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Management of patients with advanced prostate cancer : report of the Advanced Prostate Cancer Consensus Conference 2019

(2020) EUROPEAN UROLOGY. 77(4). p.508-547
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Abstract
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.
Keywords
ANDROGEN-DEPRIVATION THERAPY, SALVAGE RADIATION-THERAPY, LYMPH-NODE, DISSECTION, LYMPH-NODE DISSECTION, QUALITY-OF-LIFE, HOT FLASHES, RADICAL PROSTATECTOMY, CLINICAL-TRIALS, FREE SURVIVAL, PHASE-II, TESTOSTERONE MEASUREMENTS, Advanced prostate cancer, High-risk localised prostate cancer, Hormone-sensitive prostate cancer, Castration-resistant prostate cancer, Oligometastatic prostate cancer, Progression-free survival, Overall, survival, Overall survival, Prostate cancer treatment, Imaging, Genetics, Tumour genomic, profiling

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MLA
Gillessena, Silke, et al. “Management of Patients with Advanced Prostate Cancer : Report of the Advanced Prostate Cancer Consensus Conference 2019.” EUROPEAN UROLOGY, vol. 77, no. 4, 2020, pp. 508–47, doi:10.1016/j.eururo.2020.01.012.
APA
Gillessena, S., Attard, G., Beer, T. M., Beltran, H., Bjartell, A., Bossi, A., … Omlind, A. (2020). Management of patients with advanced prostate cancer : report of the Advanced Prostate Cancer Consensus Conference 2019. EUROPEAN UROLOGY, 77(4), 508–547. https://doi.org/10.1016/j.eururo.2020.01.012
Chicago author-date
Gillessena, Silke, Gerhardt Attard, Tomasz M. Beer, Himisha Beltran, Anders Bjartell, Alberto Bossi, Alberto Briganti, et al. 2020. “Management of Patients with Advanced Prostate Cancer : Report of the Advanced Prostate Cancer Consensus Conference 2019.” EUROPEAN UROLOGY 77 (4): 508–47. https://doi.org/10.1016/j.eururo.2020.01.012.
Chicago author-date (all authors)
Gillessena, Silke, Gerhardt Attard, Tomasz M. Beer, Himisha Beltran, Anders Bjartell, Alberto Bossi, Alberto Briganti, Rob G. Bristow, Kim N. Chi, Noel Clarke, Ian D. Davis, Johann de Bono, Charles G. Drake, Ignacio Duran, Ros Eeles, Eleni Efstathiou, Christopher P. Evans, Stefano Fanti, Felix Y. Feng, Karim Fizazi, Mark Frydenberg, Martin Gleave, Susan Halabi, Axel Heidenreich, Daniel Heinrich, Celestia (Tia) S. Higano, Michael S. Hofman, Maha Hussain, Nicolas James, Ravindran Kanesvaran, Philip Kantoff, Raja B. Khauli, Raya Leibowitz, Chris Logothetis, Fernando Maluf, Robin Millman, Alicia K. Morgans, Michael J. Morris, Nicolas Mottet, Hind Mrabti, Declan G. Murphy, Vedang Murthy, William K. Oh, Piet Ost, Joe M. OSullivan, Anwar R. Padhani, Chris Parker, Darren M. C. Poon, Colin C. Pritchard, Robert E. Reiter, Mack Roach, Mark Rubin, Charles J. Ryan, Fred Saad, Juan Pablo Sade, Oliver Sartor, I Scher, Howard, Neal Shore, Eric Small, Matthew Smith, Howard Soule, Cora N. Sternberg, Thomas Steuber, Hiroyoshi Suzuki, Christopher Sweeneyh, Matthew R. Sydes, Mary-Ellen Taplinh, Bertrand Tombal, Levent Turkeri, Inge van Oort, Almudena Zapatero, and Aurelius Omlind. 2020. “Management of Patients with Advanced Prostate Cancer : Report of the Advanced Prostate Cancer Consensus Conference 2019.” EUROPEAN UROLOGY 77 (4): 508–547. doi:10.1016/j.eururo.2020.01.012.
Vancouver
1.
Gillessena S, Attard G, Beer TM, Beltran H, Bjartell A, Bossi A, et al. Management of patients with advanced prostate cancer : report of the Advanced Prostate Cancer Consensus Conference 2019. EUROPEAN UROLOGY. 2020;77(4):508–47.
IEEE
[1]
S. Gillessena et al., “Management of patients with advanced prostate cancer : report of the Advanced Prostate Cancer Consensus Conference 2019,” EUROPEAN UROLOGY, vol. 77, no. 4, pp. 508–547, 2020.
@article{8674279,
  abstract     = {{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.}},
  author       = {{Gillessena, Silke and Attard, Gerhardt and Beer, Tomasz M. and Beltran, Himisha and Bjartell, Anders and Bossi, Alberto and Briganti, Alberto and Bristow, Rob G. and Chi, Kim N. and Clarke, Noel and Davis, Ian D. and de Bono, Johann and Drake, Charles G. and Duran, Ignacio and Eeles, Ros and Efstathiou, Eleni and Evans, Christopher P. and Fanti, Stefano and Feng, Felix Y. and Fizazi, Karim and Frydenberg, Mark and Gleave, Martin and Halabi, Susan and Heidenreich, Axel and Heinrich, Daniel and Higano, Celestia (Tia) S. and Hofman, Michael S. and Hussain, Maha and James, Nicolas and Kanesvaran, Ravindran and Kantoff, Philip and Khauli, Raja B. and Leibowitz, Raya and Logothetis, Chris and Maluf, Fernando and Millman, Robin and Morgans, Alicia K. and Morris, Michael J. and Mottet, Nicolas and Mrabti, Hind and Murphy, Declan G. and Murthy, Vedang and Oh, William K. and Ost, Piet and OSullivan, Joe M. and Padhani, Anwar R. and Parker, Chris and Poon, Darren M. C. and Pritchard, Colin C. and Reiter, Robert E. and Roach, Mack and Rubin, Mark and Ryan, Charles J. and Saad, Fred and Sade, Juan Pablo and Sartor, Oliver and Scher, Howard, I and Shore, Neal and Small, Eric and Smith, Matthew and Soule, Howard and Sternberg, Cora N. and Steuber, Thomas and Suzuki, Hiroyoshi and Sweeneyh, Christopher and Sydes, Matthew R. and Taplinh, Mary-Ellen and Tombal, Bertrand and Turkeri, Levent and van Oort, Inge and Zapatero, Almudena and Omlind, Aurelius}},
  issn         = {{0302-2838}},
  journal      = {{EUROPEAN UROLOGY}},
  keywords     = {{ANDROGEN-DEPRIVATION THERAPY,SALVAGE RADIATION-THERAPY,LYMPH-NODE,DISSECTION,LYMPH-NODE DISSECTION,QUALITY-OF-LIFE,HOT FLASHES,RADICAL PROSTATECTOMY,CLINICAL-TRIALS,FREE SURVIVAL,PHASE-II,TESTOSTERONE MEASUREMENTS,Advanced prostate cancer,High-risk localised prostate cancer,Hormone-sensitive prostate cancer,Castration-resistant prostate cancer,Oligometastatic prostate cancer,Progression-free survival,Overall,survival,Overall survival,Prostate cancer treatment,Imaging,Genetics,Tumour genomic,profiling}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{508--547}},
  title        = {{Management of patients with advanced prostate cancer : report of the Advanced Prostate Cancer Consensus Conference 2019}},
  url          = {{http://dx.doi.org/10.1016/j.eururo.2020.01.012}},
  volume       = {{77}},
  year         = {{2020}},
}

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