Improving the identification of high-risk non-metastatic castration-resistant prostate cancer patients in clinical practice

Alina Rosinha; Carlos Rabaça; Fernando Calais; João Moreira Pinto; João Vasco Barreira; Ricardo Fernandes; Rodrigo Ramos; Ana Cristina Fialho; José Palma Dos Reis

doi:10.3389/fonc.2023.1266369

Improving the identification of high-risk non-metastatic castration-resistant prostate cancer patients in clinical practice

Front Oncol. 2024 Jan 23:13:1266369. doi: 10.3389/fonc.2023.1266369. eCollection 2023.

Authors

Alina Rosinha¹, Carlos Rabaça², Fernando Calais³, João Moreira Pinto⁴, João Vasco Barreira^{5

6}, Ricardo Fernandes⁷, Rodrigo Ramos⁸, Ana Cristina Fialho⁹, José Palma Dos Reis¹⁰

Affiliations

¹ Oncology Department, Portuguese Institute of Oncology (IPO) Porto, Porto, Portugal.
² Urology Department, Portuguese Institute of Oncology (IPO) Coimbra, Coimbra, Portugal.
³ Urology Department, Centro Hospitalar Lisboa Central, Lisbon, Portugal.
⁴ Oncology Department, Hospital Beatriz Ângelo, Lisbon, Portugal.
⁵ Oncology Department, CUF Oncologia, Lisbon, Portugal.
⁶ Institute of Health Sciences, Universidade Católica Portuguesa, Lisbon, Portugal.
⁷ Oncology Department, Hospital de Braga, Braga, Portugal.
⁸ Urology Department, Portuguese Institute of Oncology (IPO) Lisboa, Lisbon, Portugal.
⁹ Medical Affairs Department, Janssen-Cilag, Lda., Porto Salvo, Portugal.
¹⁰ Urology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal.

Abstract

Non-metastatic castration-resistant prostate cancer (nmCRPC) represents a challenging disease state in prostate cancer care. nmCRPC patients with a high risk of progression to metastatic disease who are identified by a prostate-specific antigen doubling time (PSADT) ≤10 months are eligible for treatment with the novel androgen receptor inhibitors (ARIs), shown to delay disease progression and extend survival. However, nmCRPC is often unexploited in clinical practice due to a lack of standardization in the methodology and in the tools used for its identification. In this article, a group of Urology and Oncology specialists with acknowledged expertise in prostate cancer reviews the state of the art in the management of high-risk nmCRPC patients, identifies gaps and unmet needs, and proposes strategies to optimize the identification of this patient subgroup in the clinical practice and improve their health outcomes.

Keywords: high-risk; identification; non-metastatic castration-resistant prostate cancer; prostate-specific antigen; prostate-specific antigen doubling time; standardization.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This project received financial support from Janssen-Cilag Farmacêutica, Lda.