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James L. Mohler

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James L. Mohler

Since its introduction more than 70 years ago, the use of androgen deprivation therapy (ADT) for prostate cancer has evolved to become part of a multimodal management approach. In this presentation from the NCCN 21st Annual Conference, James L. Mohler, MD, reviewed data that inform these strategies and gave his bottom-line recommendations on issues such as ADT plus radiotherapy, continuous versus intermittent ADT, ADT for positive nodes, and ADT plus docetaxel. He suggested that ADT plus radiation therapy should be used in patients at high risk, intermittent ADT is more appropriate for most patients than continuous ADT, and docetaxel should be given with ADT for high-volume metastatic disease.

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James L. Mohler and Emmanuel S. Antonarakis

Updates to the NCCN Guidelines for Prostate Cancer include further refinements in taking a family history, new recommendations for germline and somatic testing, use of androgen receptor blockers for nonmetastatic castration-resistant prostate cancer, advice regarding intermittent versus continuous androgen deprivation therapy, and consideration of whether to treat the primary tumor in men diagnosed with de novo metastatic prostate cancer.

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Peter H. Carroll and James L. Mohler

Peter H. Carroll, MD, MPH, and James L. Mohler, MD, updated attendees on what is new in the 2018 NCCN Guidelines for Prostate Cancer Early Detection and for Prostate Cancer, respectively. Their presentations touched on new screening recommendations, shared decision-making, risk stratification, the role of genomic and molecular testing, active surveillance, and newer systemic treatments.

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Philip W. Kantoff and James L. Mohler

Rapid progress was recently made in the treatment of prostate cancer, especially metastatic castration-resistant prostate cancer. At the NCCN 18th Annual Conference, Dr. Philip W. Kantoff reviewed the data supporting the use of abiraterone acetate, enzalutamide, cabazitaxel, sipuleucel-T, and radium-223 (pending approval), and offered recommendations for their sequential use in different settings. Dr. James L. Mohler described factors that dictate who should receive treatment, when they should receive it, and how to treat in the setting of prostate-specific antigen elevation. He explained how better treatment decisions will result from individualized estimation of threat-to-life posed by prostate cancer, chance of cure by treatment, and treatment risks.

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James L. Mohler and the NCCN Prostate Cancer Panel

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Peter B. Bach, Stephen B. Edge, Linda House, Jennifer Malin, James L. Mohler, and Clifford Goodman

As part of the NCCN 20th Annual Conference: Advancing the Standard of Cancer Care, a distinguished and diverse group of experts on value-based decision-making in oncology discussed guidelines and pathways and how their use has impacted bedside evidence-based decision-making for both physicians and patients. Moderated by Clifford Goodman, PhD, the roundtable also reflected on the criteria used to assess shared decision-making and the relationship between outcomes and cost when determining value.