title: Castration-resistant prostate cancer: AUA Guideline.
abstract: OBJECTIVE
  This Guideline is intended to provide a rational basis for the management of patients with castration-resistant prostate cancer based on currently available published data.
  
  
  METHODS
  A systematic review and meta-analysis of the published literature was conducted using controlled vocabulary supplemented with keywords relating to the relevant concepts of prostate cancer and castration resistance. The search strategy was developed and executed by reference librarians and methodologists to create an evidence report limited to English-language, published peer-reviewed literature. This review yielded 303 articles published from 1996 through 2013 that were used to form a majority of the guideline statements. Clinical Principles and Expert Opinions were used for guideline statements lacking sufficient evidence-based data.
  
  
  RESULTS
  Guideline statements were created to inform clinicians on the appropriate use of observation, androgen-deprivation and antiandrogen therapy, androgen synthesis inhibitors, immunotherapy, radionuclide therapy, systemic chemotherapy, palliative care and bone health. These were based on six index patients developed to represent the most common scenarios encountered in clinical practice.
  
  
  CONCLUSIONS
  As a direct result of the significant increase in FDA-approved therapeutic agents for use in patients with metastatic CRPC, clinicians are challenged with a multitude of treatment options and potential sequencing of these agents that, consequently, make clinical decision-making more complex. Given the rapidly evolving nature of this field, this guideline should be used in conjunction with recent systematic literature reviews and an understanding of the individual patient's treatment goals. In all cases, patients' preferences and personal goals should be considered when choosing management strategies.
authors.affiliation: American Urological Association Education and Research, Inc., Linthicum, Maryland, USA.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Cookson
authors.forename: Bruce J
authors.initials: BJ
authors.lastname: Roth
authors.forename: Philipp
authors.initials: P
authors.lastname: Dahm
authors.forename: Christine
authors.initials: C
authors.lastname: Engstrom
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Freedland
authors.forename: Maha
authors.initials: M
authors.lastname: Hussain
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Lin
authors.forename: William T
authors.initials: WT
authors.lastname: Lowrance
authors.forename: Mohammad Hassan
authors.initials: MH
authors.lastname: Murad
authors.forename: William K
authors.initials: WK
authors.lastname: Oh
authors.forename: David F
authors.initials: DF
authors.lastname: Penson
authors.forename: Adam S
authors.initials: AS
authors.lastname: Kibel
mesh_terms: D000726:Androgen Antagonists / Q000008:administration & dosage*; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D019008:Drug Resistance, Neoplasm; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D008297:Male; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000473:pathology
chemical_list: D000726:Androgen Antagonists; D000970:Antineoplastic Agents; D018931:Antineoplastic Agents, Hormonal; D005938:Glucocorticoids
keywords: ADT; CRPC; FDA; Food and Drug Administration; H&P; OS; PFS; PSA; QOL; SRE; androgen antagonists; androgen deprivation therapy; castration-resistant prostate cancer; drug therapy; history and physical; immunotherapy; mCRPC; metastatic castration-resistant prostate cancer; overall survival; progression-free survival; prostate specific antigen; prostatic neoplasms; quality of life; skeletal-related event