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The 2010 NCCN Clinical Practice Guidelines in Oncology on Prostate Cancer

James L. Mohler

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Reflecting the Debates of Updating the Prostate Cancer Guidelines

James L. Mohler

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Evolving Use of Androgen Deprivation Therapy in Prostate Cancer Management

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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Ten Years of Progress in Prostate Cancer

James L. Mohler

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Androgen Deprivation Therapy for Advanced Prostate Cancer: Can Evolution Be Accelerated?

James L. Mohler

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Joint Statement by Members of the NCCN Prostate Cancer Guidelines Panel

James L. Mohler and the NCCN Prostate Cancer Panel

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New Developments in the Management of Prostate Cancer

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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NCCN Guidelines Updates: Management of Prostate Cancer

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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NCCN Guidelines Updates: Prostate Cancer and Prostate Cancer Early Detection

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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Validation of the Kattan Nomogram for Prostate Cancer Recurrence After Radical Prostatectomy

Rochelle Payne Ondracek, Michael W. Kattan, Christine Murekeyisoni, Changhong Yu, Eric C. Kauffman, James R. Marshall, and James L. Mohler

Background: The Kattan postoperative radical prostatectomy (RP) nomogram is used to predict biochemical recurrence-free progression (BCRFP) after RP. However, external validation among contemporary patients using modern outcome definitions is limited. Methods: A total of 1,931 patients who underwent RP at Roswell Park Cancer Institute (RPCI) between 1993 and 2014 (median follow-up, 47 months; range, 0–244 months) were assessed for NCCN-defined biochemical failure (BF) and RPCI-defined treatment failure (TF). Actual rates of biochemical failure-free survival (BFS; defined as 1 – BF) and treatment failure-free survival (TFS; defined as 1 – TF) were compared with Kattan BCRFP nomogram predictions. Results: The Kattan BCRFP nomogram predictions at 5 and 10 years were predictive of BFS (area under the receiver operating characteristic curve [AUC], 0.772) and TFS (AUC, 0.774). The Kattan BCRFP nomogram tended to underestimate BFS and TFS compared with actual outcomes. The Kattan 5-year BCRFP predictions consistently overestimated actual 5-year BFS outcomes among subgroups of high- and intermediate-risk patients with at least 5-year outcomes. Conclusions: The Kattan BCRFP nomogram is a robust predictor of NCCN-defined BF in a large sample of patients with RP with substantial follow-up and modern, standardized failure definitions