Background and objective
Innovations have improved outcomes in advanced prostate cancer (PC). Nonetheless, we continue to lack high-level evidence on a variety of topics that greatly impact daily practice. The 2024 Advanced Prostate Cancer Consensus Conference (APCCC) surveyed experts on key questions in clinical management in order to supplement evidence-based guidelines.
Here we present voting results for questions from APCCC 2024.
Methods
Before the conference, a panel of 120 international PC experts used a modified Delphi process to develop 183 multiple-choice consensus questions on eight different topics. Before the conference, these questions were administered via a web-based survey to the voting panel members ("panellists").
Key findings and limitations
Consensus was a priori defined as ≥75% agreement, with strong consensus defined as ≥90% agreement. The voting results show varying degrees of consensus, as discussed in this article and detailed in the Supplementary material. These findings do not include a formal literature review or meta-analysis.
Conclusions and clinical implications
The voting results can help physicians and patients navigate controversial areas of clinical management for which high-level evidence is scant or conflicting. The findings can also help funders and policymakers in prioritising areas for future research. Diagnostic and treatment decisions should always be individualised on the basis of patient and cancer characteristics, and should incorporate current and emerging clinical evidence, guidelines, and logistic and economic factors. Enrolment in clinical trials is always strongly encouraged. Importantly, APCCC 2024 once again identified important gaps (areas of nonconsensus) that merit evaluation in specifically designed trials.
European urology. 2024 Oct 10 [Epub ahead of print]
Related Content:
UroToday Exclusive APCCC 2024 Clinical Conversations
UroToday Exclusive APCCC 2024 Written Conference Coverage
Silke Gillessen, Fabio Turco, Ian D Davis, Jason A Efstathiou, Karim Fizazi, Nicholas D James, Neal Shore, Eric Small, Matthew Smith, Christopher J Sweeney, Bertrand Tombal, Thomas Zilli, Neeraj Agarwal, Emmanuel S Antonarakis, Ana Aparicio, Andrew J Armstrong, Diogo Assed Bastos, Gerhardt Attard, Karol Axcrona, Mouna Ayadi, Himisha Beltran, Anders Bjartell, Pierre Blanchard, Maria T Bourlon, Alberto Briganti, Muhammad Bulbul, Consuelo Buttigliero, Orazio Caffo, Daniel Castellano, Elena Castro, Heather H Cheng, Kim N Chi, Caroline S Clarke, Noel Clarke, Johann S de Bono, Maria De Santis, Ignacio Duran, Eleni Efstathiou, Onyeanunam N Ekeke, Tamer I H El Nahas, Louise Emmett, Stefano Fanti, Omolara A Fatiregun, Felix Y Feng, Peter C C Fong, Valerie Fonteyne, Nicola Fossati, Daniel J George, Martin E Gleave, Gwenaelle Gravis, Susan Halabi, Daniel Heinrich, Ken Herrmann, Michael S Hofman, Thomas A Hope, Lisa G Horvath, Maha H A Hussain, Barbara Alicja Jereczek-Fossa, Robert J Jones, Anthony M Joshua, Ravindren Kanesvaran, Daniel Keizman, Raja B Khauli, Gero Kramer, Stacy Loeb, Brandon A Mahal, Fernando C Maluf, Joaquin Mateo, David Matheson, Mika P Matikainen, Ray McDermott, Rana R McKay, Niven Mehra, Axel S Merseburger, Alicia K Morgans, Michael J Morris, Hind Mrabti, Deborah Mukherji, Declan G Murphy, Vedang Murthy, Shingai B A Mutambirwa, Paul L Nguyen, William K Oh, Piet Ost, Joe M O'Sullivan, Anwar R Padhani, Chris Parker, Darren M C Poon, Colin C Pritchard, Danny M Rabah, Dana Rathkopf, Robert E Reiter, Raphaele Renard-Penna, Charles J Ryan, Fred Saad, Juan Pablo Sade, Shahneen Sandhu, Oliver A Sartor, Edward Schaeffer, Howard I Scher, Nima Sharifi, Iwona A Skoneczna, Howard R Soule, Daniel E Spratt, Sandy Srinivas, Cora N Sternberg, Hiroyoshi Suzuki, Mary-Ellen Taplin, Camilla Thellenberg-Karlsson, Derya Tilki, Levent N Türkeri, Hiroji Uemura, Yüksel Ürün, Claire L Vale, Neha Vapiwala, Jochen Walz, Kosj Yamoah, Dingwei Ye, Evan Y Yu, Almudena Zapatero, Aurelius Omlin
Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland; Faculty of Biosciences, Università della Svizzera Italiana, Lugano, Switzerland. Electronic address: ., Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland., Monash University, Melbourne, Australia; Eastern Health, Melbourne, Australia., Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA., Institut Gustave Roussy, University of Paris Saclay, Villejuif, France., Institute of Cancer Research, London, UK., Carolina Urologic Research Center and GenesisCare, Myrtle Beach, SC, USA., Helen Diller Family Comprehensive Cancer Center, University of California-San Francisco, San Francisco, CA, USA., Massachusetts General Hospital Cancer Center, Boston, MA, USA., South Australian Immunogenomics Cancer Institute, University of Adelaide, Adelaide, Australia., Division of Urology, Clinique Universitaire St. Luc, Brussels, Belgium., Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland; Faculty of Biosciences, Università della Svizzera Italiana, Lugano, Switzerland., Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA., Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA., Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA., Center for Prostate and Urologic Cancer, Duke Cancer Institute, Duke University, Durham, NC, USA., Hospital Sirio-Libanês, São Paulo, Brazil., UCL Cancer Institute, University College London, London, UK., Department of Molecular Oncology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway; Department of Urology, Akershus University Hospital, Lørenskog, Norway., Salah Azaiz Institute, Medical School of Tunis, Tunis, Tunisia., Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Harvard Medical School, Boston, MA, USA., Department of Urology, Skåne University Hospital, Malmö, Sweden., Department of Radiation Oncology, Oncostat U1018 INSERM, Université Paris-Saclay, Gustave-Roussy, Villejuif, France., Instituto Nacional de Ciencias Medicas y Nutrición Salvador Zubirán, Mexico City, Mexico., Unit of Urology/Division of Oncology, Urological Research Institute, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy., Division of Urology, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon., Department of Oncology, San Luigi Hospital, University of Turin, Orbassano, Italy., Medical Oncology Department, Santa Chiara Hospital, APSS, Trento, Italy., Department of Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, Spain., Department of Medicine, Division of Hematology and Oncology, University of Washington, Seattle, WA, USA; Division of Clinical Research, Fred Hutchinson Cancer Center, Seattle, WA USA., BC Cancer and University of British Columbia, Vancouver, Canada., Research Department of Primary Care and Population Health, University College London, London, UK., The Christie and Salford Royal Hospitals, Manchester, UK., Institute of Cancer Research, London, UK; Royal Marsden Hospital, London, UK., Department of Urology, Charité Universitätsmedizin Berlin, Berlin, Germany; Department of Urology, Medical University of Vienna, Vienna, Austria., Medical Oncology Department, Hospital Universitario Marques de Valdecilla, IDIVAL, Santander, Spain., Houston Methodist Cancer Center, Houston, TX, USA., Urology Division, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria., Kasr Al Ainy Hospital, Cairo University, Giza, Egypt., Department of Theranostics and Nuclear Medicine, St. Vincent's Hospital, Sydney, Australia; Faculty of Medicine, UNSW Sydney, Sydney, Australia., Department of Nuclear Medicine, IRCCS AOU Bologna, Bologna, Italy., Lagos State University Teaching Hospital, Ikeja, Nigeria., University of California-San Francisco, San Francisco, CA, USA., Auckland City Hospital and University of Auckland, Auckland, New Zealand., Ghent University Hospital, Ghent, Belgium., Department of Surgery (Urology Service), Ente Ospedaliero Cantonale, Università della Svizzera Italiana Lugano, Switzerland., Departments of Medicine and Surgery, Duke Cancer Institute, Duke University, Durham, NC, USA., Department of Urologic Sciences, University of British Columbia, Vancouver, Canada., Department of Medical Oncology, Institut Paoli Calmettes, Aix-Marseille Université, Marseille, France., Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA., Department of Oncology and Radiotherapy, Innlandet Hospital Trust, Gjøvik, Norway., Department of Nuclear Medicine, University of Duisburg-Essen, Essen, Germany; German Cancer Consortium, University Hospital Essen, Essen, Germany., Prostate Cancer Theranostics and Imaging Centre of Excellence, Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia., Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, CA, USA., Chris O'Brien Lifehouse, University of Sydney, Sydney, Australia., Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA., Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy; Department of Radiation Oncology, European Institute of Oncology IRCCS, Milan, Italy., School of Cancer Sciences, University of Glasgow, Glasgow, UK., Department of Medical Oncology, Kinghorn Cancer Centre, St. Vincent's Hospital, Sydney, Australia., Division of Medical Oncology, National Cancer Centre, Singapore., Genitourinary Unit, Division of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel., Naef