation for low volume disease patients; EB-H) ➤ The appropriate regimen of docetaxel is six doses of docetaxel given every three weeks at 75 mg/m 2 either alone (per CHAARTED) or with prednisolone (per STAMPEDE). (Strong Recommendation; EB-H)

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