Optimal management of metastatic castration-resistant prostate cancer: Highlights from a European Expert Consensus Panel

John M. Fitzpatrick; Joaquim Bellmunt; Karim Fizazi; Axel Heidenreich; Cora N. Sternberg; Bertrand Tombal; Antonio Alcaraz; Amit Bahl; Sergio Bracarda; Giuseppe Di Lorenzo; Eleni Efstathiou; Stephen P. Finn; Sophie Fosså; Silke Gillessen; Pirkko Liisa Kellokumpu-Lehtinen; Frédéric E. Lecouvet; Stephane Oudard; Theo M. De Reijke; Craig N. Robson; Maria De Santis; Bostjan Seruga; Ronald De Wit

doi:10.1016/j.ejca.2014.03.010

Optimal management of metastatic castration-resistant prostate cancer: Highlights from a European Expert Consensus Panel

John M. Fitzpatrick, Joaquim Bellmunt, Karim Fizazi, Axel Heidenreich, Cora N. Sternberg, Bertrand Tombal, Antonio Alcaraz, Amit Bahl, Sergio Bracarda, Giuseppe Di Lorenzo, Eleni Efstathiou, Stephen P. Finn, Sophie Fosså, Silke Gillessen, Pirkko Liisa Kellokumpu-Lehtinen, Frédéric E. Lecouvet, Stephane Oudard, Theo M. De Reijke, Craig N. Robson, Maria De SantisBostjan Seruga, Ronald De Wit

Genitourinary Medical Oncology

Research output: Contribution to journal › Review article › peer-review

128 Scopus citations

Abstract

The exponential growth of novel therapies for the treatment of metastatic castration-resistant prostate cancer (mCRPC) over the last decade has created an acute need for education and guidance of clinicians regarding optimal strategies for patient management. A multidisciplinary panel of 21 European experts in mCRPC assembled for comprehensive discussion and consensus development, seeking to move the field forward and provide guidance and perspectives on optimal selection and sequencing of therapeutic agents and monitoring of response to treatment and disease progression. A total of 110 clinically-relevant questions were addressed and a modified Delphi method was utilised to obtain a consensus. The panel reached a consensus on several important issues, providing recommendations on appropriate phase III clinical trial end-points and optimal strategies for imaging and monitoring of bone metastases. Guidance regarding selection and sequencing of therapy in patients with newly diagnosed or progressive mCRPC is emphasised, including the use of novel bone-targeted agents, chemotherapy, androgen receptor pathway-targeted agents and immunotherapy. The impact of drug resistance and prostate-specific antigen flare on treatment decisions was also addressed. Ultimately, individualised therapy for patients with mCRPC is dependent on continued refinement of clinical decision-making based on patient and disease characteristics. This consensus statement offers clinicians expert guidance on the implementation of recent advances to improve patient outcome, focusing on the future of prostate cancer care.

Original language	English (US)
Pages (from-to)	1617-1627
Number of pages	11
Journal	European Journal of Cancer
Volume	50
Issue number	9
DOIs	https://doi.org/10.1016/j.ejca.2014.03.010
State	Published - Jun 2014

Keywords

Abiraterone
Cabazitaxel
Circulating tumour cells
Consensus
Denosumab
Docetaxel
Enzalutamide
Metastatic castration-resistant prostate cancer
Radium 223 dichloride
Sipuleucel-T

ASJC Scopus subject areas

Oncology
Cancer Research

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10.1016/j.ejca.2014.03.010

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Fitzpatrick, J. M., Bellmunt, J., Fizazi, K., Heidenreich, A., Sternberg, C. N., Tombal, B., Alcaraz, A., Bahl, A., Bracarda, S., Di Lorenzo, G., Efstathiou, E., Finn, S. P., Fosså, S., Gillessen, S., Kellokumpu-Lehtinen, P. L., Lecouvet, F. E., Oudard, S., De Reijke, T. M., Robson, C. N., ... De Wit, R. (2014). Optimal management of metastatic castration-resistant prostate cancer: Highlights from a European Expert Consensus Panel. European Journal of Cancer, 50(9), 1617-1627. https://doi.org/10.1016/j.ejca.2014.03.010

