Optimizing therapy for high-risk biochemically recurrent non-metastatic prostate cancer

Current and emerging strategies

Authors

  • Christian Kollmannsberger Department of Medical Oncology, BC Cancer Vancouver Center / Division of Medical Oncology, University of British Columbia, Vancouver BC https://orcid.org/0000-0002-6329-761X
  • Antonio Finelli Department of Surgery, Division of Urology, University Health Network, University of Toronto, Toronto, ON
  • Andrew Loblaw Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON
  • Tamim Niazi Department of Radiation Oncology, Jewish General Hospital, McGill University, Montreal, QC https://orcid.org/0000-0002-6283-8920
  • Frédéric Pouliot Department of Surgery, Urology Division, CHU de Québec, Laval University, QC, Canada https://orcid.org/0000-0002-6651-1079
  • Ricardo A. Rendon Department of Urology, Dalhousie University and Queen Elizabeth II Health Sciences Centre, Halifax NS https://orcid.org/0000-0002-4670-8384
  • Bobby Shayegan Department of Surgery, Division of Urology, McMaster University, Hamilton, ON, Canada https://orcid.org/0000-0001-9570-610X
  • Fred Saad Department of Surgery/Urology, Centre Hospitalier de l’Université de Montréal, Université de Montréal https://orcid.org/0000-0003-2986-5617

DOI:

https://doi.org/10.5489/cuaj.9100

Keywords:

Prostate cancer, castrate sensitive, biochemical recurrence, androgen receptor pathway inhibitor, enzalutamide

Abstract

Prostate cancer is a leading malignancy affecting men globally and in Canada. Biochemical recurrence (BCR), marked by rising prostate-specific antigen (PSA) levels post-curative-intended local treatment, is prevalent in nearly one-third of prostate cancer patients and is associated with increased risk of metastases and mortality. The management of patients with BCR is evolving rapidly, highlighting the need for practical guidance. This review aims to provide guidance to clinicians on the use and subsequent implications of advanced imaging results in patients with BCR. In addition, current management approaches, including salvage therapies post-radical prostatectomy, as well as the integration of androgen deprivation therapy (ADT) plus androgen receptor pathway inhibitors (ARPI), are explored.

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Published

2025-04-17

How to Cite

Kollmannsberger, C. ., Finelli, A. ., Loblaw, A., Niazi, T., Pouliot, F. ., Rendon, R. A., … Saad, F. (2025). Optimizing therapy for high-risk biochemically recurrent non-metastatic prostate cancer: Current and emerging strategies. Canadian Urological Association Journal, 19(8), 282–8. https://doi.org/10.5489/cuaj.9100

Issue

Vol. 19 No. 8 (2025): CUAJ August

Section

Review

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