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Review
. 2025 Feb;23(1):102292.
doi: 10.1016/j.clgc.2024.102292. Epub 2024 Dec 16.

Clinical, Diagnostic and Therapeutic Framework of mHSPC and nmCRPC: A Multidisciplinary Consensus Project of the Italian Society for Uro-Oncology (SIUrO)

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Free article
Review

Clinical, Diagnostic and Therapeutic Framework of mHSPC and nmCRPC: A Multidisciplinary Consensus Project of the Italian Society for Uro-Oncology (SIUrO)

Rolando Maria D'Angelillo et al. Clin Genitourin Cancer. 2025 Feb.
Free article

Abstract

The recent evidences provided in metastatic hormone sensitive prostate cancer (nmHSPC) and in nonmetastatic castration resistant (nmCRPC) introduced the possibility to adopt Androgen Receptor Signaling inhibitor (ARSi) alone (both settings) or with chemotherapy (in mHSPC). In daily clinical practice there are some opening questions regarding the inclusion of next generation imaging, mainly PSMA-PET, how integrate local treatment as radiotherapy, how to select patients or drugs in a multiple-choice scenario, and how to manage patients with comorbidities and polypharmacy. These issues led the Italian Society for Uro-Oncology (SIUrO) to develop a consensus project involving all of the most important Italian scientific societies engaged in the multidisciplinary and multiprofessional management of the disease. This paper describes the items and statements approved, with the aim to support clinicians in managing metastatic hormone sensitive and nonmetastatic castration resistant prostate cancer patients.

Keywords: ARSI; Metastatic de novo; Multimodality treatment; PSMA-PET; Prostate cancer.

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Conflict of interest statement

Disclosure Nicolò Borsellino declares grants or contracts from Merck Serono and Pfizer; consulting fees from Bayer and Ipsen; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from A.A.A./Novartis, Recordati industria chimica e farmaceutica, Ipsen, Amgen, AstraZeneca and MSD. Sergio Bracarda declares support for attending meetings and/or travel from MSD, Bayer, Pfizer; participation on a Data Safety Monitoring Board or Advisory Board for Bayer, Astellas, Janssen, Ipsen, Novartis, AstraZeneca. Orazio Caffo declares payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Astellas, Astra Zeneca, Bayer, Janssen, Ipsen, MSD, Pfizer, Recordati; support for attending meetings and/or travel from Janssen, MSD, Ipsen; participation on a Data Safety Monitoring Board or Advisory Board for Astellas, Astra Zeneca, Bayer, MSD, Pfizer. Giuseppe Ferdinando Colloca declares unpaid leadership or fiduciary role in other board, society, committee or advocacy group for Gioger Gruppo italiano oncogeriatria and SIGG società italiana geriatria e gerontologia. Giario Natale Conti declares grants or contracts from Astellas, Janssen, Bayer–Orion, Ipsen, MSD, Recordati, Astrazeneca. Rolando M. D'Angelillo declares payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Astellas, Janssen, Ipsen, Orion, AstraZeneca, Merck Serono; support for attending meetings and/or travel from Elekta, Tecnologie Avanzate, Tema Sinergie; participation on a Data Safety Monitoring Board or Advisory Board for Astellas, Bayer, Ferring, Janssen, Recordati. Marzia del Re declares consulting fees from Astellas, AstraZeneca, Celgene, Novartis, Pfizer, Bio-Rad, Janssen, Sanofi Aventis, Roche, MSD, Lilly, Ipsen; participation on a Data Safety Monitoring Board or Advisory Board for AstraZeneca, MSD, IPSEN, Janssen, Sanofi-Aventis, Amgen. Stefano Fanti declares grants or contracts from Amgen, Telix; consulting fees from AAA, Amgen, Novartis, Telix, Janssen; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from AAA, Novartis, Bayer, Telix, Astra Zeneca, Janssen; support for attending meetings and/or travel from AAA, Bayer, Novartis, Telix; participation on a Data Safety Monitoring Board or Advisory Board for AAA, Novartis. Barbara Alicja Jereczek-Fossa declares grants or contracts from ACCURAY, AIRC, IBA, Fondazione IEO-CCM; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from ACCURAY, ASTELLAS PHARMA, BAYER, ASTRA ZENECA, IBA, IPSEN, TECNOLOGIE AVANZATE, RECORDATI, NOVARTIS, ELSEVIER, ESO, ESTRO; participation on a Data Safety Monitoring Board or Advisory Board for IPSEN, ASTRA ZENECA, BAYER, SEAGEN, ASTELLAS PHARMA. Alberto Lapini declares payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from MSDR, ASTRA ZENECA; participation on a Data Safety Monitoring Board or Advisory Board for MEDAC, BAYER. Giovanni Pappagallo declares consulting fees from Astellas, Bayer, Astrazeneca, MSD. Tommaso Prayer Galetti declares payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Curium; support for attending meetings and/or travel from Ipsen, Recordati. All the other authors do not have any conflicts of interest.

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