Therapeutic Alliances for Optimizing the Management of Patients with Prostate Cancer : SOGUG Multidisciplinary Expert Panel Recommendations
González-del-Alba, Aránzazu (Hospital Universitario Puerta de Hierro Majadahonda (Madrid))
Martínez Ballesteros, Claudio (Hospital Universitario Puerta de Hierro Majadahonda (Madrid))
Arranz, José Ángel (Hospital General Universitario Gregorio Marañón)
Gallardo Díaz, Enrique (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Gironés Sarrió, Regina (Hospital Universitari i Politècnic La Fe (València))
Lopez Campos, Fernando (Hospital Universitario Ramón y Cajal (Madrid))
Muñoz-Rodríguez, Jesús (Universitat Autònoma de Barcelona. Departament de Cirurgia)
Méndez-Vidal, María José (Hospital Universitario Reina Sofía (Còrdova, Espanya))
Gómez de Iturriaga, Alfonso (Hospital Universitario de Cruces (Barakaldo, País Basc))

Date:	2025
Abstract:	Prostate cancer (PCa) is a clinically relevant disease because it is one of the most common cancer types in men and one of the leading causes of cancer-related death. Prostate cancer is a heterogeneous disease, although most cases of PCa are slow and often indolent, with a low propensity to progress. In other cases, it may have a clinical pattern characterized by aggressive disease, a high likelihood of recurrence, and progression to an advanced metastatic stage. Although there are available evidence-based guidelines for the management of the different stages of PCa, appropriate knowledge and full application of the novel and advisable strategies in daily practice are still limited. This review is focused on the importance of therapeutic alliances for optimizing the management of PCa patients with localized and locally advanced disease, biochemical recurrence, and advanced stage, especially in case of metastatic castration-resistant PCa (mCRPC) and in patients older than 70 years of age, an increasing segment of the population with special needs due to functional and physical disabilities related to aging. Therapeutic alliances in the framework of a multidisciplinary team approach are the cornerstone of the quality of care and improvement of clinical outcome in the PCa setting. 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.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Prostate cancer ; Multidisciplinary team ; Therapeutic alliances ; Localized disease ; Locally advanced disease ; Biochemical recurrence ; Metastatic disease ; Geriatric assessment
Published in:	Cancers, Vol. 17, Num. 19 (October 2025) , art. 3208, ISSN 2072-6694

DOI: 10.3390/cancers17193208
PMID: 41097735

23 p, 1.1 MB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Parc Taulí Research and Innovation Institute (I3PT
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Articles > Published articles