Background: Innovations in treatments, imaging, and molecular characterisation in advanced prostate cancer have improved outcomes, but various areas of management still lack high-level evidence to inform clinical practice. The 2021 Advanced Prostate Cancer Consensus Conference (APCCC) addressed some of these questions to supplement guidelines that are based on level 1 evidence. Objective: To present the voting results from APCCC 2021. Design, setting, and participants: The experts identified three major areas of controversy related to management of advanced prostate cancer: newly diagnosed metastatic hormone-sensitive prostate cancer (mHSPC), the use of prostate-specific membrane antigen ligands in diagnostics and therapy, and molecular characterisation of tissue and blood. A panel of 86 international prostate cancer experts developed the programme and the consensus questions. Outcome measurements and statistical analysis: The panel voted publicly but anonymously on 107 pre-defined questions, which were developed by both voting and non-voting panel members prior to the conference following a modified Delphi process. Results and limitations: The voting reflected the opinions of 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 reported in the Supplementary material. Conclusions: These voting results from a panel of experts in advanced prostate cancer can help clinicians and patients to navigate controversial areas of management for which high-level evidence is scant. However, diagnostic and treatment decisions should always be individualised according to patient characteristics, such as the extent and location of disease, prior treatment(s), comorbidities, patient preferences, and treatment recommendations, and should also incorporate current and emerging clinical evidence and logistic and economic constraints. Enrolment in clinical trials should be strongly encouraged. Importantly, APCCC 2021 once again identified salient questions that merit evaluation in specifically designed trials. Patient summary: The Advanced Prostate Cancer Consensus Conference is a forum for discussing current diagnosis and treatment options for patients with advanced prostate cancer. An expert panel votes on predefined questions focused on the most clinically relevant areas for treatment of advanced prostate cancer for which there are gaps in knowledge. The voting results provide a practical guide to help clinicians in discussing treatment options with patients as part of shared decision-making.
Bibliographical noteFunding Information:
Acknowledgments: We would like to especially thank Dr. Amy Karon for editorial assistance with the manuscript. We thank the APC Society, namely Thomas Cerny, Claude Thomann, and Ruth Lyner, for their support. We gratefully acknowledge the following organisations for providing financial support for APCCC 2021: Swiss Cancer Research, Prostate Cancer Foundation and Movember Foundation, and the European School of Oncology. We also acknowledge sponsorship from several for-profit organisations, including Advanced Accelerator Applications, Amgen, Astellas, AstraZeneca, Bayer Health Care, Debiopharm, MSD, Janssen Oncology, Myovant, Orion Pharma, Pfizer Oncology, Roche, and Tolmar. These for-profit organisations supported the conference financially but had no input into the scientific content or the final publication. Ian D. Davis is supported by a National Health and Medical Research Council (NHMRC) Practitioner Fellowship (APP1102604). Michael S. Hofman is supported by a grant from the Prostate Cancer Foundation funded by CANICA AS Oslo Norway, the Peter MacCallum Foundation, and an NHMRC Investigator Grant.
© 2022 The Author(s)
- Advanced prostate cancer
- Castration-resistant prostate cancer
- Hormone-sensitive prostate cancer
- Lu-PSMA therapy
- Next-generation sequencing
- PARP inhibition
- Prostate cancer treatment
- Tumour genomic profiling
- Prostatic Neoplasms/diagnosis
PubMed: MeSH publication types
- Journal Article