Daniel Vaena, MD, medical oncologist and hematologist, West Cancer Center, discusses the importance of risk stratification in prostate cancer.

It is important to remember that patients need to be carefully selected for treatment based on risk stratification, says Vaena. There are many new therapeutic agents available to patients with metastatic disease and castration-naïve disease; however, risk stratification can help physicians understand the potential benefits of each therapy. In the most recent trials conducted to date, patients were stratified based on burden of disease.

As there is no uniform rule for how patients should be treated, it is important to acknowledge a patient’s burden of disease before proceeding with therapy. The same holds true for patients with nonmetastatic prostate cancer, adds Vaena. Trials performed in this patient population selected treatment based on several features, including prostate specific antigen doubling times. The current recommendations and approvals do not necessarily apply to all patients with nonmetastatic disease, Vaena warns.

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