What is the rationale for the recent change in the NCCN criteria for very high risk prostate cancer?
T3b and number of positive cores with GG4 disease are no longer criteria used to qualify patients for intensified hormone blockade, what rationale went into this change?
Answer from: Radiation Oncologist at Community Practice
As the new Chair of NCCN's Prostate Cancer Guidelines, I am happy to answer this.The purpose of risk groups is not merely to be a prognostic divider, but to help guide treatment. Many systems have been developed that have greater prognostication than NCCN risk groups, such as STAR-CAP (which is supe...
Answer from: Radiation Oncologist at Academic Institution
It looks like the panel decided to define very high risk using eligibility criteria from the STAMPEDE M0 results (James et al., PMID 28578639) that established a benefit for intensifying systemic therapy with abiraterone. This makes a lot of sense to me because we want our risk groups to be tied to ...