AUTHOR=Rosinha Alina , Rabaça Carlos , Calais Fernando , Pinto João Moreira , Barreira João Vasco , Fernandes Ricardo , Ramos Rodrigo , Fialho Ana Cristina , Palma dos Reis José TITLE=Improving the identification of high-risk non-metastatic castration-resistant prostate cancer patients in clinical practice JOURNAL=Frontiers in Oncology VOLUME=13 YEAR=2024 URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2023.1266369 DOI=10.3389/fonc.2023.1266369 ISSN=2234-943X ABSTRACT=

Non-metastatic castration-resistant prostate cancer (nmCRPC) represents a challenging disease state in prostate cancer care. nmCRPC patients with a high risk of progression to metastatic disease who are identified by a prostate-specific antigen doubling time (PSADT) ≤10 months are eligible for treatment with the novel androgen receptor inhibitors (ARIs), shown to delay disease progression and extend survival. However, nmCRPC is often unexploited in clinical practice due to a lack of standardization in the methodology and in the tools used for its identification. In this article, a group of Urology and Oncology specialists with acknowledged expertise in prostate cancer reviews the state of the art in the management of high-risk nmCRPC patients, identifies gaps and unmet needs, and proposes strategies to optimize the identification of this patient subgroup in the clinical practice and improve their health outcomes.