The expansion of treatment options for prostate cancer (PC) has improved disease-specific and overall survival outcomes but has also raised questions about the optimal level of treatment needed for patients based on their individual prognosis and accounting for potential toxicity, incorporating quality of life considerations.
A panel of experts met to discuss current controversies in the care of patients with PC across the disease continuum. Multidisciplinary experts review advances and persistent uncertainties in biomarker-guided assessment, imaging, and systemic therapy for prostate cancer. The discussion outlines priority gaps in evidence that must be addressed to optimize individualized patient care.
Workshop topics included use of genomic biomarkers and artificial intelligence-guided tools to identify and manage high-risk and very-high risk localized disease, management of biochemical recurrence, identification of patients with metastatic hormone-sensitive PC who warrant treatment escalation, radiopharmaceutical therapy for metastatic castration-resistant PC including optimal sequencing of approved therapies, role of imaging in identification and management of extraprostatic disease, and lifestyle interventions to optimize survivorship.
Many questions remain about management of PC related to biomarker-based risk stratification to guide treatment selection, use of prostate-specific membrane antigen-positron emission tomography, and balancing the risk for PC-related death with risks for treatment-related toxicity. Ongoing research efforts are needed to optimize risk-based treatment, sequence of therapies throughout the disease continuum, and survivorship care.
Cancer. 2026 Feb 15 [Epub]
Rana R McKay, Benjamin L Maughan, Alicia K Morgans, Neal D Shore, Evan Y Yu, Ravi A Madan, Jacob E Berchuck, Bradley C Carthon, Steven E Finkelstein, Leonard Gomella, Michael A Gorin, Andrew W Hahn, Stacy Loeb, Vivek K Narayan, Daniel P Petrylak, Charles J Ryan, Karine Tawagi, Phuoc T Tran, Tanya Dorff
Genitourinary Oncology, Moores Cancer Center, University of California, San Diego, La Jolla, California, USA., Division of Medical Oncology, Huntsman Cancer Institute, Salt Lake City, Utah, USA., Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA., START Carolinas/Carolina Urologic Research Center, Myrtle Beach, South Carolina, USA., Division of Hematology & Oncology, Department of Medicine, University of Washington, Seattle, Washington, USA., Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia, USA., Radiation Oncology, US Urology Partners, Syracuse, New York, USA., Department of Urology, Clinical Affairs Sidney Kimmel Cancer Center, Enterprise EVP Urology, Jefferson Health System, Philadelphia, Pennsylvania, USA., Milton and Carrol Petrie Department of Urology, Icahn School of Medicine at Mount Sinai New York, New York, New York, USA., Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA., Departments of Urology and Population Health, NYU Langone Health, New York, New York, USA., Division of Medical Oncology, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Medicine and Urology, Smilow Cancer Center, Yale University School of Medicine, New Haven, Connecticut, USA., Genitourinary Medical Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA., Division of Hematology & Oncology, University of Illinois, Chicago, Illinois, USA., Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, Maryland, USA., Department of Medical Oncology & Therapeutics Research, City of Hope, Los Angeles, California, USA.