Initial Management of Non-Castrate Advanced, Recurrent or Metastatic Prostate Cancer

Purpose

Update all preceding ASCO guidelines based on the triplet therapy discussion and trials.

Methods

This systematic review-based guideline product was developed by a multidisciplinary Expert Panel, which included a patient representative and an ASCO guidelines staff member with health research methodology expertise.

Results

Six papers, including one meta-analysis and one network meta-analysis informed this guideline update.

Recommendations

Docetaxel, abiraterone, enzalutamide, apalutamide, or darolutamide each when administered with ADT, represent five separate SoCs for noncastrate metastatic prostate cancer. With the exception of the triplet therapies of docetaxel plus abiraterone plus ADT and docetaxel plus darolutamide plus ADT, the use of any of these agents in any other particular combination or in any particular series cannot yet be recommended.

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