Relugolix has a unique place in therapy for the treatment of prostate cancer. As a first-in-class oral LHRH antagonist, relugolix provides many benefits for patients. However, it is critical to understand how to manage the potential toxicities, drug interactions and adherence issues when initiating and maintaining this new oral agent.

The selection of systemic treatments in various lines of therapy for patients with metastatic castration-resistant prostate cancer (CRPC) has become more and more complicated over the last several years. Clinicians who work with patients with metastatic CRPC need to be educated on these updates so that they can help their patients make optimal treatment choices across lines of therapy.

Data on the use of systemic therapies for patients with metastatic CRPC is rapidly evolving, and clinicians need to be informed about the most recent clinical trial results, FDA approvals, and updates to the NCCN Guidelines for Prostate Cancer so that they can provide optimal care to their patients.

Optimal treatment of prostate cancer requires a multidisciplinary team approach, with expertise needed in medical oncology, radiation oncology, urology, genetics, pathology, diagnostic radiology, and supportive care. It is important for clinicians who treat patients with prostate cancer to understand all facets of comprehensive care so that their patients receive the best possible treatments with effective management of side effects.

The NCCN Guidelines for Prostate Cancer address staging and risk assessment after a prostate cancer diagnosis and include management options for localized, regional, and metastatic disease. This article summarizes the panel’s discussions for the 2021 update of the guidelines with regard to systemic therapy for metastatic castration-resistant prostate cancer.

Clinicians need up-to-date information about when and how to use molecular assays to inform individual patient risk; the side effects of ADT and management options for these side effects; and the results of recent clinical trials in the non-metastatic CRPC setting, so that patients can receive optimal care and delay the onset of metastases as long as possible.

Clinicians need up-to-date information on patient selection for active surveillance and the recommended active surveillance protocol, so that appropriate men with prostate cancer can be encouraged to pursue active surveillance and avoid treatment and side effects. In addition, clinicians must be aware of results of recent clinical trials in the non-metastatic CRPC setting, so that patients can receive optimal care and delay the onset of metastases as long as possible.

During this tumor board, faculty will discuss the emerging role of tumor and germline genetic testing and the treatment of advanced disease.