Management of Patients with Advanced Prostate Cancer: Report of the Advanced Prostate Cancer Consensus Conference 2019.

Bone Neoplasms / secondary Humans Male Neoplasm Metastasis Neoplasm Recurrence, Local / blood Neoplasm Staging Practice Guidelines as Topic Prostate-Specific Antigen / blood Prostatic Neoplasms / blood
Advanced prostate cancer Castration-naïve prostate cancer Castration-resistant prostate cancer Genetics High-risk localised prostate cancer Hormone-sensitive prostate cancer Imaging Oligometastatic prostate cancer Overall survival Progression-free survival Prostate cancer treatment Tumour genomic profiling

Journal

European urology
ISSN: 1873-7560
Titre abrégé: Eur Urol
Pays: Switzerland
ID NLM: 7512719

Informations de publication

Date de publication:
04 2020
Historique:
received: 30 12 2019
accepted: 10 01 2020
pubmed: 1 2 2020
medline: 28 5 2021
entrez: 1 2 2020
Statut: ppublish

Résumé

Innovations in treatments, imaging, and molecular characterisation in advanced prostate cancer have improved outcomes, but there are still many aspects of management that lack high-level evidence to inform clinical practice. The Advanced Prostate Cancer Consensus Conference (APCCC) 2019 addressed some of these topics to supplement guidelines that are based on level 1 evidence. To present the results from the APCCC 2019. Similar to prior conferences, experts identified 10 important areas of controversy regarding the management of advanced prostate cancer: locally advanced disease, biochemical recurrence after local therapy, treating the primary tumour in the metastatic setting, metastatic hormone-sensitive/naïve prostate cancer, nonmetastatic castration-resistant prostate cancer, metastatic castration-resistant prostate cancer, bone health and bone metastases, molecular characterisation of tissue and blood, inter- and intrapatient heterogeneity, and adverse effects of hormonal therapy and their management. A panel of 72 international prostate cancer experts developed the programme and the consensus questions. The panel voted publicly but anonymously on 123 predefined questions, which were developed by both voting and nonvoting panel members prior to the conference following a modified Delphi process. Panellists voted based on their opinions rather than a standard literature review or formal meta-analysis. The answer options for the consensus questions had varying degrees of support by the panel, as reflected in this article and the detailed voting results reported in the Supplementary material. These voting results from a panel of prostate cancer experts can help clinicians and patients navigate controversial areas of advanced prostate management for which high-level evidence is sparse. However, diagnostic and treatment decisions should always be individualised based on patient-specific factors, such as disease extent and location, prior lines of therapy, comorbidities, and treatment preferences, together with current and emerging clinical evidence and logistic and economic constraints. Clinical trial enrolment for men with advanced prostate cancer should be strongly encouraged. Importantly, APCCC 2019 once again identified important questions that merit assessment in specifically designed trials. The Advanced Prostate Cancer Consensus Conference provides a forum to discuss and debate current diagnostic and treatment options for patients with advanced prostate cancer. The conference, which has been held three times since 2015, aims to share the knowledge of world experts in prostate cancer management with health care providers worldwide. At the end of the conference, an expert panel discusses and votes on predefined consensus questions that target the most clinically relevant areas of advanced prostate cancer treatment. The results of the voting provide a practical guide to help clinicians discuss therapeutic options with patients as part of shared and multidisciplinary decision making.

Sections du résumé

BACKGROUND
Innovations in treatments, imaging, and molecular characterisation in advanced prostate cancer have improved outcomes, but there are still many aspects of management that lack high-level evidence to inform clinical practice. The Advanced Prostate Cancer Consensus Conference (APCCC) 2019 addressed some of these topics to supplement guidelines that are based on level 1 evidence.
OBJECTIVE
To present the results from the APCCC 2019.
DESIGN, SETTING, AND PARTICIPANTS
Similar to prior conferences, experts identified 10 important areas of controversy regarding the management of advanced prostate cancer: locally advanced disease, biochemical recurrence after local therapy, treating the primary tumour in the metastatic setting, metastatic hormone-sensitive/naïve prostate cancer, nonmetastatic castration-resistant prostate cancer, metastatic castration-resistant prostate cancer, bone health and bone metastases, molecular characterisation of tissue and blood, inter- and intrapatient heterogeneity, and adverse effects of hormonal therapy and their management. A panel of 72 international prostate cancer experts developed the programme and the consensus questions.
OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS
The panel voted publicly but anonymously on 123 predefined questions, which were developed by both voting and nonvoting panel members prior to the conference following a modified Delphi process.
RESULTS AND LIMITATIONS
Panellists voted based on their opinions rather than a standard literature review or formal meta-analysis. The answer options for the consensus questions had varying degrees of support by the panel, as reflected in this article and the detailed voting results reported in the Supplementary material.
CONCLUSIONS
These voting results from a panel of prostate cancer experts can help clinicians and patients navigate controversial areas of advanced prostate management for which high-level evidence is sparse. However, diagnostic and treatment decisions should always be individualised based on patient-specific factors, such as disease extent and location, prior lines of therapy, comorbidities, and treatment preferences, together with current and emerging clinical evidence and logistic and economic constraints. Clinical trial enrolment for men with advanced prostate cancer should be strongly encouraged. Importantly, APCCC 2019 once again identified important questions that merit assessment in specifically designed trials.
PATIENT SUMMARY
The Advanced Prostate Cancer Consensus Conference provides a forum to discuss and debate current diagnostic and treatment options for patients with advanced prostate cancer. The conference, which has been held three times since 2015, aims to share the knowledge of world experts in prostate cancer management with health care providers worldwide. At the end of the conference, an expert panel discusses and votes on predefined consensus questions that target the most clinically relevant areas of advanced prostate cancer treatment. The results of the voting provide a practical guide to help clinicians discuss therapeutic options with patients as part of shared and multidisciplinary decision making.

