@article{Danielson_Saad_So_Morgan_Hamilton_Malone_Park-Wyllie_Zardan_Shayegan_2019, title={Management algorithms for prostate-specific antigen progression in prostate cancer: Biochemical recurrence after definitive therapy and progression to non-metastatic castrate-resistant prostate cancer}, volume={13}, url={https://cuaj.ca/index.php/journal/article/view/5600}, DOI={10.5489/cuaj.5600}, abstractNote={<p><strong>Introduction:</strong> Current prostate cancer (PCa) guidelines primarily focus on localized or metastatic PCa. A multidisciplinary genitourinary oncology panel determined that additional guidance focusing on monitoring and management of biochemical recurrence (BCR) following radical therapy and non-metastatic castration-resistant prostate cancer (nmCRPC) was warranted.</p> <p><strong>Methods:</strong> The most up-to-date national and international guidelines, consensus statements, and emerging phase 3 trials were identified and used to inform development of algorithms by a multidisciplinary genitourinary oncology panel outlining optimal monitoring and treatment for patients with non-metastatic PCa.</p> <p><strong>Results:</strong> A total of eight major national and international guidelines/ consensus statements published since 2015 and three phase 3 trials were identified. Working group discussions among the multidisciplinary genitourinary oncology panel led to the development of two algorithms: the first addressing management of patients with BCR following radical therapy (post-BCR), and the second addressing management of nmCRPC. The post-BCR algorithm suggests consideration of early salvage treatment in select patients and provides guidance regarding observation vs. intermittent or continuous androgen-deprivation therapy (ADT). The nmCRPC algorithm suggests continued ADT and monitoring for all patients, with consideration of treatment with apalutamide or enzalutamide for patients with high-risk disease (prostate-specific antigen [PSA] doubling time of ≤10 months).</p> <p><strong>Conclusions:</strong> Two treatment algorithms have been developed to guide the management of non-metastatic PCa and should be considered in the context of local guidelines and practice patterns.</p>}, number={12}, journal={Canadian Urological Association Journal}, author={Danielson, Brita and Saad, Fred and So, Alan and Morgan, Scott and Hamilton, Robert J. and Malone, Shawn and Park-Wyllie, Laura and Zardan, Anousheh and Shayegan, Bobby}, year={2019}, month={Feb.}, pages={420–6} }