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Genitourinary Cancers • Medical Oncology
How do you approach patients with biochemical relapse of high-risk prostate cancer, with PSA doubling time less than 6 months?
Pt previously treated with radical prostatectomy and adjuvant radiotherapy.
If recommending therapy, what is the role of concurrent abiraterone + ADT?
The STAMPEDE study in NEJM July 2017 included some patients who were previously treated with radical surgery or radiotherapy and were relapsing with high-risk features (in men no longer receiving therapy, a PSA level >4 ng per milliliter with a doubling time of <6 months, a PSA level >20 ng per milliliter, nodal or metastatic relapse, or <12 months of total ADT with an interval of >12 months without treatment)
Answer from: Medical Oncologist at Academic Institution
This is a very thoughtful question. The assumption is that the patient has no evidence on conventional imaging by (CT/Bone scan) and BCR with rapidly doubling PSA after both prostatectomy and adjuvant XRT. The biology of these patients remains concerning and although STAMPEDE would include these typ...
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