Identifiants

DOI: 10.1016/j.eururo.2020.01.012 PMID: 32001144
pubmed: 32001144
pii: S0302-2838(20)30048-8
doi: 10.1016/j.eururo.2020.01.012
pii:
doi:

Substances chimiques

Prostate-Specific Antigen EC 3.4.21.77

Types de publication

Consensus Development Conference Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

508-547

Subventions

Organisme : Cancer Research UK
ID : 3804
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_12023/25
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_12023/28
Pays : United Kingdom

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.

Auteurs

Silke Gillessen (S)

Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Universita della Svizzera Italiana, Lugano, Switzerland; Cantonal Hospital, St. Gallen, Switzerland; University of Bern, Bern, Switzerland; Division of Cancer Science, University of Manchester, Manchester, UK. Electronic address: silke.gillessen@eoc.ch.

Gerhardt Attard (G)

University College London Cancer Institute, London, UK.

Tomasz M Beer (TM)

Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA.

Himisha Beltran (H)

Dana-Farber Cancer Institute, Boston, MA, USA; Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

Anders Bjartell (A)

Department of Urology, Skåne University Hospital, Malmö, Sweden.

Alberto Bossi (A)

Genito Urinary Oncology, Prostate Brachytherapy Unit, Goustave Roussy, Paris, France.

Alberto Briganti (A)

Unit of Urology/Division of Oncology, URI, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy.

Rob G Bristow (RG)

Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; Christie NHS Trust, Manchester, UK; CRUK Manchester Institute and Cancer Centre, Manchester, UK.

Kim N Chi (KN)

BC Cancer, Vancouver Prostate Centre, University of British Columbia, Vancouver, British Columbia, Canada.

Noel Clarke (N)

The Christie and Salford Royal Hospitals, Manchester, UK.

Ian D Davis (ID)

Monash University and Eastern Health, Victoria, Australia.

Johann de Bono (J)

The Institute of Cancer Research/Royal Marsden NHS Foundation Trust, Surrey, UK.

Charles G Drake (CG)

Division of Haematology/Oncology, Columbia University Medical Center, New York, NY, USA.

Ignacio Duran (I)

Department of Medical Oncology, Hospital Universitario Marques de Valdecilla, IDIVAL, Santander, Cantabria, Spain.

Ros Eeles (R)

The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK.

Eleni Efstathiou (E)

University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Christopher P Evans (CP)

University of California Davis School of Medicine, Sacramento, CA, USA.

Stefano Fanti (S)

Policlinico S.Orsola, Università di Bologna, Italy.

Felix Y Feng (FY)

University of California San Francisco, San Francisco, CA, USA.

Karim Fizazi (K)

Institut Gustave Roussy, University of Paris Sud, Villejuif, France.

Mark Frydenberg (M)

Department of Surgery, Monash University, Melbourne, Australia; Prostate Cancer Research Program, Monash University, Melbourne, Australia; Department Anatomy & Developmental Biology, Faculty of Nursing, Medicine & Health Sciences, Monash University, Melbourne, Australia.

Martin Gleave (M)

Urological Sciences, Vancouver Prostate Centre, University of British Columbia, Vancouver, Canada.

Susan Halabi (S)

Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA.

Axel Heidenreich (A)

Department of Urology, Uro-Oncology, Robot-Assisted and Reconstructive Urology, University of Cologne, Cologne, Germany; Department of Urology, Medical University, Vienna, Austria.

Daniel Heinrich (D)

Department of Oncology, Akershus University Hospital, Lørenskog, Norway.

Celestia Tia S Higano (CTS)

University of Washington, Seattle, WA, USA; Fred Hutchinson Cancer Research Center, Seattle, WA, USA.

Michael S Hofman (MS)

Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia.

Maha Hussain (M)

Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA.

Nicolas James (N)

The Institute of Cancer Research, London, UK.

Ravindran Kanesvaran (R)

Division of Medical Oncology, National Cancer Centre, Singapore.

Philip Kantoff (P)

Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weill Cornell Medical College, New York, NY, USA.

Raja B Khauli (RB)

Department of Urology, American University of Beirut Medical Center, Beirut, Lebanon; Naef K. Basile Cancer Institute (NKBCI), American University of Beirut Medical Center, Beirut, Lebanon.

Raya Leibowitz (R)

Oncology institute, Shamir Medical Center and Faculty of medicine, Tel-Aviv University, Israel.