Fitzpatrick, JM, Bellmunt, J, Fizazi, K, Heidenreich, A, Sternberg, CN, Tombal, B, Alcaraz, A, Bahl, A, Bracarda, S, Di Lorenzo, G, Efstathiou, E, Finn, SP, Fosså, S, Gillessen, S, Kellokumpu-Lehtinen, PL, Lecouvet, FE, Oudard, S, De Reijke, TM, Robson, CN, De Santis, M, Seruga, B & De Wit, R 2014, 'Optimal management of metastatic castration-resistant prostate cancer: Highlights from a European Expert Consensus Panel', European Journal of Cancer, vol. 50, no. 9, pp. 1617-1627. https://doi.org/10.1016/j.ejca.2014.03.010

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title = "Optimal management of metastatic castration-resistant prostate cancer: Highlights from a European Expert Consensus Panel",

abstract = "The exponential growth of novel therapies for the treatment of metastatic castration-resistant prostate cancer (mCRPC) over the last decade has created an acute need for education and guidance of clinicians regarding optimal strategies for patient management. A multidisciplinary panel of 21 European experts in mCRPC assembled for comprehensive discussion and consensus development, seeking to move the field forward and provide guidance and perspectives on optimal selection and sequencing of therapeutic agents and monitoring of response to treatment and disease progression. A total of 110 clinically-relevant questions were addressed and a modified Delphi method was utilised to obtain a consensus. The panel reached a consensus on several important issues, providing recommendations on appropriate phase III clinical trial end-points and optimal strategies for imaging and monitoring of bone metastases. Guidance regarding selection and sequencing of therapy in patients with newly diagnosed or progressive mCRPC is emphasised, including the use of novel bone-targeted agents, chemotherapy, androgen receptor pathway-targeted agents and immunotherapy. The impact of drug resistance and prostate-specific antigen flare on treatment decisions was also addressed. Ultimately, individualised therapy for patients with mCRPC is dependent on continued refinement of clinical decision-making based on patient and disease characteristics. This consensus statement offers clinicians expert guidance on the implementation of recent advances to improve patient outcome, focusing on the future of prostate cancer care.",

keywords = "Abiraterone, Cabazitaxel, Circulating tumour cells, Consensus, Denosumab, Docetaxel, Enzalutamide, Metastatic castration-resistant prostate cancer, Radium 223 dichloride, Sipuleucel-T",

author = "Fitzpatrick, {John M.} and Joaquim Bellmunt and Karim Fizazi and Axel Heidenreich and Sternberg, {Cora N.} and Bertrand Tombal and Antonio Alcaraz and Amit Bahl and Sergio Bracarda and {Di Lorenzo}, Giuseppe and Eleni Efstathiou and Finn, {Stephen P.} and Sophie Foss{\aa} and Silke Gillessen and Kellokumpu-Lehtinen, {Pirkko Liisa} and Lecouvet, {Fr{\'e}d{\'e}ric E.} and Stephane Oudard and {De Reijke}, {Theo M.} and Robson, {Craig N.} and {De Santis}, Maria and Bostjan Seruga and {De Wit}, Ronald",

note = "Funding Information: The authors would like to thank Julian Lee Lokey, MD, and Sanneke Koekkoek, BSN, for assistance with data collection; Tristin Abair, PhD, and Julian Lee Lokey, MD, for their assistance in drafting this manuscript; and Trudy Grenon Stoddert, ELS, for editorial assistance and assistance preparing the manuscript for submission. All were compensated by prIME Oncology. Financial support was provided by an educational grant from Sanofi Oncology . ",

year = "2014",

month = jun,

doi = "10.1016/j.ejca.2014.03.010",

language = "English (US)",

volume = "50",

pages = "1617--1627",

journal = "European Journal of Cancer",

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T2 - Highlights from a European Expert Consensus Panel

AU - Fitzpatrick, John M.

