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    ASCO issues guidance on second-line hormonal Tx in CRPC

    The American Society of Clinical Oncology (ASCO) has issued its first provisional clinical opinion on the use of second-line hormonal therapy for chemotherapy-naïve men with castration-resistant prostate cancer.

    This is an area left largely unaddressed as treatment of castration-resistant prostate cancer has rapidly evolved, according to Katherine S. Virgo, PhD, MBA, co-chair of the expert panel that developed the clinical opinion, which was published online in the Journal of Clinical Oncology (April 25, 2017).

    “The last few years have seen an unprecedented number of systemic therapies reporting improvements in pre- and post-docetaxel [Taxotere] men diagnosed with castration-resistant prostate cancer. Newer systemic therapies, such as enzalutamide [XTANDI] and abiraterone acetate [ZYTIGA], are considered hormonal interventions,” said Dr. Virgo, of Emory University, Atlanta.

    A companion ASCO guideline addresses the use of systemic therapy agents, such as chemotherapy and radium-223 [Xofigo], in men with radiographic or pathologic evidence of metastatic castration-resistant prostate cancer, Dr. Virgo noted, but that document does not address second-line hormonal therapy management of non-metastatic prostate cancer recurrence. It also does not directly address second-line hormonal therapy in the chemotherapy-naïve population.

    Without published guidelines, physicians managing these patients faced challenges and, even today, treatment patterns for castration-resistant prostate cancer vary considerably. According to Dr. Virgo, that’s likely due to the scarcity of high-quality data on the topic, the relative efficacy and nonspecific mechanisms of action of available treatment approaches, and uncertainty among clinicians regarding optimal treatment.

    Next: What the panel recommends

    Lisette Hilton
    Lisette Hilton is a writer in Boca Raton, Fla., who heads up her company, Words Come Alive.

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