Chris Logothetis (C)

Department of Genitourinary Medical Oncology, MD Anderson Cancer Centre, Houston, TX, USA; Department of Clinical Therapeutics, David H. Koch Centre, University of Athens Alexandra Hospital, Athens, Greece.

Fernando Maluf (F)

Beneficiência Portuguesa de São Paulo, São Paulo, SP, Brazil; Departamento de Oncologia, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.

Robin Millman (R)

UK.

Alicia K Morgans (AK)

Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA.

Michael J Morris (MJ)

Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Nicolas Mottet (N)

University Hospital Nord, St Etienne, France.

Hind Mrabti (H)

National Institute of Oncology, University hospital, Rabat, Morocco.

Declan G Murphy (DG)

Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia.

Vedang Murthy (V)

Tata Memorial Centre, Mumbai, India.

William K Oh (WK)

Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, The Tisch Cancer Institute, New York, NY, USA.

Piet Ost (P)

Radiation Oncology, Ghent University Hospital, Ghent, Belgium.

Joe M O'Sullivan (JM)

Centre for Cancer Research and Cell Biology, Queen's University Belfast, Belfast, Northern Ireland, UK; Radiotherapy Department, Cancer Centre, Belfast City Hospital, Belfast, Northern Ireland, UK.

Anwar R Padhani (AR)

Mount Vernon Cancer Centre and Institute of Cancer Research, London, UK.

Chris Parker (C)

Royal Marsden Hospital and Institute of Cancer Research, Sutton, UK.

Darren M C Poon (DMC)

Comprehensive Oncology Centre, Hong Kong Sanatorium & Hospital, The Chinese University of Hong Kong, Hong Kong.

Colin C Pritchard (CC)

Department of Laboratory Medicine, University of Washington, Seattle, WA, USA.

Robert E Reiter (RE)

University of California Los Angeles, Los Angeles, CA, USA.

Mack Roach (M)

UCSF Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA.

Mark Rubin (M)

Bern Center for Precision Medicine, Bern, Switzerland; Department for Biomedical Research, University of Bern, Bern, Switzerland.

Charles J Ryan (CJ)

Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA.

Fred Saad (F)

Centre Hospitalier de Université de Montréal, Montreal, Canada.

Juan Pablo Sade (JP)

Instituto Alexander Fleming, Buenos Aires, Argentina.

Oliver Sartor (O)

Tulane Cancer Center, New Orleans, LA, USA.

Howard I Scher (HI)

Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Medicine, Weill Cornell Medical College, New York, NY, USA.

Neal Shore (N)

Carolina Urologic Research Center, Myrtle Beach, SC, USA.

Eric Small (E)

UCSF Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA.

Matthew Smith (M)

Massachusetts General Hospital Cancer Center, Boston, MA, USA.

Howard Soule (H)

Prostate Cancer Foundation, Santa Monica, CA, USA.

Cora N Sternberg (CN)

Division of Hematology and Oncology, Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, NY, USA.

Thomas Steuber (T)

Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.

Hiroyoshi Suzuki (H)

Toho University Sakura Medical Center, Chiba, Japan.

Christopher Sweeney (C)

Dana-Farber Cancer Institute, Boston, MA, USA; Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

Matthew R Sydes (MR)

MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, University College London, London, UK.

Mary-Ellen Taplin (ME)

Dana-Farber Cancer Institute, Boston, MA, USA; Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

Bertrand Tombal (B)

Cliniques Universitaires Saint Luc, Brussels, Belgium.

Levent Türkeri (L)

Department of Urology, M.A. Aydınlar Acıbadem University, Altunizade Hospital, Istanbul, Turkey.

Inge van Oort (I)

Radboud University Medical Center, Nijmegen, The Netherlands.

Almudena Zapatero (A)

Department of Radiation Oncology, University Hospital La Princesa, Health Research Institute, Madrid, Spain.

Aurelius Omlin (A)

University of Bern, Bern, Switzerland; Department of Medical Oncology and Haematology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.

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Classifications MeSH

questionsmedicales.fr › Maladies ostéomusculaires › Maladies osseuses › Tumeurs osseuses › Management of Patients with Advanced Prostate...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Management of Patients with Advanced Prostate...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Processus néoplasiques › Métastase tumorale › Management of Patients with Advanced Prostate...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Processus néoplasiques › Récidive tumorale locale › Management of Patients with Advanced Prostate...
questionsmedicales.fr › Diagnostic › Pronostic › Stadification tumorale › Management of Patients with Advanced Prostate...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Assurance de la qualité des soins de santé › Recommandations comme sujet › Guides de bonnes pratiques cliniques comme sujet › Management of Patients with Advanced Prostate...
questionsmedicales.fr › Facteurs biologiques › Marqueurs biologiques › Marqueurs biologiques tumoraux › Antigène spécifique de la prostate › Management of Patients with Advanced Prostate...
questionsmedicales.fr › Maladies urogénitales › Tumeurs de l'appareil urogénital › Tumeurs de l'appareil génital mâle › Tumeurs de la prostate › Management of Patients with Advanced Prostate...