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

Silke Gillessen; Alberto Bossi; Ian D. Davis; Johann de Bono; Karim Fizazi; Nicholas D. James; Nicolas Mottet; Neal Shore; Eric Small; Matthew Smith; Christopher J. Sweeney; Bertrand Tombal; Emmanuel S. Antonarakis; Ana M. Aparicio; Andrew J. Armstrong; Gerhardt Attard; Tomasz M. Beer; Himisha Beltran; Anders Bjartell; Pierre Blanchard; Alberto Briganti; Rob G. Bristow; Muhammad Bulbul; Orazio Caffo; Daniel Castellano; Elena Castro; Heather H. Cheng; Kim N. Chi; Simon Chowdhury; Caroline S. Clarke; Noel Clarke; Gedske Daugaard; Maria De Santis; Ignacio Duran; Ross Eeles; Eleni Efstathiou; Jason Efstathiou; Onyeanunam Ngozi Ekeke; Christopher P. Evans; Stefano Fanti; Felix Y. Feng; Valerie Fonteyne; Nicola Fossati; Mark Frydenberg; Dan George; Martin Gleave; Gwenaelle Gravis; Susan Halabi; Daniel Heinrich; Ken Herrmann; Celestia Higano; Michael S. Hofman; Lisa G. Horvath; Maha Hussain; Barbara A. Jereczek-Fossa; Rob Jones; Ravindran Kanesvaran; Pirkko Liisa Kellokumpu-Lehtinen; Raja B. Khauli; Laurence Klotz; Gero Kramer; Raja Leibowitz; Christopher Logothetis; Brandon Mahal; Fernando Maluf; Joaquin Mateo; David Matheson; Niven Mehra; Axel Merseburger; Alicia K. Morgans; Michael J. Morris; Hind Mrabti; Deborah Mukherji; Declan G. Murphy; Vedang Murthy; Paul L. Nguyen; William K. Oh; Piet Ost; Joe M. O'Sullivan; Anwar R. Padhani; Carmel J. Pezaro; Darren M.C. Poon; Colin C. Pritchard; Danny M. Rabah; Dana Rathkopf; Robert E. Reiter; Mark A. Rubin; Charles J. Ryan; Fred Saad; Juan Pablo Sade; Oliver Sartor; Howard I. Scher; Nima Sharifi; Iwona Skoneczna; Howard Soule; Daniel E. Spratt; Sandy Srinivas; Cora N. Sternberg; Thomas Steuber; Hiroyoshi Suzuki; Matthew R. Sydes; Mary Ellen Taplin; Derya Tilki; Levent Türkeri; Fabio Turco; Hiroji Uemura; Hirotsugu Uemura; Yüksel Ürün; Claire L. Vale; Inge van Oort; Neha Vapiwala; Jochen Walz; Kosj Yamoah; Dingwei Ye; Evan Y. Yu; Almudena Zapatero; Thomas Zilli; Aurelius Omlin

