How to cite: Garnick MB. Guidelines for Management of Advanced PC: NCCN and Beyond. Grand Rounds in Urology. September 15, 2025. Accessed Jan 2026. https://grandroundsinurology.com/guidelines-for-management-of-advanced-pc-nccn-and-beyond/
Summary
Marc B. Garnick, MD, Gorman Brothers Professor of Medicine at Harvard Medical School, Boston, Massachusetts, highlights the evolving landscape of advanced prostate cancer management, particularly as it relates to the integration of novel therapies into standard care pathways. Dr. Garnick notes that the NCCN guidelines continue to adapt to incorporate new clinical trial evidence, balancing treatment efficacy with patient quality of life.
Dr. Garnick addresses patient stratification based on disease stage and molecular characteristics, recommendations for systemic therapy, and the importance of sequencing androgen receptor-targeted agents, chemotherapy, and radiopharmaceuticals. He highlights areas where evidence is robust, as well as those requiring additional research.
Dr. Garnick also considers the role of multidisciplinary management, as the collaboration between urologists, oncologists, and radiation oncologists is critical for optimizing patient outcomes. He stresses that decision-making should account for individual patient values, comorbidities, and preferences, particularly given the potential toxicities associated with advanced therapies.
Dr. Garnick emphasizes the need for continued clinical trial enrollment, real-world data collection, and refinement of biomarkers to improve the personalization of care for men with advanced prostate cancer.
The Global Summit on Precision Diagnosis and Treatment of Prostate Cancer is a unique multi-disciplinary forum organized to inform the key health care stakeholders about the emerging advances in clinical case and research and create a consensus-based vision for the future of precision care and educational and research strategy for its realization. The mission of the Summit is to fill the currently existing gap between the key experts of in vivo imaging, the world authorities in the in vitro fluid- and tissue-based molecular diagnostics, including genomics, and thought leaders in the development of novel observation strategies (e.g., active surveillance, or AS) and therapeutic interventions.
ABOUT THE AUTHOR
Marc B. Garnick, MD, is the Gorman Brothers Professor of Medicine at Harvard Medical School in Boston, Massachusetts. Additionally, Dr. Garnick directs the hospital’s role as a tertiary cancer center for the Beth Israel Deaconess Medical Center in Boston. He has dedicated his career to the development of new therapies for prostate cancer.
