Case-Based Discussion: Early M1 CRPC and Advanced M1 CRPC Podcast (2021)

As a direct result of the significant increase in multiple FDA-approved therapeutic agents for use in patients with advanced prostate cancer, clinicians are challenged with a multitude of treatment options and potential sequencing of these agents that, consequently, make clinical decision-making more complex. This activity will build upon the newly updated 2020 AUA Guidelines on Metastatic Hormone Sensitive Prostate Cancer (HSPC) and Castration-Resistant Prostate Cancer (CRPC). Topics will include the latest on Genetic Testing in Advanced Prostate Cancer and the Role of Immunotherapy and PARP Inhibitors. 

To extend the educational reach, the AUA will capture the live case study discussions and develop three podcasts with a faculty interview segment. This activity will focus on the following topics: 

Early M1 CRPC & Advanced M1 CRPC

Presented by Kelly Stratton, MD and Deborah Kaye, MD


Support provided by independent educational grants from:

  • Amgen
  • Astellas
  • AstraZeneca
  • Bayer HealthCare Pharmaceuticals Inc.
  • Exact Sciences Corporation
  • Merck
  • Pfizer, Inc.
  • Sanofi Genzyme

Target Audience

  • Urologist
  • Resident
  • Advanced Practice Provider (Nurse Practitioners & Physician Assistants)
  • Nurse

Learning Objectives

At the conclusion of this activity, participants will be able to:  


  1. Describe the natural course of advanced prostate cancer from non-metastatic (M0) to metastatic hormone-sensitive disease (mHSPC), with progression to the development of castration-resistant disease (CRPC).
  2. Describe the treatment options and outcomes for patients with biochemical recurrence after failed local therapy.
  3. Identify available imaging and indications for use including next generation PET imaging in the assessment of men with biochemical recurrence after failed local therapy.
  4. Describe the treatment options and outcomes for newly diagnosed mHSPC.
  5. Explain the implications of CRPC on the management of both M0 and M1.
  6. Discuss the molecular mechanisms and characterization of CRPC.
  7. Discuss the incorporation of genetic testing (both germline and somatic testing) into the management of men with high risk, metastatic prostate cancer and CRPC.


  1. Discuss specific recommendations within the AUA Clinical Practice Guidelines.
  2. Define M0 CRPC and the treatment options.
  3. Discuss clinically meaningful endpoints in clinical trials of patients with M0 CRPC.
  4. Describe gaps in the knowledge for treatment and sequencing of agents in the management of CRPC.
  5. Discuss challenges in incorporating AUA Guidelines and management of advanced mHSPC and CRPC into community practice.


  1. Identify approved androgen biosynthesis and receptor blockers for treatment of CRPC.
  2. Appraise the clinical use and efficacy of approved androgen-axis therapeutics for CRPC.
  3. Anticipate, manage and treat adverse events from therapeutic interventions directed at the androgen-axis used in the treatment of CRPC.
  4. Discuss new uses for androgen axis agents in M0 CRPC.


  1. Identify approved chemotherapeutics, immunotherapy and PARP Inhibitors for mCRPC.
  2. Describe indications and contraindications for chemotherapy, immunotherapy and PARP Inhibitors in patients with mCRPC.
  3. Identify co-morbid states and recognize their impact on treatment options for mCRPC.
  4. Identify germline and somatic mutations and implications for treatment in mCRPC including indications for PAPR Inhibitors and pembrolizumab.
  5. Discuss treatment sequencing in the advanced, metastatic and CRPC disease state.


  1. Integrate advances in bone health management into patient-specific care plans.
  2. Identify patients and prescribe radionuclide therapy in appropriate patients with symptomatic mCRPC.
  3. Discuss known adverse events associated with androgen biosynthesis inhibitors and radionuclide therapy.


