7051ee63e344b5f721012772ad5fdc42 cancers-17-03208.pdf 0f519a86d214110a7615e7c8004e6887077749d2 cancers-17-03208.pdf bb9ad54d5fd3d1860fa0b14da256477e51c89963efd95b98ca8c42204ba99d69 cancers-17-03208.pdf Title: Therapeutic Alliances for Optimizing the Management of Patients with Prostate Cancer: SOGUG Multidisciplinary Expert Panel Recommendations Subject: A group of Spanish experts of different specialties participated in the ENFOCA2 project, promoted by the Spanish Oncology Genitourinary Group (SOGUG), which was designed to provide updated information on current and novel aspects contributing to the optimal care of prostate cancer (PCa) patients. In localized disease, it is important to implement strategic alliances with other institutions for improving adherence to active surveillance in low-risk groups and to explore genetic testing for a better indication of focal therapy. Local control of the disease should be maximized to prevent local failure and biochemical recurrence. In patients with locally advanced disease, with PSMA PET/CT-positive lesions in M0 staging on conventional imaging techniques, therapeutic decisions should be carefully evaluated due to insufficient evidence regarding the gold standard in this setting. In patients with metastatic castration-resistant PCa (mCRPC), assessment of BRCA somatic and germline mutations provides prognostic information and familial cancer risk and informs treatment decisions. Combinations of androgen receptor signaling inhibitor (ARSi) agents and poly-ADP ribose polymerase inhibitors (PARPi) are emerging alternatives for advanced PCa. The oldest segment of PCa patients (>70 years of age) may require geriatric assessment to evaluate physical and functional reserves, tailoring treatment to their individual characteristics and circumstances. The concept of a comprehensive multidisciplinary approach together with inter-center and/or inter-specialty therapeutic alliances should be implemented in the routine care of patients with PCa. Keywords: prostate cancer; multidisciplinary team; therapeutic alliances; localized disease; locally advanced disease; biochemical recurrence; metastatic disease; geriatric assessment Author: Aránzazu González-del-Alba, Claudio Martínez Ballesteros, José Ángel Arranz, Enrique Gallardo, Regina Gironés Sarrió, Fernando López Campos, Jesús Muñoz-Rodríguez, María José Méndez-Vidal and Alfonso Gómez de Iturriaga Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25; modified using OpenPDF 1.4.2 CreationDate: Wed Oct 1 10:46:28 2025 CEST ModDate: Wed Oct 1 10:49:07 2025 CEST Custom Metadata: yes Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 23 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1128324 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- SMUSXL+URWPalladioL-Bold Type 1 Custom yes yes yes 168 0 AIRHKL+VnURWPalladioL Type 1 Custom yes yes yes 169 0 AKSHID+URWPalladioL-Roma Type 1 Custom yes yes yes 170 0 EKMZDZ+URWPalladioL-Ital Type 1 Custom yes yes yes 171 0 ALRLBO+CMSY10 Type 1 Builtin yes yes yes 256 0 MDPOOK+PalatinoLinotype TrueType WinAnsi yes yes no 318 0 MDPOOK+PalatinoLinotype TrueType WinAnsi yes yes no 402 0 MDPOOK+PalatinoLinotype TrueType WinAnsi yes yes no 378 0 MDPPLL+Arial TrueType WinAnsi yes yes no 379 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes yes 450 0 MDPOOK+PalatinoLinotype TrueType WinAnsi yes yes no 522 0 MDPPLL+Arial TrueType WinAnsi yes yes no 523 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2026-03-19 04:08:01 CET RepresentationInformation: cancers-17-03208.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2026-03-18 19:14:45 CET Size: 1128324 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 788 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: ViewerPreferences: HideToolbar: false HideMenubar: false HideWindowUI: false FitWindow: true CenterWindow: false DisplayDocTitle: false NonFullScreenPageMode: UseNone Direction: L2R ViewArea: CropBox ViewClip: CropBox PrintArea: CropBox PageClip: CropBox PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Item: Title: Therapeutic Alliances for Optimizing Treatment of Localized Disease Children: Item: Title: Overview of the Current Situation Children: Item: Title: Low-Risk PCa Item: Title: Favorable Intermediate-Risk PCa Item: Title: Unfavorable Intermediate-Risk PCa Item: Title: Challenges Item: Title: Recommendations Item: Title: Therapeutic Alliances for Optimizing Treatment of Locally Advanced Disease Children: Item: Title: Overview of the Current Situation Item: Title: Challenges Item: Title: Recommendations Item: Title: Therapeutic Alliances for Optimizing Treatment of Biochemical Recurrence Children: Item: Title: Overview of the Current Situation Item: Title: Challenges Item: Title: Recommendations Item: Title: Therapeutic Alliances for Optimizing Treatment in the Sequence of Advanced Disease Children: Item: Title: Overview of the Current Situation Item: Title: Challenges Item: Title: Recommendations Item: Title: Inter-Center and/or Inter-Specialty Therapeutic Alliances for Optimizing Treatment in Localized and Disseminated Disease Children: Item: Title: Overview of the Current Situation Item: Title: Challenges Item: Title: Recommendations Item: Title: Therapeutic Alliances for Optimizing Geriatric Assessment in Therapeutic Decision-Making Children: Item: Title: Overview of the Current Situation Item: Title: Challenges Item: Title: Recommendations Item: Title: Conclusions Item: Title: References Info: Title: Therapeutic Alliances for Optimizing the Management of Patients with Prostate Cancer: SOGUG Multidisciplinary Expert Panel Recommendations Author: Aránzazu González-del-Alba, Claudio Martínez Ballesteros, José Ángel Arranz, Enrique Gallardo, Regina Gironés Sarrió, Fernando López Campos, Jesús Muñoz-Rodríguez, María José Méndez-Vidal and Alfonso Gómez de Iturriaga Subject: A group of Spanish experts of different specialties participated in the ENFOCA2 project, promoted by the Spanish Oncology Genitourinary Group (SOGUG), which was designed to provide updated information on current and novel aspects contributing to the optimal care of prostate cancer (PCa) patients. In localized disease, it is important to implement strategic alliances with other institutions for improving adherence to active surveillance in low-risk groups and to explore genetic testing for a better indication of focal therapy. Local control of the disease should be maximized to prevent local failure and biochemical recurrence. In patients with locally advanced disease, with PSMA PET/CT-positive lesions in M0 staging on conventional imaging techniques, therapeutic decisions should be carefully evaluated due to insufficient evidence regarding the gold standard in this setting. In patients with metastatic castration-resistant PCa (mCRPC), assessment of BRCA somatic and germline mutations provides prognostic information and familial cancer risk and informs treatment decisions. Combinations of androgen receptor signaling inhibitor (ARSi) agents and poly-ADP ribose polymerase inhibitors (PARPi) are emerging alternatives for advanced PCa. The oldest segment of PCa patients (>70 years of age) may require geriatric assessment to evaluate physical and functional reserves, tailoring treatment to their individual characteristics and circumstances. The concept of a comprehensive multidisciplinary approach together with inter-center and/or inter-specialty therapeutic alliances should be implemented in the routine care of patients with PCa. 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