Management of patients with advanced prostate cancer-metastatic and/or castration-resistant prostate cancer: report of the Advanced Prostate Cancer Consensus Conference (APCCC) 2022

被引：93

作者：

Gillessen, Silke ^{[1
,2
]}

Bossi, Alberto ^{[3
]}

Davis, Ian D. ^{[4
,5
]}

de Bono, Johann ^{[6
,7
]}

Fizazi, Karim ^{[8
]}

James, Nicholas D. ^{[6
]}

Mottet, Nicolas ^{[9
]}

Shore, Neal ^{[10
,11
]}

Small, Eric ^{[12
]}

Smith, Matthew ^{[13
]}

Sweeney, Christopher J. ^{[14
]}

Tombal, Bertrand ^{[15
]}

Antonarakis, Emmanuel S. ^{[16
]}

Aparicio, Ana M. ^{[17
]}

Armstrong, Andrew J. ^{[18
]}

Attard, Gerhardt ^{[19
]}

Beer, Tomasz M. ^{[20
]}

Beltran, Himisha ^{[21
,22
]}

Bjartell, Anders ^{[23
]}

Blanchard, Pierre ^{[24
]}

Briganti, Alberto ^{[25
]}

Bristow, Rob G. ^{[26
,27
,28
]}

Bulbul, Muhammad ^{[29
]}

Caffo, Orazio ^{[30
]}

Castellano, Daniel ^{[31
]}

Castro, Elena ^{[32
]}

Cheng, Heather H. ^{[33
]}

Chi, Kim N. ^{[34
]}

Chowdhury, Simon ^{[35
]}

Clarke, Caroline S. ^{[36
]}

Clarke, Noel ^{[37
,38
]}

Daugaard, Gedske ^{[39
]}

De Santis, Maria ^{[40
,41
]}

Duran, Ignacio ^{[42
]}

Eeles, Ross ^{[6
,43
]}

Efstathiou, Eleni ^{[44
]}

Efstathiou, Jason ^{[45
]}

Ekeke, Onyeanunam Ngozi ^{[46
]}

Evans, Christopher P. ^{[47
]}

Fanti, Stefano ^{[48
]}

Feng, Felix Y. ^{[49
]}

Fonteyne, Valerie ^{[50
]}

Fossati, Nicola ^{[51
]}

Frydenberg, Mark ^{[52
]}

George, Dan ^{[53
,54
]}

Gleave, Martin ^{[55
]}

Gravis, Gwenaelle ^{[56
]}

Halabi, Susan ^{[57
]}

Heinrich, Daniel ^{[58
]}

Herrmann, Ken ^{[59
,60
]}

机构：

[1] Oncol Inst Southern Switzerland, EOC, Bellinzona, Switzerland

[2] Univ Svizzera Italiana, Lugano, Switzerland

[3] Gustave Roussy, Prostate Brachytherapy Unit, Genitourinary Oncol, Paris, France

[4] Monash Univ, Clayton, Vic, Australia

[5] Eastern Hlth, Box Hill, Vic, Australia

[6] Inst Canc Res, London, England

[7] Royal Marsden Hosp, London, England

[8] Univ Paris Saclay, Inst Gustave Roussy, Villejuif, France

[9] Univ Jean Monnet, St Etienne, France

[10] Carolina Urol Res Ctr, Myrtle Beach, SC USA

[11] GenesisCare, CMO, Urol Surg Oncol, Myrtle Beach, SC USA

[12] Univ Calif San Francisco, UCSF Helen Diller Family Comprehens Canc Ctr, San Francisco, CA 94143 USA

[13] Massachusetts Gen Hosp, Canc Ctr, Boston, MA 02114 USA

[14] Univ Adelaide, South Australian Immunogen Canc Inst, Adelaide, SA, Australia

[15] Clin Univ St Luc, Brussels, Belgium

[16] Univ Minnesota, Masonic Canc Ctr, Minneapolis, MN USA

[17] Univ Texas MD Anderson Canc Ctr, Dept Genitourinary Med Oncol, Houston, TX 77030 USA

[18] Duke Canc Inst, Ctr Prostate & Urol Cancers, Durham, NC USA

[19] UCL, Canc Inst, London, England

[20] Oregon Hlth & Sci Univ, Knight Canc Inst, Portland, OR 97201 USA

[21] Dana Farber Canc Inst, Boston, MA 02115 USA

[22] Harvard Med Sch, Brigham & Womens Hosp, Boston, MA 02115 USA

[23] Skane Univ Hosp, Dept Urol, Malmo, Sweden

[24] Univ Paris Saclay, Gustave Roussy, Dept Radiotherapie, INSERM,U1018,Oncostat, F-94805 Villejuif, France

[25] Univ Vita Salute San Raffaele, IRCCS Osped San Raffaele, URI, Unit Urol,Div Oncol, Milan, Italy

[26] Univ Manchester, Div Canc Sci, Fac Biol Med & Hlth, Manchester, Lancs, England

[27] Christie NHS Trust, Manchester, Lancs, England

[28] CRUK Manchester Inst & Canc Ctr, Manchester, Lancs, England

[29] Amer Univ Beirut, Med Ctr, Div Urol, Dept Surg, Beirut, Lebanon

[30] Santa Chiara Hosp, Dept Med Oncol, I-38122 Trento, Italy

[31] Hosp Univ 12 Octubre, Med Oncol, Madrid, Spain

[32] Inst Biomed Res Malaga IBIMA, Malaga, Spain

[33] Univ Washington, Fred Hutchinson Canc Ctr, Seattle, WA 98195 USA

[34] Univ British Columbia, Vancouver Prostate Ctr, BC Canc, Vancouver, BC, Canada

