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

PRACTICE GAP #1 (DISEASE STATE)

1. Recognize the natural course of advanced prostate cancer from biochemical recurrence to metastatic hormone-sensitive disease (mHSPC), with progression to the development of non-metastatic (M0CRPC) and metastatic castration-resistant disease (mCRPC).
2. Analyze the risk stratification, treatment options, goals of therapy and outcomes for patients with biochemical recurrence after failed local therapy.
3. Develop a plan to determine metastatic disease in unfavorable intermediate and high-risk patients and to detect and localize lesions at biochemical recurrence after failed local therapy utilizing available imaging and, where indicated, advanced imaging including PSMA PET for staging.
4. Describe the risk and volume stratification, treatment options, goals of therapy and outcomes for newly diagnosed mHSPC including treatment intensification with doublet and triple therapy (novel hormonal therapy agents and/or chemotherapy).
5. Manage the implications of CRPC on both M0 and M1, including sequencing of agents and combination therapy.
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 and implications for treatment.
8. Explain the role of precision-based medicine in the treatment of men with advanced prostate cancer (APC).

PRACTICE GAP #2 (GUIDELINES)

1. Adjust methods for treatment of APC based on the AUA/SUO Advanced Prostate Cancer Guidelines.
2. Determine the impact of new FDA-approved agents on the management of men with APC.
3. Discuss M0 CRPC, treatment options and goals of therapy.
4. Interpret clinically meaningful endpoints in clinical trials of patients with BCR and M0 CRPC.
5. Counsel patients on available treatment options for CRPC including sequencing of agents.
6. Analyze challenges in incorporating AUA APC Guidelines and management of BCR, mHSPC and CRPC into community practice.

PRACTICE GAP #3 (ANDROGEN AXIS)

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

PRACTICE GAP #4 (CHEMOTHERAPY, IMMUNOTHERAPY, PARP INHIBITORS AND THERANOSTICS and COMORBIDITIES)

1. Identify approved chemotherapeutics, immunotherapy, PARP Inhibitors and theranostics for mCRPC.
2. Describe indications and contraindications for chemotherapy, immunotherapy, PARP Inhibitors and theranostics 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 PARP Inhibitors.
5. Select proper candidates for theranostic therapy using novel PSMA PET imaging. 24. Utilize treatment sequencing in the advanced, metastatic and CRPC disease state.

PRACTICE GAP #5 (BONE HEALTH AND RADIONUCLIDE THERAPY)

1. Integrate advances in bone health management into patient-specific care plans.
2. Recommend and prescribe radionuclide therapy in appropriate patients with symptomatic mCRPC.
3. Address known adverse events associated with radionuclide therapy. PRACTICE GAP #6 (PAIN MANAGEMENT AND PALLIATIVE CARE)
4. Assess and manage pain in patients with symptomatic mHSPC and mCRPC.
5. Analyze the role of chemotherapy, performance status and pain management in mCRPC.
6. Determine the role of palliative care and supportive services in the management of late stage CRPC.