K. Basile Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon; Division of Urology, Carle-Illinois College of Medicine, Urbana, IL, USA., Department of Urology, Medical University of Vienna, Vienna, Austria., Department of Urology and Population Health, New York University Langone Health, New York, NY, USA; Department of Surgery/Urology, Manhattan Veterans Affairs, New York, NY, USA., Department of Radiation Oncology, University of Miami Sylvester Cancer Center, Miami, FL, USA., Beneficiência Portuguesa de São Paulo, São Paulo, Brazil; Departamento de Oncologia, Hospital Israelita Albert Einstein, São Paulo, Brazil., Vall d'Hebron Institute of Oncology, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain., Faculty of Education Health and Wellbeing, University of Wolverhampton, Walsall, UK., Department of Urology, Helsinki University Hospital, Helsinki, Finland., Department of Medical Oncology, St. Vincent's University Hospital and Cancer Trials, Dublin, Ireland., University of California-San Diego, Palo Alto, CA, USA., Department of Medical Oncology, Radboudumc, Nijmegen, The Netherlands., Department of Urology, University Hospital Schleswig-Holstein, Lübeck, Germany., Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA., Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Institut National d'Oncologie, Mohamed V University, Rabat, Morocco., Clemenceau Medical Center, Dubai, United Arab Emirates; Division of Hematology and Oncology, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon., Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia; Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia., Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India., Department of Urology, Sefako Makgatho Health Science University, Dr. George Mukhari Academic Hospital, Medunsa, South Africa., Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA., Division of Hematology and Medical Oncology, Tisch Cancer Institute at Mount Sinai, New York, NY, USA., Department of Radiation Oncology, Iridium Network, Antwerp, Belgium; Department of Human Structure and Repair, Ghent University, Ghent, Belgium., Patrick G. Johnston Centre for Cancer Research, Queen's University, Belfast, UK., Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, UK., Hong Kong Sanatorium and Hospital, Chinese University of Hong Kong, Hong Kong, China., Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA., Cancer Research Chair and Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Department of Urology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia., University of California-Los Angeles, Los Angeles, CA, USA., Department of Imagery, GRC 5 Predictive Onco-Uro, Pitie-Salpetriere Hospital, AP-HP, Sorbonne University, Paris, France., Centre Hospitalier de Université de Montréal, Montreal, Canada., Instituto Alexander Fleming, Buenos Aires, Argentina., Department of Medical Oncology, Mayo Clinic Comprehensive Cancer Center, Rochester, MN, USA., Desai Sethi Urology Institute and Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA., Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland., Prostate Cancer Foundation, Santa Monica, CA, USA., Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Cleveland, OH, USA., Division of Medical Oncology, Stanford University Medical Center, Stanford, CA, USA., Englander Institute for Precision Medicine, Weill Cornell Medicine, Division of Hematology and Oncology, Meyer Cancer Center, New York Presbyterian Hospital, New York, NY, USA., Department of Urology, Toho University Sakura Medical Center, Sakura, Japan., Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA., Department of Diagnostics and Intervention, Oncology, Umeå University, Umeå, Sweden., Martini-Klinik Prostate Cancer Center and Department of Urology, University Hospital Hamburg Eppendorf, Hamburg, Germany., Department of Urology, M.A. Aydınlar Acıbadem University, Altunizade Hospital, Istanbul, Turkey., Yokohama City University Medical Center, Yokohama, Japan., Department of Medical Oncology, Ankara University School of Medicine, Ankara, Turkey., MRC Clinical Trials Unit, University College London, London, UK., Department of Radiation Oncology, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA., Institut Paoli-Calmettes Cancer Center, Marseille, France., H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA., Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China., University Hospital La Princesa, Health Research Institute, Madrid, Spain., Onkozentrum Zurich, University of Zurich and Tumorzentrum Hirslanden Zurich, Zurich, Switzerland.