{"entity":{"id":"biochemical-recurrence","kind":"term","name":"Biochemical recurrence (BCR)","aka":[],"tldr":"PSA rising again after surgery or radiation, usually years before anything shows on a scan.","summary":"Biochemical recurrence is a rising PSA after treatment for prostate cancer, usually years before anything is visible on a scan. It is defined as a PSA of 0.2 ng/mL or more after prostatectomy, or a rise of 2 ng/mL above the nadir after radiation. PSMA PET, with agents such as fluciclovine F-18 and Illuccix, can now find the recurrent disease at very low PSA levels in most men, opening the way to salvage radiation or metastasis-directed therapy. The EMBARK trial, reported in 2023, showed that enzalutamide with or without androgen deprivation delays metastasis in high-risk recurrence defined by a short PSA doubling time. The term is linked from the PSA entry and from ideas on PSMA-PET-guided metastasis-directed therapy and on localising residual disease.","asOf":"2026-09-06","wikipedia":"https://en.wikipedia.org/wiki/Biochemical_recurrence","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Biochemical_recurrence"},{"label":"NICE NG131: prostate cancer, diagnosis and management","url":"https://www.nice.org.uk/guidance/ng131/chapter/Recommendations"}],"tags":[],"related":[],"cancers":["prostate"],"sections":[],"technologies":["psma-pet"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["embark"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":["NICE NG131 (1.3.57) says to offer radical radiotherapy to the prostatic bed for people with biochemical relapse after radical prostatectomy with no known metastases, (1.3.54) not to offer routine MRI before salvage radiotherapy but to offer an isotope bone scan where symptoms or PSA trends suggest metastases, and (1.3.58) to consider entry to appropriate clinical trials. NG131 (1.3.52) says not to biopsy the prostatic bed after prostatectomy, and (1.3.53) to biopsy the prostate after radiotherapy only where salvage therapy in a trial is possible."],"category":"Clinical"},"route":"/terms/biochemical-recurrence/","neighbours":{"cancer":[{"id":"prostate-high-risk","kind":"cancer","name":"Localised prostate cancer, high and very high risk","route":"/cancers/prostate-high-risk/"},{"id":"prostate","kind":"cancer","name":"Prostate cancer","route":"/cancers/prostate/"}],"technology":[{"id":"rejuv-mind-scan-anxiety","kind":"technology","name":"Anxiety around scans, and what the evidence says about how often to scan","route":"/technologies/rejuv-mind-scan-anxiety/"},{"id":"psma-pet","kind":"technology","name":"PSMA PET","route":"/technologies/psma-pet/"},{"id":"serum-tumour-markers","kind":"technology","name":"Serum tumour markers: proper use and misuse","route":"/technologies/serum-tumour-markers/"}],"trial":[{"id":"artistic-meta-analysis","kind":"trial","name":"ARTISTIC meta-analysis","route":"/trials/artistic-meta-analysis/"},{"id":"ascende-rt","kind":"trial","name":"ASCENDE-RT","route":"/trials/ascende-rt/"},{"id":"embark","kind":"trial","name":"EMBARK","route":"/trials/embark/"},{"id":"eortc-22911","kind":"trial","name":"EORTC 22911","route":"/trials/eortc-22911/"},{"id":"eortc-22991","kind":"trial","name":"EORTC 22991","route":"/trials/eortc-22991/"},{"id":"getug-afu-16","kind":"trial","name":"GETUG-AFU 16","route":"/trials/getug-afu-16/"},{"id":"getug-afu-17","kind":"trial","name":"GETUG-AFU 17","route":"/trials/getug-afu-17/"},{"id":"oriole","kind":"trial","name":"ORIOLE","route":"/trials/oriole/"},{"id":"radicals-rt","kind":"trial","name":"RADICALS-RT","route":"/trials/radicals-rt/"},{"id":"raves","kind":"trial","name":"RAVES (TROG 08.03/ANZUP)","route":"/trials/raves/"},{"id":"stomp-oligorecurrence","kind":"trial","name":"STOMP","route":"/trials/stomp-oligorecurrence/"},{"id":"swog-8794","kind":"trial","name":"SWOG 8794","route":"/trials/swog-8794/"}],"term":[{"id":"extraprostatic-extension","kind":"term","name":"Extraprostatic extension and seminal vesicle invasion","route":"/terms/extraprostatic-extension/"},{"id":"metastasis-free-survival","kind":"term","name":"Metastasis-free survival (MFS)","route":"/terms/metastasis-free-survival/"},{"id":"psa","kind":"term","name":"PSA (prostate-specific antigen)","route":"/terms/psa/"}],"idea":[{"id":"idea-psma-pet-guided-mdt","kind":"idea","name":"PSMA-PET-guided metastasis-directed therapy as a curative strategy in oligorecurrent prostate cancer","route":"/ideas/idea-psma-pet-guided-mdt/"},{"id":"idea-bio2-localise-the-mrd","kind":"idea","name":"When the blood test is positive, hunt for the lesion with sensitive imaging","route":"/ideas/idea-bio2-localise-the-mrd/"}],"paper":[{"id":"paper-fendler-psma-pet-biochemical-recurrence-jama-oncol-2019","kind":"paper","name":"Accuracy of gallium-68 PSMA-11 PET in localising recurrent prostate cancer: a prospective single-arm clinical trial","route":"/key-papers/paper-fendler-psma-pet-biochemical-recurrence-jama-oncol-2019/"},{"id":"paper-stamey-psa-serum-marker-nejm-1987","kind":"paper","name":"Prostate-specific antigen as a serum marker for adenocarcinoma of the prostate","route":"/key-papers/paper-stamey-psa-serum-marker-nejm-1987/"},{"id":"paper-pettersson-tmprss2-erg-outcome-meta-analysis-cebp-2012","kind":"paper","name":"The TMPRSS2-ERG rearrangement, ERG expression and prostate cancer outcomes: a cohort study and meta-analysis","route":"/key-papers/paper-pettersson-tmprss2-erg-outcome-meta-analysis-cebp-2012/"}],"biomarker":[{"id":"tmprss2-erg-fusion","kind":"biomarker","name":"TMPRSS2-ERG fusion (and the other ETS rearrangements)","route":"/biomarkers/tmprss2-erg-fusion/"}],"drug":[{"id":"fluciclovine-f18","kind":"drug","name":"Fluciclovine F-18","route":"/drugs/fluciclovine-f18/"},{"id":"illuccix","kind":"drug","name":"Illuccix (kit for Ga-68 gozetotide)","route":"/drugs/illuccix/"}]}}