doi:10.1016/j.ejca.2023.02.018

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

Silke Gillessen, Alberto Bossi, Ian D. Davis, Johann de Bono, Karim Fizazi, Nicholas D. James, Nicolas Mottet, Neal Shore, Eric Small, Matthew Smith, Christopher J. Sweeney, Bertrand Tombal, Emmanuel S. Antonarakis, Ana M. Aparicio, Andrew J. Armstrong, Gerhardt Attard, Tomasz M. Beer, Himisha Beltran, Anders Bjartell, Pierre BlanchardAlberto Briganti, Rob G. Bristow, Muhammad Bulbul, Orazio Caffo, Daniel Castellano, Elena Castro, Heather H. Cheng, Kim N. Chi, Simon Chowdhury, Caroline S. Clarke, Noel Clarke, Gedske Daugaard, Maria De Santis, Ignacio Duran, Ross Eeles, Eleni Efstathiou, Jason Efstathiou, Onyeanunam Ngozi Ekeke, Christopher P. Evans, Stefano Fanti, Felix Y. Feng, Valerie Fonteyne, Nicola Fossati, Mark Frydenberg, Dan George, Martin Gleave, Gwenaelle Gravis, Susan Halabi, Daniel Heinrich, Ken Herrmann, Celestia Higano, Michael S. Hofman, Lisa G. Horvath, Maha Hussain, Barbara A. Jereczek-Fossa, Rob Jones, Ravindran Kanesvaran, Pirkko Liisa Kellokumpu-Lehtinen, Raja B. Khauli, Laurence Klotz, Gero Kramer, Raja Leibowitz, Christopher Logothetis, Brandon Mahal, Fernando Maluf, Joaquin Mateo, David Matheson, Niven Mehra, Axel Merseburger, Alicia K. Morgans, Michael J. Morris, Hind Mrabti, Deborah Mukherji, Declan G. Murphy, Vedang Murthy, Paul L. Nguyen, William K. Oh, Piet Ost, Joe M. O'Sullivan, Anwar R. Padhani, Carmel J. Pezaro, Darren M.C. Poon, Colin C. Pritchard, Danny M. Rabah, Dana Rathkopf, Robert E. Reiter, Mark A. Rubin, Charles J. Ryan, Fred Saad, Juan Pablo Sade, Oliver Sartor, Howard I. Scher, Nima Sharifi, Iwona Skoneczna, Howard Soule, Daniel E. Spratt, Sandy Srinivas, Cora N. Sternberg, Thomas Steuber, Hiroyoshi Suzuki, Matthew R. Sydes, Mary Ellen Taplin, Derya Tilki, Levent Türkeri, Fabio Turco, Hiroji Uemura, Hirotsugu Uemura, Yüksel Ürün, Claire L. Vale, Inge van Oort, Neha Vapiwala, Jochen Walz, Kosj Yamoah, Dingwei Ye, Evan Y. Yu, Almudena Zapatero, Thomas Zilli, Aurelius Omlin

Genitourinary Medical Oncology

Research output: Contribution to journal › Article › peer-review

31 Scopus citations

Abstract

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 hormonal 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, diagnostic and treatment decisions always have to be individualised based on patient characteristics, 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 experts 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-metastatic 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.

Original language	English (US)
Pages (from-to)	178-215
Number of pages	38
Journal	European Journal of Cancer
Volume	185
DOIs	https://doi.org/10.1016/j.ejca.2023.02.018
State	Published - May 2023

Keywords

Androgen receptor pathway inhibitors (ARPI)
Chemotherapy
Hormonal treatment
Metastatic castration-resistant prostate cancer (mCRPC) and oligometastatic and oligoprogressive prostate cancer
Metastatic hormone-sensitive prostate cancer (mHSPC)
Next-generation imaging
Non metastatic castration-resistant prostate cancer (nmCRPC)
PSMA PET-imaging
Systemic therapy

ASJC Scopus subject areas

Oncology
Cancer Research

Access to Document

10.1016/j.ejca.2023.02.018

Cite this

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. J., Tombal, B., Antonarakis, E. S., Aparicio, A. M., Armstrong, A. J., Attard, G., Beer, T. M., Beltran, H., Bjartell, A., ... Omlin, A. (2023). Management of patients with advanced prostate cancer—metastatic and/or castration-resistant prostate cancer: report of the Advanced Prostate Cancer Consensus Conference (APCCC) 2022. European Journal of Cancer, 185, 178-215. https://doi.org/10.1016/j.ejca.2023.02.018

Management of patients with advanced prostate cancer—metastatic and/or castration-resistant prostate cancer: report of the Advanced Prostate Cancer Consensus Conference (APCCC) 2022. / Gillessen, Silke; Bossi, Alberto; Davis, Ian D. et al.
In: European Journal of Cancer, Vol. 185, 05.2023, p. 178-215.

