EAU 2017: Risk-based selection for active surveillance: Results of the Movember Foundation’s Global Action Plan prostate cancer active surveillance (GAP3) initiative
The authors utilized 23 cohorts from the Movember sponsored Global Action Plan (GAP3) consortium of patients on AS. The GAP3 initiative is to pool data from worldwide leaders in prostate cancer with the aim to develop new guidelines leading to optimal treatment of men with low risk prostate cancer. This study used generalized linear mixed models to estimate pooled odds ratios for predictors of progression, defined as any increase in Gleason grade at 1 or 4 years of follow-up. Among 5,483 men evaluated at 1 year, 814 patients (15%) had reclassification and among 1,564 patients evaluated at 4 years, 233 patients (15%) had reclassification from biopsy Gleason score upgrading. Predictors at 1-year for progression risk included age, year of diagnosis, prostate volume, T-stage at diagnosis, number of cores of cancer at diagnosis, PSA, and PSA density. Similarly, predictors of progression at 4-years included age, number of cores of cancer at diagnosis, PSA, and PSA density.
One of the strengths of this study is the pragmatic and “real world” experience gained from including AS patterns from around the world, albeit at major academic centers (no community centers). As data matures, we will eagerly await downstream clinical outcomes form the GAP3 AS consortium.
Speaker(s): Daan Nieboer, Department of Public Health, Erasmus MC, Rotterdam, The Netherlands
Co-Authors: E. Steyerberg, S. Bruinsma, C. Bangma, M. Roobol
Written By: Zachary Klaassen, MD, Urologic Oncology Fellow, University of Toronto
Twitter: @zklaassen_md
at the #EAU17 - March 24-28, 2017- London, England