[35] Guys & St Thomass NHS Fdn Trust, London, England

[36] UCL, Res Dept Primary Care & Populat Hlth, Royal Free Campus, London, England

[37] Christie Hosp, Manchester, Lancs, England

[38] Salford Royal Hosp, Manchester, Lancs, England

[39] Rigshosp, Copenhagen Univ Hosp, Dept Oncol, Copenhagen, Denmark

[40] Charite, Dept Urol, Berlin, Germany

[41] Med Univ Vienna, Dept Urol, Vienna, Austria

[42] Hosp Univ Marques de Valdecilla, Dept Med Oncol, IDIVAL, Santander, Cantabria, Spain

[43] Royal Marsden NHS Fdn Trust, London, England

[44] Houston Methodist Canc Ctr, Houston, TX USA

[45] Massachusetts Gen Hosp, Dept Radiat Oncol, Boston, MA 02114 USA

[46] Univ Port Harcourt, Teaching Hosp, Dept Surg, Port Harcourt, Nigeria

[47] Univ Calif Davis, Sch Med, Sacramento, CA 95817 USA

[48] IRCCS Azienda Osped Univ Bologna, Bologna, Italy

[49] Univ Calif San Francisco, San Francisco, CA 94143 USA

[50] Ghent Univ Hosp, Dept Radiat Oncol, Ghent, Belgium

来源：

EUROPEAN JOURNAL OF CANCER | 2023年 / 185卷

关键词：

Metastatic hormone-sensitive prostate cancer (mHSPC); Non metastatic castration-resistant prostate cancer (nmCRPC); Metastatic castration-resistant prostate cancer (mCRPC) and oligometastatic and oligoprogressive prostate cancer; Hormonal treatment; Systemic therapy; Chemotherapy; Androgen receptor pathway inhibitors (ARPI); Next-generation imaging; PSMA PET-imaging; ANDROGEN-DEPRIVATION THERAPY; POST-HOC ANALYSIS; OPEN-LABEL; RADIOGRAPHIC PROGRESSION; UPDATED RECOMMENDATIONS; LINEAGE PLASTICITY; BODY RADIOTHERAPY; DIRECTED THERAPY; GLOBAL ACCESS; OUTCOMES;

D O I：

10.1016/j.ejca.2023.02.018

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Innovations in imaging and molecular characterisation together with novel treatment options have improved outcomes in advanced prostate cancer. However, we still lack high-level evidence in many areas relevant to making management decisions in daily clinical practise. The 2022 Advanced Prostate Cancer Consensus Conference (APCCC 2022) addressed some questions in these areas to supplement guidelines that mostly are based on level 1 evidence. Objective: To present the voting results of the APCCC 2022.Design, setting, and participants: The experts voted on controversial questions where high-level evidence is mostly lacking: locally advanced prostate cancer; biochemical recurrence after local treatment; metastatic hormone-sensitive, non-metastatic, and metastatic castration-resistant prostate cancer; oligometastatic prostate cancer; and managing side effects of hor-monal therapy. A panel of 105 international prostate cancer experts voted on the consensus questions.Outcome measurements and statistical analysis: The panel voted on 198 pre-defined questions, which were developed by 117 voting and non-voting panel members prior to the conference following a modified Delphi process. A total of 116 questions on metastatic and/or castration-resistant prostate cancer are discussed in this manuscript. In 2022, the voting was done by a web-based survey because of COVID-19 restrictions.Results and limitations: The voting reflects the expert opinion of these panellists and did not incorporate a standard literature review or formal meta-analysis. The answer options for the consensus questions received varying degrees of support from panellists, as reflected in this article and the detailed voting results are reported in the supplementary material. We report here on topics in metastatic, hormone-sensitive prostate cancer (mHSPC), non-metastatic, castration-resistant prostate cancer (nmCRPC), metastatic castration-resistant prostate cancer (mCRPC), and oligometastatic and oligoprogressive prostate cancer.Conclusions: These voting results in four specific areas from a panel of experts in advanced prostate cancer can help clinicians and patients navigate controversial areas of management for which high-level evidence is scant or conflicting and can help research funders and policy makers identify information gaps and consider what areas to explore further. However, di-agnostic and treatment decisions always have to be individualised based on patient char-acteristics, including the extent and location of disease, prior treatment(s), co-morbidities, patient preferences, and treatment recommendations and should also incorporate current and emerging clinical evidence and logistic and economic factors. Enrolment in clinical trials is strongly encouraged. Importantly, APCCC 2022 once again identified important gaps where there is non-consensus and that merit evaluation in specifically designed trials.Patient summary: The Advanced Prostate Cancer Consensus Conference (APCCC) provides a forum to discuss and debate current diagnostic and treatment options for patients with advanced prostate cancer. The conference aims to share the knowledge of international ex-perts in prostate cancer with healthcare providers worldwide. At each APCCC, an expert panel votes on pre-defined questions that target the most clinically relevant areas of advanced prostate cancer treatment for which there are gaps in knowledge. The results of the voting provide a practical guide to help clinicians discuss therapeutic options with patients and their relatives as part of shared and multidisciplinary decision-making. This report focuses on the advanced setting, covering metastatic hormone-sensitive prostate cancer and both non -me-tastatic and metastatic castration-resistant prostate cancer.Twitter summary: Report of the results of APCCC 2022 for the following topics: mHSPC, nmCRPC, mCRPC, and oligometastatic prostate cancer.Take-home message: At APCCC 2022, clinically important questions in the management of advanced prostate cancer management were identified and discussed, and experts voted on pre-defined consensus questions. The report of the results for metastatic and/or castration -resistant prostate cancer is summarised here.(c) 2023 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

引用

页码：178 / 215

页数：38

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