Amol Akhade: ASCO 2025 Guideline Update: mCRPC Treatment Sequencing Simplified
Amol Akhade, Senior Consultant Medical Oncologist and Hemato-Oncologist at Suyog Cancer Clinics and Reliance Hospitals, shared a post on LinkedIn:
“ASCO 2025 Guideline Update: mCRPC Treatment Sequencing Simplified
A big step forward in how we treat metastatic castration-resistant prostate cancer (mCRPC)!
The latest ASCO update offers a structured, biomarker-driven, and personalized approach. Here’s what you need to know:
Start with Prior Exposure:
Treatment is now sequenced based on what the patient already received:
- ADT only
- ADT + ARPI
- ADT + Docetaxel
- Triplet (ADT + ARPI + Docetaxel)
Key Recommendations by Line:
- BRCA1/2+: Start with PARPi + ARPI (e.g., talazoparib + enzalutamide)
- Post-ARPI: Olaparib (BRCA+), Docetaxel/Cabazitaxel (HRR–)
- Post-Docetaxel: Consider ARPI, Cabazitaxel, or Radium-223
- Triplet failure: 177Lu-PSMA-617 (PSMA+), PARPi or platinum combos
Biomarkers matter:
- HRR mutation → PARPi
- MSI-H/dMMR → Pembrolizumab
- PSMA+ → Radioligand therapy
- TP53/RB1/PTEN loss → Consider platinum chemo
Also emphasized:
- Early genetic testing
- Equity in access
- Shared decision-making
- Supportive and palliative care from the start
Let’s move from reactive to proactive, and from empirical to personalized.”
Title: Systemic Therapy in Patients With Metastatic Castration-Resistant Prostate Cancer: ASCO Guideline Update
Journal: Journal of Clinical Oncology
Authors: Rohan Garje, Irbaz Bin Riaz, Syed Arsalan Ahmed Naqvi, R. Bryan Rumble, Mary-Ellen Taplin, Terry M. Kungel, Daniel Herchenhorn, Tian Zhang, Kathryn E. Beckermann, Neha Vapiwala, Michael A. Carducci, Paul Celano, Sebastien J. Hotte, Arnab Basu, Hala Borno, Alan H. Bryce, Peng Wang, Elizabeth Wulff-Burchfield, Lisa Bodei, Andrew Loblaw, Robert J. Hamilton, Hamid Emamekhoo, Thomas A. Hope, Huan He, M. Hassan Murad, Hongfang Liu, James Elbert Williams, Rahul A. Parikh
Read the Full Article.
More posts featuring Amol Akhade.
-
Challenging the Status Quo in Colorectal Cancer 2024
December 6-8, 2024
-
ESMO 2024 Congress
September 13-17, 2024
-
ASCO Annual Meeting
May 30 - June 4, 2024
-
Yvonne Award 2024
May 31, 2024
-
OncoThon 2024, Online
Feb. 15, 2024
-
Global Summit on War & Cancer 2023, Online
Dec. 14-16, 2023