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Newer MRI techniques are being tested to improve the accuracy of prostate cancer diagnosis. Three presentations during the 2018 American Urological Association Annual Meeting discussed potential approaches to reduce the need for prostate biopsies for men with prostate cancer

Three presentations during the 2018 American Urological Association Annual Meeting in San Francisco, California, together demonstrated the potential and utility of different assays to identify prostate cancer and guide treatment decisions for patients with prostate cancer. Each assay suggested a simpler and more cost-effective tool for guiding decision making in prostate cancer than immediate tissue biopsy.

Risk stratification to guide molecular testing and treatment is emphasized in the latest prostate cancer guidelines from the NCCN. Recommendations for germline testing, molecular testing, and initial therapy have been developed for each risk category, each of which has its own management page in the newest version of the NCCN guidelines.

Patients with prostate cancer and DNA damage repair defects could be candidates for therapy involving poly polymerase inhibitors, and there is strong justification for activating clinical trials in this space, according to Maha Hussain, MD, the Genevieve Teuton Professor of Medicine and deputy director of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University.

Updated results from the phase II LuPSMA study published in<em> The Lancet Oncology </em>showed radionuclide treatment with&nbsp;Lutetium-177 [<sup>177</sup>Lu]-PSMA-617 nearly doubled median PSA progression-free survival in men with progressive metastatic castrate-resistant prostate cancer compared with previous results with another radiopharmaceutical, radium-223.

Molecular tumor profiling is rapidly driving personalized medicine within oncology. The value of identifying a targetable mutation using next-generation sequencing for available therapies or clinical trials cannot be underestimated.&nbsp;Herein, we review essential considerations in the initial assessment, specialty referral, and sequencing of treatment for advanced prostate cancer with an identified actionable mutation.