Research output: Contribution to journal › Article › peer-review

Gillessen, S, Bossi, A, Davis, ID, de Bono, J, Fizazi, K, James, ND, Mottet, N, Shore, N, Small, E, Smith, M, Sweeney, CJ, Tombal, B, Antonarakis, ES, Aparicio, AM, Armstrong, AJ, Attard, G, Beer, TM, Beltran, H, Bjartell, A, Blanchard, P, Briganti, A, Bristow, RG, Bulbul, M, Caffo, O, Castellano, D, Castro, E, Cheng, HH, Chi, KN, Chowdhury, S, Clarke, CS, Clarke, N, Daugaard, G, De Santis, M, Duran, I, Eeles, R, Efstathiou, E, Efstathiou, J, Ekeke, ON, Evans, CP, Fanti, S, Feng, FY, Fonteyne, V, Fossati, N, Frydenberg, M, George, D, Gleave, M, Gravis, G, Halabi, S, Heinrich, D, Herrmann, K, Higano, C, Hofman, MS, Horvath, LG, Hussain, M, Jereczek-Fossa, BA, Jones, R, Kanesvaran, R, Kellokumpu-Lehtinen, PL, Khauli, RB, Klotz, L, Kramer, G, Leibowitz, R, Logothetis, C, Mahal, B, Maluf, F, Mateo, J, Matheson, D, Mehra, N, Merseburger, A, Morgans, AK, Morris, MJ, Mrabti, H, Mukherji, D, Murphy, DG, Murthy, V, Nguyen, PL, Oh, WK, Ost, P, O'Sullivan, JM, Padhani, AR, Pezaro, CJ, Poon, DMC, Pritchard, CC, Rabah, DM, Rathkopf, D, Reiter, RE, Rubin, MA, Ryan, CJ, Saad, F, Sade, JP, Sartor, O, Scher, HI, Sharifi, N, Skoneczna, I, Soule, H, Spratt, DE, Srinivas, S, Sternberg, CN, Steuber, T, Suzuki, H, Sydes, MR, Taplin, ME, Tilki, D, Türkeri, L, Turco, F, Uemura, H, Uemura, H, Ürün, Y, Vale, CL, van Oort, I, Vapiwala, N, Walz, J, Yamoah, K, Ye, D, Yu, EY, Zapatero, A, Zilli, T & Omlin, A 2023, 'Management of patients with advanced prostate cancer—metastatic and/or castration-resistant prostate cancer: report of the Advanced Prostate Cancer Consensus Conference (APCCC) 2022', European Journal of Cancer, vol. 185, pp. 178-215. https://doi.org/10.1016/j.ejca.2023.02.018

@article{aa4f09c824514f54aeb248c6c91ae6ea,

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

abstract = "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 hormonal 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, diagnostic and treatment decisions always have to be individualised based on patient characteristics, 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 experts 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-metastatic 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.",

keywords = "Androgen receptor pathway inhibitors (ARPI), Chemotherapy, Hormonal treatment, Metastatic castration-resistant prostate cancer (mCRPC) and oligometastatic and oligoprogressive prostate cancer, Metastatic hormone-sensitive prostate cancer (mHSPC), Next-generation imaging, Non metastatic castration-resistant prostate cancer (nmCRPC), PSMA PET-imaging, Systemic therapy",

