In 2018, there will be an estimated 164,690 new cases of prostate cancer (PC) in the U.S. and approximately 29,430 patients will die of the disease, making it the third-leading cause of cancer death in men (American Cancer Society [ACS], 2018). The majority of men with PC are treated with curative intent (i.e., with radical prostatectomy or radiation therapy) with good outcomes, but a fraction of men with locoregional PC will develop progressive disease. Men who have initial PSA/biochemical recurrence after curative treatment are a heterogeneous group of individuals with good overall prognosis, including a median metastasis-free survival (MFS) >8 years and a median overall survival (OS) of >23 years (Rozet et al., 2016).

Approximately 10%-20% of prostate cancer patients develop castration-resistant PC (CRPC) within approximately 5 years of follow-up. Decisions about clinical management (i.e., when to start treatment) are challenging because it is unclear which patients will have shorter versus longer survival, and metastatic disease is not always reliably detected with imaging (Rozet et al., 2016).

Multiple new targeted agents, including immunotherapy, second-generation hormone therapy, and androgen biosynthesis inhibitors have been recently approved. Two recently published studies (PROSPER and SPARTAN) have changed the standard of care for patients with nmCRPC.

At the conclusion of this podcast episode, listeners should be able to:

Utilize new data regarding the evidence-based management of patients with nmCRPC
Discuss implications of decisions regarding timing and treatment sequencing for patients with nmCRPC on subsequent therapy
Identify ongoing late phase clinical trials in nmCRPC
Implement strategies to manage education and symptoms for men with nmCRPC