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    CRPC document aids in complex decisions

    Recent updates ensure that clinicians remain current on treatments

    Treatment for castration-resistant prostate cancer (CRPC) has evolved rapidly in the past several years, and there are now six drugs approved for this indication, including five that became available between 2010 and 2013 (table 1).

    Commentary - Prostate cancer guidelines: A primer for urologists

    Having multiple therapeutic options makes choosing initial and sequential treatment challenging, and the complexity of this task is further compounded by the fact that the approved medications were studied in varying patient populations. Thus, the AUA developed its first guideline to assist practitioners with clinical decision-making for men with CRPC.

    Released in May 2013 and already amended twice to reflect new information, the evidence-based guideline takes into account the diversity of “disease states” found among men with CRPC in its aim to provide a rational basis for treatment. In its current iteration, the CRPC guideline contains 20 statements relating to treatments for six index patients defined by the presence or absence of metastatic disease, presence and degree of symptoms, ECOG performance status, and prior treatment with docetaxel (Taxotere) (table 2) along with two statements on the use of preventive treatments for bone health.

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    Each guideline statement is rated as a standard, recommendation, option, clinical principle, or expert opinion depending on the strength and quality of the evidence and the panel’s assessment of the benefits and harms of treatment. The guideline statements are also concisely summarized in a flowchart that enables clinicians to match a man they are treating with an index patient.

    Next: "The AUA CRPC guideline allows physicians to identify treatments that are appropriate for individual patients across the spectrum of CRPC presentations."


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