author = "Silke Gillessen and Alberto Bossi and Davis, {Ian D.} and {de Bono}, Johann and Karim Fizazi and James, {Nicholas D.} and Nicolas Mottet and Neal Shore and Eric Small and Matthew Smith and Sweeney, {Christopher J.} and Bertrand Tombal and Antonarakis, {Emmanuel S.} and Aparicio, {Ana M.} and Armstrong, {Andrew J.} and Gerhardt Attard and Beer, {Tomasz M.} and Himisha Beltran and Anders Bjartell and Pierre Blanchard and Alberto Briganti and Bristow, {Rob G.} and Muhammad Bulbul and Orazio Caffo and Daniel Castellano and Elena Castro and Cheng, {Heather H.} and Chi, {Kim N.} and Simon Chowdhury and Clarke, {Caroline S.} and Noel Clarke and Gedske Daugaard and {De Santis}, Maria and Ignacio Duran and Ross Eeles and Eleni Efstathiou and Jason Efstathiou and Ekeke, {Onyeanunam Ngozi} and Evans, {Christopher P.} and Stefano Fanti and Feng, {Felix Y.} and Valerie Fonteyne and Nicola Fossati and Mark Frydenberg and Dan George and Martin Gleave and Gwenaelle Gravis and Susan Halabi and Daniel Heinrich and Ken Herrmann and Celestia Higano and Hofman, {Michael S.} and Horvath, {Lisa G.} and Maha Hussain and Jereczek-Fossa, {Barbara A.} and Rob Jones and Ravindran Kanesvaran and Kellokumpu-Lehtinen, {Pirkko Liisa} and Khauli, {Raja B.} and Laurence Klotz and Gero Kramer and Raja Leibowitz and Christopher Logothetis and Brandon Mahal and Fernando Maluf and Joaquin Mateo and David Matheson and Niven Mehra and Axel Merseburger and Morgans, {Alicia K.} and Morris, {Michael J.} and Hind Mrabti and Deborah Mukherji and Murphy, {Declan G.} and Vedang Murthy and Nguyen, {Paul L.} and Oh, {William K.} and Piet Ost and O'Sullivan, {Joe M.} and Padhani, {Anwar R.} and Pezaro, {Carmel J.} and Poon, {Darren M.C.} and Pritchard, {Colin C.} and Rabah, {Danny M.} and Dana Rathkopf and Reiter, {Robert E.} and Rubin, {Mark A.} and Ryan, {Charles J.} and Fred Saad and Sade, {Juan Pablo} and Oliver Sartor and Scher, {Howard I.} and Nima Sharifi and Iwona Skoneczna and Howard Soule and Spratt, {Daniel E.} and Sandy Srinivas and Sternberg, {Cora N.} and Thomas Steuber and Hiroyoshi Suzuki and Sydes, {Matthew R.} and Taplin, {Mary Ellen} and Derya Tilki and Levent T{\"u}rkeri and Fabio Turco and Hiroji Uemura and Hirotsugu Uemura and Y{\"u}ksel {\"U}r{\"u}n and Vale, {Claire L.} and {van Oort}, Inge and Neha Vapiwala and Jochen Walz and Kosj Yamoah and Dingwei Ye and Yu, {Evan Y.} and Almudena Zapatero and Thomas Zilli and Aurelius Omlin",

note = "Publisher Copyright: {\textcopyright} 2023 The Authors",

year = "2023",

month = may,

doi = "10.1016/j.ejca.2023.02.018",

language = "English (US)",

volume = "185",

pages = "178--215",

journal = "European Journal of Cancer",

issn = "0959-8049",

publisher = "Elsevier Limited",

}

TY - JOUR

T1 - Management of patients with advanced prostate cancer—metastatic and/or castration-resistant prostate cancer

T2 - report of the Advanced Prostate Cancer Consensus Conference (APCCC) 2022

AU - Gillessen, Silke

AU - Bossi, Alberto

AU - Davis, Ian D.

AU - de Bono, Johann

AU - Fizazi, Karim

AU - James, Nicholas D.

AU - Mottet, Nicolas

AU - Shore, Neal

AU - Small, Eric

AU - Smith, Matthew

AU - Sweeney, Christopher J.

AU - Tombal, Bertrand

AU - Antonarakis, Emmanuel S.

AU - Aparicio, Ana M.

AU - Armstrong, Andrew J.

AU - Attard, Gerhardt

AU - Beer, Tomasz M.

AU - Beltran, Himisha

AU - Bjartell, Anders

AU - Blanchard, Pierre

AU - Briganti, Alberto

AU - Bristow, Rob G.

AU - Bulbul, Muhammad

AU - Caffo, Orazio

AU - Castellano, Daniel

AU - Castro, Elena

AU - Cheng, Heather H.

AU - Chi, Kim N.

AU - Chowdhury, Simon

AU - Clarke, Caroline S.

AU - Clarke, Noel

AU - Daugaard, Gedske

AU - De Santis, Maria

AU - Duran, Ignacio

AU - Eeles, Ross

AU - Efstathiou, Eleni

AU - Efstathiou, Jason

AU - Ekeke, Onyeanunam Ngozi

AU - Evans, Christopher P.

