Dr Shore on the Importance of Addressing Gaps in Prostate Cancer Management

“Ultimately, the overarching goal is to refine therapeutic recommendations to optimize patient outcomes and advance the standard of care.”

Neal Shore, MD, FACS, medical director for the Carolina Urologic Research Center, discussed the significance of the 2025 Bridging the Gaps in Prostate Cancer meeting and highlighted the need for additional research to improve the multidisciplinary treatment of patients with high-risk localized prostate cancer.

The Bridging the Gaps meeting was a critical forum for addressing existing divides in the treatment of patients with prostate cancer across disciplines, Shore began. Significant unmet needs remain across aspects of prostate cancer clinical practice, particularly due to variations in specialty focus, geographical practice settings—like urban, suburban, rural, and academic centers—and institutional resources, he emphasized. This diversity necessitates ongoing discussions to harmonize treatment approaches across specialties, including radiation oncology, nuclear medicine, medical oncology, and urology, he explained. Given that there are no universal treatment approaches for patients with prostate cancer, the need for tailored therapeutic strategies is high, he said.

A key focus of the meeting was the importance of identifying clinical trial priorities and optimizing the real-world implementation of emerging therapies, Shore noted. The ability to engage in critical discourse, challenge differing perspectives, and question assumptions fosters a dynamic exchange of ideas, he stated. This process allows for the examination of various treatment strategies, the evaluation of their clinical efficacy, and, in cases of inconclusive consensus, the recognition of areas where further evidence is required, he reported.

One critical area of discussion at the meeting was the optimal management of high-risk localized prostate cancer, according to Shore. Although currently available interventions—including radiation therapy and radical prostatectomy—have achieved reasonable efficacy, disease progression persists, he explained. Consequently, refining peri-procedural strategies remains an urgent priority, he noted. The role of neoadjuvant and adjuvant therapies is under evaluation, with particular interest in androgen receptor pathway inhibition, testosterone suppression, and multimodal combination approaches, Shore emphasized. Determining the appropriate sequence of these interventions also remains an area of active investigation, with potential distinctions between radiation-based and surgical-based treatment paradigms, he continued.

Furthermore, the meeting underscored the importance of biomarkers and advanced imaging modalities in guiding clinical decision-making, Shore stated. However, the precise role of biomarkers in risk stratification, treatment selection, and patient monitoring remains an area of ongoing debate, he said. Ultimately, the overarching goal of multidisciplinary collaboration is to refine therapeutic recommendations to optimize patient outcomes and advance the standard of care, Shore concluded.