Page 6 - Castration-resistant prostate cancer (CRPC): CUA/CUOG

Saad et al

Astellas, Janssen, Merck, Roche, and Sanofi; and has participated in clinical trials supported by Astra
Malignant spinal cord compression is an oncological
emergency that requires immediate diagnosis with an MRI Zeneca, Merck, Roche, and Sanofi. Dr. Pouliot has been an advisory board member for Amgen, Astellas,
Bayer , and Janssen; has received payment from Abbott, Amgen, Astellas, Astra Zeneca, Bayer, Ferring,
if suspected. Options for treatment are debulking surgery Janssen, and Sanofi; has received grants from Astra Zeneca and Sanofi; and has participated in clinical
+ RT, vertebrectomy with stabilization and RT, or RT + trials supported by Astellas, Bayer, Ferring, and Janssen. Dr. Rendon has been an advisory board and
steroids (Level 1, Strong recommendation). speakers’ bureau member for and has received honoraria from Abbvie, Amgen, Astellas, Astra Zeneca,
Bayer, Ferring, Jansen, and Sanofi. Dr. Shayegan has been an advisory board member for Astellas,
Conclusions Bayer, and Janssen; and has received a research grant from Janssen. Dr. Sridhar has been an advisory
board member for Astellas, AstraZeneca, Bayer, Janssen, Merck, and Roche; and has participated in
Advances in treatment for men with CRPC have improved sur- several pharma-supported clinical trials. Dr. So has been an advisory board member for Abbvie, Amgen,
vival and quality of life, but most, if not all, patients eventually Astellas, Bayer, Janssen, Ferring, and TerSera; and has participated in clinical trials supported by Astellas,
succumb to their disease and better treatments are required. Ferring, and Janssen. Dr. Usmani has been an advisory board member for Amgen, Astellas, and Bayer;
and has received grants from Best Medical and Concure Oncology Canada. Dr. Vigneaulthas been an

Several new agents are being studied in all states of CRPC advisory board member for Abbvie, Bayer, Ferring, and Sanofi. Dr. Chi has received honoraria from

and an increase in options is likely in the near future.Because Astellas, Bayer, Janssen, and Sanofi; and has participated in clinical trials supported by Astellas, Astra
CRPC remains an incurable and ultimately fatal illness, inclu- Zeneca, Bayer, Eli Lilly, Essa, Janssen, Merck, Novartis, Pfizer, Roche, and Sanofi.
sion of patients in clinical trials remains paramount.
A summary on the recommended treatment of CRPC is
shown in Fig. 1. Prior to publication, this guideline underwent review by the CUA Guidelines Committee, CUA members
at large, the CUAJ Editorial Board, and the CUA Executive Board.
Competing interests: Dr. Saad has been an advisory board member for and has received payment/
honoraria from Abbvie, Amgen, Astellas, Bayer, Janssen, and Sanofi; and has participated in clinical
trials supported by Amgen, Astellas, Bayer, Janssen, and Sanofi. Dr. Aprikian has been an advisory
board member for Abbvie, Astellas, and Bayer; and has received grants from Abbvie, Astellas Bayer, References
Sanofi, and TerSera. Dr. Finelli has been an advisory board member for Abbvie, Astellas, Bayer, Janssen,
Ipsen, Sanofi, and TerSera; and has participated in clinical trials supported by Astellas, Bayer, and 1. Mohler JL, Gregory CW, Ford OH, 3rd, et al. The androgen axis in recurrent prostate cancer. Clin Cancer
Janssen. Dr. Fleshner has been a consultant or advisory board member for Abbvie, Amgen, Astellas, Res 2004;10:440-8. http://dx.doi.org/10.1158/1078-0432.CCR-1146-03
Bayer, Ferring, Hybridyne Health, Janssen, and Sanofi; and has participated in clinical trials supported 2. Scher HI, Halabi S, Tannock I, et al. Design and end points of clinical trials for patients with progressive
by Astellas, Bavarian Nordic, Bayer, Ferring, Janssen, Medivalion, Nucleix, Progenics Pharmaceutical, prostate cancer and castrate levels of testosterone: recommendations of the Prostate Cancer Clinical
Sanofi, and Spectracure AB. Dr. Gleave has been a consultant for and has received honoraria/grants Trials Working Group. J Clin Oncol 2008;26:1148-59. http://dx.doi.org/10.1200/JCO.2007.12.4487
from Abbvie, Amgen, Astellas, Bayer, GDx, Janssen, MDX, Pfizer, and Sanofi; and is founder/holds a 3. Smith MR, Kabbinavar F, Saad F, et al. Natural history of rising serum prostate-specific antigen in men with
patent with OncoGenex. Dr. Kapoor has been an advisory board member for BMS, Eisai, Ipsen, Merck, castrate non-metastatic prostate cancer. J Clin Oncol 2005;23:2918-25. http://dx.doi.org/10.1200/
Novartis, Pfizer, and Roche; a speakers’ bureau member for Eisai, Ipsen, Novartis, and Roche; and has JCO.2005.01.529
received grants/honoraria from BMS, Eisai, Ipsen, Merck, Novartis, Pfizer, and Roche. Dr. Niazi has 4. Small EJ, Halabi S, Dawson NA, et al. Antiandrogen withdrawal alone or in combination with ketocon-
received research grants and honoraria from Abbvie, Amgen, Astellas, Astra Zeneca, Bayer, Janssen, azole in androgen-independent prostate cancer patients: A phase 3 trial (CALGB 9583). J Clin Oncol
2004;22:1025-33. http://dx.doi.org/10.1200/JCO.2004.06.037
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Dr. North has been an advisory board member for Astellas, has received honoraria from Astra Zeneca, 6. treatment and metastasis-free survival in prostate cancer. N Engl J Med 2018;378:1408-18.
https://doi.org/10.1056/NEJMoa1715546
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Summary 8. Fizazi K, Shore N, Tammela TL, et al; ARAMIS Investigators. Darolutamide in non-metastatic, castration-
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Health Canada-approved agents that have shown 9. Saad F, Cella D, Basch E, et al. Effect of apalutamide on health-related quality of life in patients with non-
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abiraterone, enzalutamide, docetaxel, cabazitaxel, 10. Tombal B, Saad F, Penson D, et al. Patient-reported outcomes following enzalutamide or placebo in men
and radium-223. Health Canada-approved agents with non-metastatic, castration-resistant prostate cancer (PROSPER): A multicenter, randomized, double-
that have shown improvements in delaying metas- blind, phase 3 trial. Lancet Oncol 2019 Feb 12. [Epub ahead of print]. https://doi.org/10.1016/
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