EAU-EANM-ESTRO-ESUR-ISUP-SIOG Guidelines on Prostate Cancer. Part II—2024 Update: Treatment of Relapsing and Metastatic Prostate Cancer

Derya Tilki*, Roderick C.N. van den Bergh, Erik Briers, Thomas Van den Broeck, Oliver Brunckhorst, Julie Darraugh, Daniel Eberli, Gert De Meerleer, Maria De Santis, Andrea Farolfi, Giorgio Gandaglia, Silke Gillessen, Nikolaos Grivas, Ann M. Henry, Michael Lardas, Geert J.L.H. van Leenders, Matthew Liew, Estefania Linares Espinos, Jan Oldenburg, Inge M. van OortDaniela E. Oprea-Lager, Guillaume Ploussard, Matthew J. Roberts, Olivier Rouvière, Ivo G. Schoots, Natasha Schouten, Emma J. Smith, Johan Stranne, Thomas Wiegel, Peter Paul M. Willemse, Philip Cornford

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Background and objective: The European Association of Urology (EAU)-European Association of Nuclear Medicine (EANM)-European Society for Radiotherapy and Oncology (ESTRO)-European Society of Urogenital Radiology (ESUR)-International Society of Urological Pathology (ISUP)-International Society of Geriatric Oncology (SIOG) guidelines on the treatment of relapsing, metastatic, and castration-resistant prostate cancer (PCa) have been updated. Here we provide a summary of the 2024 guidelines. Methods: The panel performed a literature review of new data, covering the time frame between 2020 and 2023. The guidelines were updated and a strength rating for each recommendation was added on the basis of a systematic review of the evidence. Key findings and limitations: Risk stratification for relapsing PCa after primary therapy may guide salvage therapy decisions. New treatment options, such as androgen receptor–targeted agents (ARTAs), ARTA + chemotherapy combinations, PARP inhibitors and their combinations, and prostate-specific membrane antigen–based therapy have become available for men with metastatic PCa. Conclusions and clinical implications: Evidence for relapsing, metastatic, and castration-resistant PCa is evolving rapidly. These guidelines reflect the multidisciplinary nature of PCa management. The full version is available online (http://uroweb.org/guideline/ prostate-cancer/). Patient summary: This article summarises the 2024 guidelines for the treatment of relapsing, metastatic, and castration-resistant prostate cancer. These guidelines are based on evidence and guide doctors in discussing treatment decisions with their patients. The guidelines are updated every year.

Original languageEnglish
Pages (from-to)164-182
Number of pages19
JournalEuropean Urology
Volume86
Issue number2
DOIs
Publication statusPublished - Aug 2024

Keywords

  • Guidelines
  • Metastatic prostate cancer
  • Prostate cancer
  • Relapsing prostate cancer

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