  1. Assess and manage pain in patients with symptomatic mHSPC and mCRPC.
  2. Discuss the role of chemotherapy, performance status and pain management in patients with mCRPC.
  3. Review the role of palliative care and supportive services in the management of late stage CRPC.
Course summary
Available credit: 
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 Non-Physician Participation
Course opens: 
Course expires: 

Education Council Disclosures

PDF iconEducation Council Disclosures_ June 2021.pdf

COI Review Work Group Disclosures

PDF iconCOI Review Work Group Disclosures 2021.pdf

Faculty Disclosures

NameCompany NameRelationship TypeFinancialEnd Date
Cookson, Michael S.TesoRx Pharma LLCConsultant or AdvisorYes09/15/2021
Cookson, Michael S.Astellas Pharma, Inc.Consultant or AdvisorYes12/01/2020
Cookson, Michael S.Bayer Healthcare PharmaceuticalsConsultant or AdvisorYes12/01/2021
Cookson, Michael S.Myovant SciencesConsultant or AdvisorYes11/30/2020
Cookson, Michael S.MerckConsultant or AdvisorYesCurrent
Jarrard, David F.Nothing to disclose   
Kaye, DeborahNothing to disclose   
Stratton, Kelly L.EbixConsultant or AdvisorYes02/21/2023
Stratton, Kelly L.OakstoneConsultant or AdvisorYes08/11/2022
Stratton, Kelly L.Astellas PharmaScientific Study or TrialYes02/01/2021
Stratton, Kelly L.Myovant SciencesScientific Study or TrialYes01/07/2021
Stratton, Kelly L.MJH Life SciencesConsultant or AdvisorYes09/14/2021
Stratton, Kelly L.Janssen PharmaceuticalsConsultant or AdvisorYes11/30/2023
Stratton, Kelly L.MJH Life SciencesMeeting Participant or LecturerYes12/31/2021
Stratton, Kelly L.Roche/GenentechMeeting Participant or LecturerYesCurrent

AUA Office of Education Staff has nothing to disclose.

All relevant financial relationships have been mitigated.


Learners will participate in this online educational activity by taking the pretest, listening to the podcast and completing the posttest and evaluation. To claim CME credit for this enduring material, learners must complete the posttest, passing with 80% accuracy and submit the program evaluation.

Estimated time to complete this activity: 1.00 hours

Release Date: October 2021
Expiration Date: October, 2022


The American Urological Association (AUA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.


The American Urological Association designates this enduring material for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


The AUA is not accredited to offer credit to participants who are not MDs or DOs. However, the AUA will issue documentation of participation that states that the activity was certified for AMA PRA Category 1 Credit™.


It is the policy of the AUA to ensure that the content contained in this CME activity is valid, fair, balanced, scientifically rigorous, and free of commercial bias.


All persons in a position to control the content of an educational activity (i.e., activity planners, presenters, authors) are required to disclose to the provider all financial relationships with any commercial interest (aka ineligible company) during the previous 24 months. The AUA must determine if the individual’s relationships may influence the educational content and mitigate any conflicts of interest prior to the commencement of the educational activity. The intent of this disclosure is not to prevent individuals with relevant financial relationships from participating, but rather to provide learners information with which they can make their own judgments.


All disclosures will be reviewed by the AUA Conflict of Interest (COI) Review Work Group for identification of conflicts of interest. The AUA COI Review Work Group, working with the program directors and/or editors, will document the mechanism(s) for management and mitigation of the conflict of interest and final approval of the activity will be documented prior to implementation. Any of the mechanisms below can/will be used to mitigate conflict of interest:

  • Peer review for valid, evidence-based content of all materials associated with an educational activity by the course/program director, editor, and/or AUA COI Review Work Group.
  • Limit content to evidence with no recommendations
  • Introduction of a debate format with an unbiased moderator (point-counterpoint)
  • Inclusion of moderated panel discussion
  • Publication of a parallel or rebuttal article for an article that is felt to be biased
  • Limit equipment representatives to providing logistics and operation support only in procedural demonstrations
  • Divestiture of the relationship by faculty


The audience is advised that this continuing medical education activity may contain reference(s) to off-label or unapproved uses of drugs or devices. Please consult the prescribing information for full disclosure of approved uses.


Disclaimer: The opinions and recommendations expressed by faculty, authors and other experts whose input is included in this program are their own and do not necessarily represent the viewpoint of the AUA.

Consent to Use of Photographic Images: Attendance at or participation in AUA meetings and other activities constitutes an agreement by the registrant to AUA's use and distribution (both now and in the future) of the attendee's image or voice in photographs and electronic reproductions of such meetings and activities.

Audio, Video and Photographic Equipment: The use of audio, video and other photographic recording equipment by attendees is prohibited inside AUA meeting rooms.

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Available Credit

  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 Non-Physician Participation
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