Page 15 - CUAJ Dec. 2022

CUA-CUOG GUIDELINE

2022 UPDATE: Canadian Urological Association-Canadian Urologic

Oncology Group guideline: Metastatic castration-naive and

castration-sensitive prostate cancer

Summary of changes

Alan I. So , Fred Saad 2
1
1 Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada; Division of Urology, Department of Surgery, Université de Montréal, Montreal, QC, Canada
2

Cite as: So AI, Saad F. 2022 UPDATE: Canadian Urological Association-Canadian Urologic Oncology
Group guideline: Metastatic castration-naive and castration-sensitive prostate cancer – Summary 2022 UPDATES
of changes. Can Urol Assoc J 2022;16(12):389-91. http://dx.doi.org/10.5489/cuaj.8159
In patients who can safely tolerate docetaxel and in
whom docetaxel is felt to be appropriate, triplet regimen
Full-text available at cuaj.ca and cua.org. This is an update of a CUA guideline originally published should be considered as a treatment option.
online December 5, 2019, and in print in February 2020.
• UPDATE #1: Abiraterone acetate plus prednisone in
combination with docetaxel is a treatment option for
Introduction patients with mCNPC/mCSPC in high-volume of dis-
ease (Level of evidence 1, Strong recommendation).

The most recent Canadian Urological Association-Canadian • UPDATE #2: Abiraterone acetate plus prednisone in
Urologic Oncology Group guideline on metastatic castra- combination with docetaxel may be considered for
tion-naive and castration-sensitive prostate cancer (mCNPC/ patients with mCNPC/mCSPC with low-volume dis-
mCSPC) was published in 2020. New data in this patient ease (Level of evidence 2, Weak recommendation).
1
population have prompted an update to the guideline in
order to add treatment options that have proven to improve • UPDATE #3: Darolutamide in combination with
disease progression and overall survival (OS). This brief docetaxel is a treatment option for patients with
review summarizes the changes in the guideline, as well as mCNPC/mCSPC regardless of volume of disease
the importance of ensuring proper treatment intensification (Level of evidence 1, Strong recommendation).
in addition to androgen deprivation therapy (ADT) in patients
with metastatic hormone-naive or castration-sensitive pros- • UPDATE #4: Patients with mCNPC/mCSPC should
tate cancer. be assessed in a multidisciplinary manner (Level of
evidence 3, strong recommendation).
Systemic therapies: Chemotherapy, abiraterone acetate,
enzalutamide, and apalutamide Update #1

Abiraterone acetate plus prednisone in combination with
Triplet therapy docetaxel is a treatment option for patients with mCNPC/
mCSPC in high-volume of disease (Level of evidence 1,
In patients who can safely tolerate docetaxel and in whom Strong recommendation).
docetaxel is felt to be appropriate, triplet regimen should
be considered as a treatment option.

CUAJ • December 2022 • Volume 16, Issue 12 389
© 2022 Canadian Urological Association