NCCN Guidelines for Advanced Prostate Cancer

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Raoul D. Concepcion, MD, and Bryan A. Mehlhaff, MD, discuss NCCN Guidelines for patients with asymptomatic or minimally symptomatic metastatic castration-resistant prostate cancer (CRPC M1).

Bryan A. Mehlhaff, MD, says that while his partners were not initially aware of NCCN Guidelines, they are slowly getting used to the guidelines now. Mehlhaff praises the NCCN for updating and founding the guidelines on “good science” for how physicians should care for their patients.

The NCCN Guidelines recommend that physicians should consider sipuleucel-T or enrollment in a clinical trial for a patient with CRPC M1.

Before 2005, there were not very many drugs available for CRPC M1 patients (docetaxel and mitoxantrone with prednisone). Raoul D. Concepcion, MD, says that urologists were wary of sending their patients to oncologists to receive docetaxel, even though it had a survival benefit, because of the side effect profile and patient’s asymptomatic nature.

It remains in the NCCN Guidelines that docetaxel be instituted in symptomatic CRPC M1 patients.