期刊
EUROPEAN UROLOGY
卷 77, 期 4, 页码 508-547出版社
ELSEVIER
DOI: 10.1016/j.eururo.2020.01.012
关键词
Advanced prostate cancer; High-risk localised prostate cancer; Hormone-sensitive prostate cancer; Castration-resistant prostate cancer; Oligometastatic prostate cancer; Progression-free survival; Overall survival; Prostate cancer treatment; Imaging; Genetics; Tumour genomic profiling
资金
- Canton of Basel
- European School of Oncology (ESO)
- Swiss Cancer League
- Swiss Oncology Research Network (SAKK)
- Prostate Cancer Foundation (PCF)
- Cantonal Hospital St. Gallen
- Movember Foundation
- Astellas
- Bayer Health Care
- AstraZeneca
- MSD
- Pfizer Oncology
- Janssen Oncology
- Sanofi Genzyme
- Amgen
- Clovis Oncology
- Ferring Pharmaceuticals
- Ipsen
- Roche
- Tolmar
- Advanced Accelerator Applications
- Orion Pharma
- National Health and Medical Research Council (NHMRC) [APP1102604]
- Peter MacCallum Foundation
- MRC [MC_UU_12023/28] Funding Source: UKRI
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/naive 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. (C) 2020 The Authors. Published by Elsevier B.V. on behalf of European Association of Urology.
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