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    Management of patients with advanced prostate cancer. Part I: intermediate-/high-risk and locally advanced disease, biochemical relapse, and side effects of hormonal treatment: Report of the Advanced Prostate Cancer Consensus Conference 2022

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    Authors
    Gillessen, S.
    Bossi, A.
    Davis, I. D.
    de Bono, J.
    Fizazi, K.
    James, N. D.
    Mottet, N.
    Shore, N.
    Small, E.
    Smith, M.
    Sweeney, C.
    Tombal, B.
    Antonarakis, E. S.
    Aparicio, A. M.
    Armstrong, A. J.
    Attard, G.
    Beer, T. M.
    Beltran, H.
    Bjartell, A.
    Blanchard, P.
    Briganti, A.
    Bristow, Robert G
    Bulbul, M.
    Caffo, O.
    Castellano, D.
    Castro, E.
    Cheng, H. H.
    Chi, K. N.
    Chowdhury, S.
    Clarke, C. S.
    Clarke, Noel W
    Daugaard, G.
    De Santis, M.
    Duran, I.
    Eeles, R.
    Efstathiou, E.
    Efstathiou, J.
    Ngozi Ekeke, O.
    Evans, C. P.
    Fanti, S.
    Feng, F. Y.
    Fonteyne, V.
    Fossati, N.
    Frydenberg, M.
    George, D.
    Gleave, M.
    Gravis, G.
    Halabi, S.
    Heinrich, D.
    Herrmann, K.
    Higano, C.
    Hofman, M. S.
    Horvath, L. G.
    Hussain, M.
    Alicja Jereczek-Fossa, B.
    Jones, R.
    Kanesvaran, R.
    Kellokumpu-Lehtinen, P. L.
    Khauli, R. B.
    Klotz, L.
    Kramer, G.
    Leibowitz, R.
    Logothetis, C. J.
    Mahal, B. A.
    Maluf, F.
    Mateo, J.
    Matheson, D.
    Mehra, N.
    Merseburger, A.
    Morgans, A. K.
    Morris, M. J.
    Mrabti, H.
    Mukherji, D.
    Murphy, D. G.
    Murthy, V.
    Nguyen, P. L.
    Oh, W. K.
    Ost, P.
    O'Sullivan, J. M.
    Padhani, A. R.
    Pezaro, C.
    Poon, D. M. C.
    Pritchard, C. C.
    Rabah, D. M.
    Rathkopf, D.
    Reiter, R. E.
    Rubin, M. A.
    Ryan, C. J.
    Saad, F.
    Pablo Sade, J.
    Sartor, O. A.
    Scher, H. I.
    Sharifi, N.
    Skoneczna, I.
    Soule, H.
    Spratt, D. E.
    Srinivas, S.
    Sternberg, C. N.
    Steuber, T.
    Suzuki, H.
    Sydes, M. R.
    Taplin, M. E.
    Tilki, D.
    Türkeri, L.
    Turco, F.
    Uemura, H.
    Uemura, H.
    Ürün, Y.
    Vale, C. L.
    van Oort, I.
    Vapiwala, N.
    Walz, J.
    Yamoah, K.
    Ye, D.
    Yu, E. Y.
    Zapatero, A.
    Zilli, T.
    Omlin, A.
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    Affiliation
    Oncology Institute of Southern Switzerland, EOC, Bellinzona, Switzerland; Università della Svizzera Italiana, Lugano, Switzerland.
    Issue Date
    2022
    
    Metadata
    Show full item record
    Abstract
    Background: Innovations in imaging and molecular characterisation and the evolution of new therapies have improved outcomes in advanced prostate cancer. Nonetheless, we continue to lack high-level evidence on a variety of clinical topics that greatly impact daily practice. To supplement evidence-based guidelines, the 2022 Advanced Prostate Cancer Consensus Conference (APCCC 2022) surveyed experts about key dilemmas in clinical management. Objective: To present consensus voting results for select questions from APCCC 2022. Design, setting, and participants: Before the conference, a panel of 117 international prostate cancer experts used a modified Delphi process to develop 198 multiple-choice consensus questions on (1) intermediate- and high-risk and locally advanced prostate cancer, (2) biochemical recurrence after local treatment, (3) side effects from hormonal therapies, (4) metastatic hormone-sensitive prostate cancer, (5) nonmetastatic castration-resistant prostate cancer, (6) metastatic castration-resistant prostate cancer, and (7) oligometastatic and oligoprogressive prostate cancer. Before the conference, these questions were administered via a web-based survey to the 105 physician panel members ("panellists") who directly engage in prostate cancer treatment decision-making. Herein, we present results for the 82 questions on topics 1-3. Outcome measurements and statistical analysis: Consensus was defined as ≥75% agreement, with strong consensus defined as ≥90% agreement. Results and limitations: The voting results reveal varying degrees of consensus, as is discussed in this article and shown in the detailed results in the Supplementary material. The findings reflect the opinions of an international panel of experts and did not incorporate a formal literature review and meta-analysis. Conclusions: These voting results by a panel of international experts in advanced prostate cancer can help physicians and patients navigate controversial areas of clinical management for which high-level evidence is scant or conflicting. The findings can also help funders and policymakers prioritise areas for future research. Diagnostic and treatment decisions should always be individualised based on patient and cancer characteristics (disease extent and location, treatment history, comorbidities, and patient preferences) and should incorporate current and emerging clinical evidence, therapeutic guidelines, and logistic and economic factors. Enrolment in clinical trials is always strongly encouraged. Importantly, APCCC 2022 once again identified important gaps (areas of nonconsensus) that merit evaluation in specifically designed trials.
    Citation
    Gillessen S, Bossi A, Davis ID, de Bono J, Fizazi K, James ND, et al. Management of Patients with Advanced Prostate Cancer. Part I: Intermediate-/High-risk and Locally Advanced Disease, Biochemical Relapse, and Side Effects of Hormonal Treatment: Report of the Advanced Prostate Cancer Consensus Conference 2022. Eur Urol. 2022 Dec 6. PubMed PMID: 36494221. Epub 2022/12/10. eng.
    Journal
    European Urology
    URI
    http://hdl.handle.net/10541/625890
    DOI
    10.1016/j.eururo.2022.11.002
    PubMed ID
    36494221
    Additional Links
    https://dx.doi.org/10.1016/j.eururo.2022.11.002
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.eururo.2022.11.002
    Scopus Count
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