AU - Fanti, Stefano

AU - Feng, Felix Y.

AU - Fonteyne, Valerie

AU - Fossati, Nicola

AU - Frydenberg, Mark

AU - George, Dan

AU - Gleave, Martin

AU - Gravis, Gwenaelle

AU - Halabi, Susan

AU - Heinrich, Daniel

AU - Herrmann, Ken

AU - Higano, Celestia

AU - Hofman, Michael S.

AU - Horvath, Lisa G.

AU - Hussain, Maha

AU - Jereczek-Fossa, Barbara A.

AU - Jones, Rob

AU - Kanesvaran, Ravindran

AU - Kellokumpu-Lehtinen, Pirkko Liisa

AU - Khauli, Raja B.

AU - Klotz, Laurence

AU - Kramer, Gero

AU - Leibowitz, Raja

AU - Logothetis, Christopher

AU - Mahal, Brandon

AU - Maluf, Fernando

AU - Mateo, Joaquin

AU - Matheson, David

AU - Mehra, Niven

AU - Merseburger, Axel

AU - Morgans, Alicia K.

AU - Morris, Michael J.

AU - Mrabti, Hind

AU - Mukherji, Deborah

AU - Murphy, Declan G.

AU - Murthy, Vedang

AU - Nguyen, Paul L.

AU - Oh, William K.

AU - Ost, Piet

AU - O'Sullivan, Joe M.

AU - Padhani, Anwar R.

AU - Pezaro, Carmel J.

AU - Poon, Darren M.C.

AU - Pritchard, Colin C.

AU - Rabah, Danny M.

AU - Rathkopf, Dana

AU - Reiter, Robert E.

AU - Rubin, Mark A.

AU - Ryan, Charles J.

AU - Saad, Fred

AU - Sade, Juan Pablo

AU - Sartor, Oliver

AU - Scher, Howard I.

AU - Sharifi, Nima

AU - Skoneczna, Iwona

AU - Soule, Howard

AU - Spratt, Daniel E.

AU - Srinivas, Sandy

AU - Sternberg, Cora N.

AU - Steuber, Thomas

AU - Suzuki, Hiroyoshi

AU - Sydes, Matthew R.

AU - Taplin, Mary Ellen

AU - Tilki, Derya

AU - Türkeri, Levent

AU - Turco, Fabio

AU - Uemura, Hiroji

AU - Uemura, Hirotsugu

AU - Ürün, Yüksel

AU - Vale, Claire L.

AU - van Oort, Inge

AU - Vapiwala, Neha

AU - Walz, Jochen

AU - Yamoah, Kosj

AU - Ye, Dingwei

AU - Yu, Evan Y.

AU - Zapatero, Almudena

AU - Zilli, Thomas

AU - Omlin, Aurelius

PY - 2023/5

Y1 - 2023/5

N2 - 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 hormonal 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, diagnostic and treatment decisions always have to be individualised based on patient characteristics, 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 experts 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-metastatic 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.

AB - 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 hormonal 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, diagnostic and treatment decisions always have to be individualised based on patient characteristics, 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 experts 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-metastatic 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.

KW - Androgen receptor pathway inhibitors (ARPI)

KW - Chemotherapy

KW - Hormonal treatment

KW - Metastatic castration-resistant prostate cancer (mCRPC) and oligometastatic and oligoprogressive prostate cancer

KW - Metastatic hormone-sensitive prostate cancer (mHSPC)

KW - Next-generation imaging

KW - Non metastatic castration-resistant prostate cancer (nmCRPC)

KW - PSMA PET-imaging

KW - Systemic therapy

UR - http://www.scopus.com/inward/record.url?scp=85151286476&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85151286476&partnerID=8YFLogxK

U2 - 10.1016/j.ejca.2023.02.018

DO - 10.1016/j.ejca.2023.02.018

M3 - Article

C2 - 37003085

AN - SCOPUS:85151286476

SN - 0959-8049

VL - 185

SP - 178

EP - 215

JO - European Journal of Cancer

JF - European Journal of Cancer

ER -

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

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