Prostate Cancer, Version 3.2026, NCCN Clinical Practice Guidelines In Oncology
Abstract
The NCCN Guidelines for Prostate Cancer provide a framework on which to base decisions for patients with prostate cancer across the disease spectrum. The Guidelines sections included in this article focus on metastatic castration-sensitive prostate cancer (mCSPC), nonmetastatic castration-resistant prostate cancer (CRPC), and metastatic CRPC (mCRPC). For patients with mCSPC, disease characteristics, such as whether metastases arose synchronously or metachronously and the degree of metastatic burden, impact therapy decisions, including how much treatment intensification is appropriate and when prostate-directed and/or metastasis-directed therapy should be considered. In the mCRPC setting, androgen deprivation therapy is continued with the sequential or concurrent addition of certain androgen receptor pathway inhibitors, chemotherapies, immunotherapies, radiopharmaceuticals, and/or targeted therapies. The NCCN Prostate Cancer Panel emphasizes a shared decision-making approach in all disease settings based on patient preferences, prior treatment exposures, biomarkers, the extent and location of metastases, symptoms, and potential side effects.
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Current guidelines support both germline and somatic panel-based sequencing for men with metastatic prostate cancer because these tests can identify molecular alterations linked to approved or potentially actionable therapies.
“Current guidelines support both germline and somatic panel-based sequencing for men with metastatic prostate cancer because these tests can identify molecular alterations linked to approved or potentially actionable therapies [2, 3].”
From A decision-oriented framework for genomic testing across the prostate cancer continuum (2026) · cites this paper as [3]
Traditional risk stratification using prostate-specific antigen, grade group, and stage incompletely captures tumor biology and does not fully explain heterogeneity within nominal clinical risk groups.
“Traditional risk stratification using prostate-specific antigen, grade group, and stage remains indispensable; however, these measures incompletely capture tumor biology and do not fully explain the heterogeneity observed within nominal clinical risk groups [2, 3].”
From A decision-oriented framework for genomic testing across the prostate cancer continuum (2026) · cites this paper as [3]
These findings support broader genomic evaluation strategies, particularly in high-risk and metastatic settings.
“These findings support broader genomic evaluation strategies, particularly in high-risk and metastatic settings [2, 3].”
From A decision-oriented framework for genomic testing across the prostate cancer continuum (2026) · cites this paper as [3]
Mainstreaming models, in which oncology teams initiate germline testing and genetics specialists focus on complex counseling or management of positive results, are becoming increasingly important as testing demand expands.
“Operationally, mainstreaming models, in which oncology teams initiate germline testing and genetics specialists focus on complex counseling or management of positive results, are becoming increasingly important as testing demand expands [3].”
From A decision-oriented framework for genomic testing across the prostate cancer continuum (2026) · cites this paper as [3]
Cited by
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A decision-oriented framework for genomic testing across the prostate cancer continuum
Cobran, E. K., Samadder, N. J., Schaid, D. J., Conti, D. V., Haiman, C., Vargas, L., Gionfriddo, M. R., & Tilburt, J. C. (2026) · Cancer Genetics · doi:10.1016/j.cancergen.2026.06.002 · Cited by 1 · see citing works
- Authors
- Spratt, D. E., Srinivas, S., Adra, N., Ahmed, B., An, Y., Bitting, R., Chapin, B., Cheng, H. H., Cho, S. Y., D’Amico, A. V., Desai, N., Dorff, T., Eastham, J. A., Farrington, T. A., Gao, X., Gupta, S., Ippolito, J. E., Karnes, R. J., Kishan, A., Kuettel, M. R., Lang, J. M., Lee, D., Lotan, T., McDonald, A., Morgan, T., Pessoa, R., Rais-Bahrami, S., Roach, M., Robin, T., Rosenfeld, S., Scarpato, K. R., Shabsigh, A., Szmulewitz, R., Teply, B. A., Tward, J., Valicenti, R., VanderWeele, D., Wong, J. K., Kovach, E., & Freedman-Cass, D.
- Affiliations
- Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
- Stanford Cancer Institute
- Indiana University Melvin and Bren Simon Comprehensive Cancer Center
- The University of Tennessee Health Science Center
- Yale Cancer Center/Smilow Cancer Hospital
- Duke Cancer Institute
- The University of Texas MD Anderson Cancer Center
- Fred Hutchinson Cancer Center
- University of Wisconsin Carbone Cancer Center
- Dana-Farber/Brigham and Women’s Cancer Center | Mass General Cancer Center
- UT Southwestern Simmons Comprehensive Cancer Center
- City of Hope National Cancer Center
- Memorial Sloan Kettering Cancer Center
- Prostate Health Education Network (PHEN)
- Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
- Mayo Clinic Comprehensive Cancer Center
- UCLA Jonsson Comprehensive Cancer Center
- Roswell Park Comprehensive Cancer Center
- Abramson Cancer Center at The University of Pennsylvania
- Johns Hopkins Kimmel Cancer Center
- O’Neal Comprehensive Cancer Center at UAB
- University of Michigan Rogel Cancer Center
- Moffitt Cancer Center
- UCSF Helen Diller Family Comprehensive Cancer Center
- University of Colorado Cancer Center
- University of California San Francisco Patient Services Committee Chair
- Vanderbilt-Ingram Cancer Center
- The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
- The UChicago Medicine Comprehensive Cancer Center
- Fred & Pamela Buffett Cancer Center
- Huntsman Cancer Institute at the University of Utah
- UC Davis Comprehensive Cancer Center
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University
- Fox Chase Cancer Center
- National Comprehensive Cancer Network
- Venue
- Journal of the National Comprehensive Cancer Network
- Publisher
- Harborside Press, LLC
- Published
- 2025-11
- Volume
- 23
- Issue
- 11
- Pages
- 469-493
- ISSN
- 1540-1405
- 1540-1413
- Cited by
- 146
- References
- 0
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