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Cancers & treatments·Sequencing

Biochemical recurrence of prostate cancer: lines of therapy

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4 standard-of-care settings across 2 lines and 3 biomarker subgroups. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.

LineAll comersPSMARisk group
Second line111
Other settings1··

Second line

SubgroupSettingApproachProducts and trialsEvidence
All comersAfter radiotherapy, local recurrenceSalvage prostatectomy, brachytherapy, cryotherapy or high-intensity focused ultrasound in fit men with biopsy-proven local disease and no metastases on PSMA PET.
Robotic & minimally invasive surgeryBrachytherapyFocused ultrasound & histotripsyPSMA PET
96
PSMAPSMA PET-detected oligorecurrenceStereotactic radiotherapy to the visible metastases, usually within trials or with hormone therapy; the survival benefit is unproven.
SBRT / SABR (stereotactic radiotherapy)Oligometastatic diseasePSMA-PET-guided metastasis-directed therapy as a curative strategy in oligorecurrent prostate cancer
40
Risk groupHigh-risk biochemical recurrence (doubling time under 9 months)Enzalutamide with leuprolide, or enzalutamide alone (EMBARK); PSMA PET before starting; intermittent therapy with treatment suspension when PSA becomes undetectable.
EnzalutamideLeuprolide (leuprorelin) and GnRH agonistsEMBARKPSMA PET
96

Other settings

SubgroupSettingApproachProducts and trialsEvidence
All comersAfter prostatectomyEarly salvage radiotherapy to the prostate bed, with or without pelvic nodes and four to six months of androgen deprivation for adverse features; observation for slow doubling times.
IMRT / IGRT (modern external beam)Androgen deprivation & AR pathway inhibitorsPSA (prostate-specific antigen)Decipher Prostate
95

Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.