Editor’s Note: Prostate cancer is a malignant tumor occurring in the male reproductive system. Although the incidence in China is lower than in Western countries, it has rapidly increased in recent years, now ranking as the sixth most common male malignancy. With rapid advances in related research, updating prostate cancer treatment guidelines based on the latest evidence-based medicine to suit China’s specific context is crucial for early diagnosis, treatment, and improving prognosis. The 2024 CSCO Guidelines Conference is about to take place. “Oncology Frontier” invited Prof. Yao Zhu from Fudan University Cancer Hospital to share key points of the guideline updates.
Oncology Frontier: As a core expert in the CSCO prostate cancer treatment guidelines, could you briefly explain the key updates in the 2024 guidelines?
Prof. Yao Zhu: The 2024 edition of the CSCO prostate cancer treatment guidelines held its initial meeting in early March, where experts from various committees discussed the key updates and specific directions for this year’s guidelines. This update will focus on four specific directions: “surging incidence, early screening and diagnosis; localized high-risk, intensified treatment; updating scenarios, keeping pace with the times; precise testing, offering diverse options.” These updates will be discussed in depth and revised based on the latest research and evidence-based medicine. Here’s a brief overview of these four directions:
1. Surging Incidence, Early Screening, and Diagnosis:
Over the past decade, the incidence of prostate cancer in China has continuously risen, making it one of the most common tumors in men over 60. This update will recommend early screening and diagnosis strategies and methods based on the latest technology and data to reduce the proportion of patients diagnosed at advanced stages and fundamentally improve survival rates.
2. Localized High-Risk, Intensified Treatment:
For patients with localized high-risk prostate cancer, comprehensive treatment, including surgery and radiotherapy, combined with intensified and individualized strategies, offers the best chance of cure. We will provide detailed risk stratification for these patients and those with subsequent biochemical recurrence to match the most appropriate individualized treatment, ultimately increasing cure rates and delaying progression to castration resistance, thereby prolonging overall survival.
3. Updating Scenarios, Keeping Pace with the Times:
In recent years, drug development for prostate cancer has made significant strides, with many new drugs available for first-line treatment of advanced prostate cancer. For hormone-sensitive patients, triplet therapy has become a key treatment for high-volume metastatic disease and a clinical hotspot. For patients who develop resistance, different treatment scenarios from previous castration resistance will often employ PARP inhibitors, radiopharmaceuticals, or other precise or combination therapies. It is essential for physicians to choose the most appropriate treatment plan based on different treatment scenarios. Thus, updating scenarios and individualized choices is another hot topic for discussion in this year’s guidelines.
4. Precise Testing, Offering Diverse Options:
PSMA, as a specific target for prostate cancer, plays a crucial role in its diagnosis and treatment. With accumulating evidence from evidence-based medicine, we have found that PSMA PET/CT is increasingly important for diagnosing and monitoring biochemical recurrence, non-metastatic CRPC, and even initial diagnosis of prostate cancer. Therefore, guidelines are needed to direct how these precise tests can aid clinical decision-making and long-term treatment planning.
In summary, with rapid advances in the field of prostate cancer and various academic discussions, our guideline writing group, led by Prof. Dingwei Ye, aims to incorporate the latest and most cutting-edge evidence into the guidelines, benefiting domestic patients and doctors and elevating the standard of prostate cancer diagnosis and treatment to a new level.
Prof. Yao Zhu
– Administrative Deputy Director of Urology
– Administrative Deputy Director of Urology (Head of Urology, Pudong Campus), Fudan University Cancer Hospital
– Shanghai Outstanding Academic Leader
– Distinguished Professor (Eastern Scholar) at Shanghai Higher Education Institutions
– Shanghai “Medical Star” Outstanding Young Medical Talent
– Vice President of the Youth Council of the Chinese Anti-Cancer Association
– Secretary-General of the Prostate Cancer Expert Committee of the Chinese Society of Clinical Oncology (CSCO)
– Editorial Board Member of Prostate Cancer and Prostatic Diseases
