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| Biochemical recurrence following primary treatment for prostate cancer presents an increasingly complex clinical decision point, requiring careful consideration of PSA trends and doubling time, imaging findings, recurrence risk, and the timing and selection of subsequent therapy. |
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| The Latest Research on Biochemical Recurrence in Prostate Cancer |
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- Curated Clinical Discussions
- Expert Video Perspectives
- State-of-the-Art Review Articles
- Conference Presentations and Coverage
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- Physician-Scientist Commentaries
- Publications and Journal Highlights
- Clinical Trial Updates
- Treatment Insights
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Clinical Conversations |
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| Defining High-Risk Biochemical Recurrence and its Clinical Implications |
| Ricardo Rendon, MD, MSc, FRCSC |
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| Zachary Klaassen hosts Ricardo Rendon to discuss high-risk biochemical recurrence management. Dr. Rendon defines high-risk BCR as patients with PSA doubling time under one year and Gleason 4/5 disease, referencing the Pound data showing eight-year progression to metastases. |
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| EMBARK Trial: Treatment Options for High-Risk Biochemical Recurrence |
| Neal Shore, MD, FACS |
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| Zachary Klaassen and Neal Shore discuss treatment options for high-risk biochemical recurrence following prostatectomy and salvage radiation, using a case presentation of a 67-year-old active patient with rapidly rising PSA. |
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Articles |
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| Locally Advanced and Recurrent Prostate Cancer Updates - Management of Biochemical Recurrence in 2026 |
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Karen Hoffman, MD, MHSc, MPH, FASTRO
Modern randomized trials (RAVES, GETUG-AFU17, RADICALS-RT) show early salvage radiation achieves similar oncologic control to adjuvant radiation after prostatectomy while reducing toxicity, so early salvage is preferred for most patients, with adjuvant radiation considered only for select very high-risk cases. Adding short-course ADT (4–6 months) to salvage radiation improves progression-free and metastasis-free survival even at low PSA, but the benefit of prolonged ADT is unclear and likely limited to higher-risk patients; PAM50 molecular subtyping (luminal B) is the first prospectively validated biomarker identifying who benefits from apalutamide with salvage radiation, and molecular imaging is increasingly used to guide targets and dosing.
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| Impact of PSA Doubling Time and Absolute PSA on PSMA PET Positivity in Post-Prostatectomy Biochemical Recurrence |
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Mouneeb M. Choudry, MD
In 405 post-prostatectomy patients with biochemical recurrence, PSMA PET positivity rose with higher PSA and was independently predicted by shorter PSA doubling time, with the strongest effect at lower PSA levels. These findings support using PSA doubling time—alongside absolute PSA—to optimize the timing of PSMA PET imaging in early biochemical recurrence, improving diagnostic yield and guiding more efficient clinical pathways.
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