French AFU Cancer Committee Guidelines - Update 2022-2024: prostate cancer - Management of metastatic disease and castration resistance.

The objective of the French Urology Association Cancer Committee is to propose an update of the recommendations for the management of prostate cancer.

A systematic review of the literature from 2020 to 2022 was conducted by the CCAFU on the elements of therapeutic management of metastatic and castration-resistant prostate cancer (PC), while evaluating the references and their levels of evidence.

Androgen deprivation therapy (ADT) remains the standard treatment for metastatic prostate cancer. ADT intensification is now a standard of care in the management of metastatic prostate cancer. This intensification is discussed in relation to the patient and the characteristics of the disease. For all metastatic hormone-sensitive PC (synchronous and metachronous), the overall survival benefit associated with good tolerability makes the combination of ADT and novel hormonal agents (NHA) a standard. For patients with high-volume/high-risk de novo metastatic disease, treatment with docetaxel in addition to ADT + NHA can be discussed for eligible patients. In patients with castration-resistant prostate cancer (CRPC), the contribution of new therapies that have become available in recent years, as well as the advent of precision medicine, help to improve the control of tumour progression and survival, and highlight the value of testing for alterations in DNA repair genes within the tumour tissue or constitutionally.

This update of the French recommendations should help to improve the management of patients with prostate cancer.

Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie. 2022 Nov [Epub]

G Ploussard, G Roubaud, E Barret, J-B Beauval, L Brureau, G Créhange, C Dariane, G Fiard, G Fromont, M Gauthé, R Renard-Penna, F Rozet, A Ruffion, P Sargos, R Mathieu, M Rouprêt, Comité de Cancérologie de l’Association française d’Urologie, groupe prostate

Department of Urology, La Croix du Sud Hôpital, Quint Fonsegrives, France. Electronic address: ., Department of Medical Oncology, Institut Bergonié, 33000 Bordeaux, France., Department of Urology, Institut Mutualiste Montsouris, Paris, France., Department of Urology, La Croix du Sud Hôpital, Quint Fonsegrives, France., Department of Urology, CHU de Pointe-à-Pitre, University of Antilles, University of Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, 97110 Pointe-à-Pitre, France., Department of Radiotherapy, Institut Curie, Paris, France., Department of Urology, Hôpital européen Georges-Pompidou, AP-HP, Paris-Paris University-U1151 Inserm-INEM, Necker, Paris, France., Department of Urology, Grenoble Alpes University Hospital, Université Grenoble Alpes, CNRS, Grenoble INP, TIMC-IMAG, Grenoble, France., Department of Pathology, CHRU, 37000 Tours, France., Department of Nuclear Medicine, Grenoble Alpes University Hospital, Université Grenoble Alpes, CNRS, Grenoble INP, TIMC-IMAG, Grenoble, France., Sorbonne University, AP-HP, Radiology, Pitie-Salpetriere Hospital, 75013 Paris, France., Service d'urologie Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France; Equipe 2 - Centre d'Innovation en cancérologie de Lyon (EA 3738 CICLY) - Faculté de médecine Lyon Sud - Université Lyon 1, Lyon, France., Department of Radiotherapy, Institut Bergonié, 33000 Bordeaux, France., Department of Urology, CHU Rennes, Rennes, France., Sorbonne University, GRC 5 Predictive Onco-Uro, AP-HP, Urology, Pitie-Salpetriere Hospital, 75013 Paris, France.

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