AU - Bellmunt, Joaquim

AU - Fizazi, Karim

AU - Heidenreich, Axel

AU - Sternberg, Cora N.

AU - Tombal, Bertrand

AU - Alcaraz, Antonio

AU - Bahl, Amit

AU - Bracarda, Sergio

AU - Di Lorenzo, Giuseppe

AU - Efstathiou, Eleni

AU - Finn, Stephen P.

AU - Fosså, Sophie

AU - Gillessen, Silke

AU - Kellokumpu-Lehtinen, Pirkko Liisa

AU - Lecouvet, Frédéric E.

AU - Oudard, Stephane

AU - De Reijke, Theo M.

AU - Robson, Craig N.

AU - De Santis, Maria

AU - Seruga, Bostjan

AU - De Wit, Ronald

N1 - Funding Information: The authors would like to thank Julian Lee Lokey, MD, and Sanneke Koekkoek, BSN, for assistance with data collection; Tristin Abair, PhD, and Julian Lee Lokey, MD, for their assistance in drafting this manuscript; and Trudy Grenon Stoddert, ELS, for editorial assistance and assistance preparing the manuscript for submission. All were compensated by prIME Oncology. Financial support was provided by an educational grant from Sanofi Oncology .

PY - 2014/6

Y1 - 2014/6

N2 - The exponential growth of novel therapies for the treatment of metastatic castration-resistant prostate cancer (mCRPC) over the last decade has created an acute need for education and guidance of clinicians regarding optimal strategies for patient management. A multidisciplinary panel of 21 European experts in mCRPC assembled for comprehensive discussion and consensus development, seeking to move the field forward and provide guidance and perspectives on optimal selection and sequencing of therapeutic agents and monitoring of response to treatment and disease progression. A total of 110 clinically-relevant questions were addressed and a modified Delphi method was utilised to obtain a consensus. The panel reached a consensus on several important issues, providing recommendations on appropriate phase III clinical trial end-points and optimal strategies for imaging and monitoring of bone metastases. Guidance regarding selection and sequencing of therapy in patients with newly diagnosed or progressive mCRPC is emphasised, including the use of novel bone-targeted agents, chemotherapy, androgen receptor pathway-targeted agents and immunotherapy. The impact of drug resistance and prostate-specific antigen flare on treatment decisions was also addressed. Ultimately, individualised therapy for patients with mCRPC is dependent on continued refinement of clinical decision-making based on patient and disease characteristics. This consensus statement offers clinicians expert guidance on the implementation of recent advances to improve patient outcome, focusing on the future of prostate cancer care.

AB - The exponential growth of novel therapies for the treatment of metastatic castration-resistant prostate cancer (mCRPC) over the last decade has created an acute need for education and guidance of clinicians regarding optimal strategies for patient management. A multidisciplinary panel of 21 European experts in mCRPC assembled for comprehensive discussion and consensus development, seeking to move the field forward and provide guidance and perspectives on optimal selection and sequencing of therapeutic agents and monitoring of response to treatment and disease progression. A total of 110 clinically-relevant questions were addressed and a modified Delphi method was utilised to obtain a consensus. The panel reached a consensus on several important issues, providing recommendations on appropriate phase III clinical trial end-points and optimal strategies for imaging and monitoring of bone metastases. Guidance regarding selection and sequencing of therapy in patients with newly diagnosed or progressive mCRPC is emphasised, including the use of novel bone-targeted agents, chemotherapy, androgen receptor pathway-targeted agents and immunotherapy. The impact of drug resistance and prostate-specific antigen flare on treatment decisions was also addressed. Ultimately, individualised therapy for patients with mCRPC is dependent on continued refinement of clinical decision-making based on patient and disease characteristics. This consensus statement offers clinicians expert guidance on the implementation of recent advances to improve patient outcome, focusing on the future of prostate cancer care.

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KW - Enzalutamide

KW - Metastatic castration-resistant prostate cancer

KW - Radium 223 dichloride

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Optimal management of metastatic castration-resistant prostate cancer: Highlights from a European Expert Consensus Panel

Abstract

Keywords

ASJC Scopus subject areas

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