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mCRPC Decision Support Tool
Interactive Decision Support Tool: Expert Treatment Guidance for Metastatic Castration Resistant Prostate Cancer

ABIM MOC: maximum of 0.25 Medical Knowledge MOC point

Physicians: Maximum of 0.25 AMA PRA Category 1 Credit

Released: October 15, 2025

References

Abiraterone [prescribing information]. Horsham, PA: Janssen Biotech, Inc; 2024.

Agarwal N, Azad AA, Carles J, et al. Talazoparib plus enzalutamide in men with first-line metastatic castration-resistant prostate cancer (TALAPRO-2): a randomised, placebo-controlled, phase 3 trial. Lancet. 2023;402:291-303.

Alabi BR, Liu S, Stoyanova T. Current and emerging therapies for neuroendocrine prostate cancer. Pharmacol Ther. 2022;238:108255.

Apalutamide [prescribing information]. Horsham, PA: Janssen Biotech, Inc; 2024.

Chi KN, Rathkopf D, Smith MR, et al. Niraparib and abiraterone acetate for metastatic castration-resistant prostate cancer. J Clin Oncol. 2023;41:3339-3351.

Clarke NW, Armstrong AJ, Thiery-Vuillemin A, et al. Abiraterone and olaparib for metastatic castration-resistant prostate cancer. NEJM Evid. 2022;1.

Darolutamide [prescribing information]. Whippany, NJ: Bayer HealthCare Pharmaceuticals Inc; 2025.

Enzalutamide [prescribing information]. Northbrook, IL: Astellas Pharma Inc; 2025.

Dostarlimab [prescribing information]. Durham, NC; GlaxoSmithKline; 2024.

Gallium Ga 68 gozetotide [prescribing information]. East Hanover, NJ; Novartis; 2025.

Kuo PH, Calais J, Crosby M. PSMA PET imaging in the management of patients with metastatic castration-resistant prostate cancer treated with radioligand therapy. Target Oncol. 2025;20:597-613.

Lowrance W, Dreicer R, Jarrard DF, et al. Updates to advanced prostate cancer: AUA/SUO guideline (2023). J Urol. 2023;209:1082- 1090.

Lutetium-177-PSMA-617 [prescribing information]. Millburn, NJ: Advanced Accelerator Applications USA, Inc; 2025.

National Comprehensive Cancer Network. Clinical practice guidelines in oncology: prostate cancer. v.1.2026. nccn.org. Accessed October 9, 2026.

Niraparib and abiraterone acetate [prescribing information]. Horsham, PA: Janssen Biotech, Inc; 2023.

Olaparib [prescribing information]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; 2025.

Patel KG, Chugh N, Tripathi M. Neuroendocrine differentiation of prostate cancer—an intriguing example of tumor evolution at play. Cancers (Basel). 2019;11:1405.

Pembrolizumab [prescribing information]. Rahway, NJ: Merck & Co., Inc.:2025.

Radium-223 [prescribing information]. Whippany, NJ: Bayer Healthcare Pharmaceuticals. Inc; 2019.

Saad F, Bögemann M, Suzuki K, et al. Treatment of nonmetastatic castration-resistant prostate cancer: focus on second-generation androgen receptor inhibitors. Prostate Cancer Prostatic Dis. 2021;24:323-334.

Saad F. Clarke NW, Oya M, et al. Olaparib plus abiraterone versus placebo plus abiraterone in metastatic castration-resistant prostate cancer (PROpel): final prespecified overall survival results of a randomised, double-blind, phase 3 trial. Lancet Oncol. 2023;24:1094-1108

Seifer R, Emmett L, Rowe SP, et al. Second version of the prostate cancer molecular imaging standardized evaluation framework including response evaluation for clinical trials (PROMISE V2). Eur Urol. 2023;83:405-412.

Talazoparib [prescribing information]. New York, NY: Pfizer Labs; 2023.

Wenzel M, Hoeh B, Humke C, et al. Assessment of different castration resistance definitions and staging modalities in metastatic castration-resistant prostate cancer. Cancers (Basel). 2024;16:3506.

Yamada Y, Beltran, H. Clinical biological features of neuroendocrine prostate cancer. Curr Oncol Rep. 2021;23:15.

Zhang P, Chen T, Yang M. Clinical features and gene expression analysis in low prostate-specific antigen, high-grade prostate cancer. PLoS One. 2025;20:e0321728.

Access to and use of this Interactive Decision Support Tool titled, "Interactive Decision Support Tool: Expert Treatment Guidance for Metastatic Castration Resistant Prostate cancer" is provided subject to the following terms and conditions. PLEASE READ THESE TERMS CAREFULLY.

This Interactive Decision Support Tool is designed to educate healthcare professionals on making optimal management choices for treating patients with mCRPC. The information provided is based on guideline recommendations and expert guidance of Tanya B. Dorff, MD; Shilpa Gupta, MD; Rana R. McKay, MD, FASCO; Alicia K. Morgans, MD, MPH, FASCO; and Neal D. Shore, MD, FACS.

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