What are the NCCN treatment guidelines for castration naive prostate cancer?

Updated: Jul 31, 2017
  • Author: Bagi RP Jana, MD; more...
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Answer

Answer

M0 Castration Naive Diease can be treated with Orchiectomy or LHRH agonist +/- antiandrogen or LHRH antagonist or in selected patients observation

M1 Castration Naive Disease can be treated with ADT similar to M0 disease expect a atleast 7 day pretreatment with antiandrogen is recommended to prevent testosterone flare.  Patietns can be considered for Docetaxel 75 mg/m2 with or without prednisone for 6 cycles in addition to ADT.  Patients with low volume disease ( less than 4 metastatic sites) have less certain benefit from early treatment with docetaxel. 

Patients suspected to small cell should undergo biopsy and if confirmed should be considered for clinical trial or alternatively treated with cisplatin/etoposide or carboplatin/etoposide or docetaxel/carboplatin [6]


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