Mary Dunn, MSN, NP-C, OCN, RN, on advances reshaping advanced prostate cancer care

In this video, Mary Dunn, MSN, NP-C, OCN, RN, of the University of North Carolina, Chapel Hill, discusses recent advances in advanced prostate cancer care, including earlier use of systemic therapies, treatment of high-risk biochemical recurrence, risk-stratified approaches to metastatic hormone-sensitive disease, and the evolving role of PSMA-PET and PARP inhibitors.

Dunn highlights the shift toward incorporating systemic treatment earlier in the prostate cancer treatment algorithm, including for patients with very high-risk localized disease. She emphasizes that these advances make it increasingly important for urologists and urology advanced practice providers to become familiar with newer systemic therapies. She also discusses the emerging role of treatment for select patients with high-risk biochemical recurrence after salvage options have been exhausted, noting evidence from the EMBARK trial supporting androgen deprivation therapy (ADT) plus enzalutamide (Xtandi) in appropriate patients.

For patients with metastatic hormone-sensitive prostate cancer, Dunn describes the growing importance of risk stratification to guide treatment selection between doublet therapy with ADT plus an androgen receptor pathway inhibitor and triplet therapy adding docetaxel. She also highlights the ongoing evolution of PSMA-PET as a tool for staging and surveillance and points to continued research into treatment strategies for patients with germline or somatic genomic alterations, including the expanding role of PARP inhibitors. These developments, reflected in the 2026 AUA/SUO Advanced Prostate Cancer Guideline, underscore the increasingly individualized nature of advanced prostate cancer management.