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    Consensus for treatment of metastatic castration-sensitive prostate cancer: report from the first global prostate cancer consensus conference for developing countries (PCCCDC)

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    Authors
    Maluf, F. C.
    Pereira, F. M. T.
    Serrano Uson, P. L., Jr.
    Bastos, D. A.
    Rodrigues da Rosa, D. A.
    Wiermann, E. G.
    Schutz, F. A.
    Kater, F. R.
    de Oliveira, F. N. G.
    Marques Monteiro, F. S.
    de Pádua, F. V.
    Orlandi, F. J.
    de Almeida Saito, H. P.
    Ayadi, M.
    Boghikian, P. S.
    Kopp, R. M.
    de Carvalho, R. S.
    de Fogace, R. N.
    de Araújo Cavallero, S. R.
    Aguiar, S.
    Souza, V. C.
    Gillessen, Silke
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    Affiliation
    Hospital Israelita Albert Einstein, São Paulo, Brazil
    Issue Date
    2021
    
    Metadata
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    Abstract
    Purpose: International guideline recommendations may not always be extrapolated to developing countries where access to resources is limited. In metastatic castration-sensitive prostate cancer (mCSPC), there have been successful drug and imaging advancements that were addressed in the Prostate Cancer Consensus Conference for Developing Countries for best-practice and limited-resource scenarios. Methods: A total of 24 out of 300 questions addressed staging, treatment, and follow-up for patients with mCSPC both in best-practice settings and resource-limited settings. Responses were compiled and presented in percentage of clinicians supporting each response. Questions had 4-8 options for response. Results: Recommendations for staging in mCSPC were split but there was consensus that chest x-ray, abdominal and pelvic computed tomography, and bone scan should be used where resources are limited. In both de novo and relapsed low-volume mCSPC, orchiectomy alone in limited resources was favored and in relapsed high-volume disease, androgen deprivation therapy plus docetaxel in limited resources and androgen deprivation therapy plus abiraterone in high-resource settings were consensus. A 3-weekly regimen of docetaxel was consensus among voters. When using abiraterone, a regimen of 1,000 mg plus prednisone 5 mg/d is optimal, but in limited-resource settings, half the panel agreed that abiraterone 250 mg with fatty foods plus prednisone 5 mg/d is acceptable. The panel recommended against the use of osteoclast-targeted therapy to prevent osseous complications. There was consensus that monitoring of patients undergoing systemic treatment should only be conducted in case of prostate-specific antigen elevation or progression-suggestive symptoms. Conclusion: The treatment recommendations for most topics addressed differed between the best-practice setting and resource-limited setting, accentuating the need for high-quality evidence that contemplates the effect of limited resources on the management of mCSPC.
    Citation
    Maluf FC, Pereira FMT, Serrano Uson PL Jr, Bastos DA, Rodrigues da Rosa DA, Wiermann EG, et al. Consensus for Treatment of Metastatic Castration-Sensitive Prostate Cancer: Report From the First Global Prostate Cancer Consensus Conference for Developing Countries (PCCCDC). JCO Global Oncology. 2021 Apr;(7):550–8.
    Journal
    JCO Global Oncology
    URI
    http://hdl.handle.net/10541/624052
    DOI
    10.1200/go.20.00505
    PubMed ID
    33856896
    Additional Links
    https://dx.doi.org/10.1200/go.20.00505
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1200/go.20.00505
    Scopus Count
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    All Paterson Institute for Cancer Research

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