The first St Gallen Advanced Prostate Cancer Consensus Conference (APCCC) Expert Panel identified and reviewed the available evidence for the ten most important areas of controversy in advanced prostate cancer (APC) management.
The successful registration of several drugs for castration-resistant prostate cancer and the recent studies of chemo-hormonal therapy in men with castration-naïve prostate cancer have led to considerable uncertainty as to the best treatment choices, sequence of treatment options and appropriate patient selection. Management recommendations based on expert opinion, and not based on a critical review of the available evidence, are presented.The various recommendations carried differing degrees of support, as reflected in the wording of the article text and in the detailed voting results recorded in supplementary Material, available at Annals of Oncology online.
Detailed decisions on treatment as always will involve consideration of disease extent and location, prior treatments, host factors, patient preferences as well as logistical and economic constraints. Inclusion of men with APC in clinical trials should be encouraged.
Ann Oncol. 2015 Aug;26(8):1589-604. doi: 10.1093/annonc/mdv257. Epub 2015 Jun 3.
Gillessen S1, Omlin A2, Attard G3, de Bono JS3, Efstathiou E4, Fizazi K5, Halabi S6, Nelson PS7, Sartor O8, Smith MR9, Soule HR10, Akaza H11, Beer TM12, Beltran H13, Chinnaiyan AM14, Daugaard G15, Davis ID16, De Santis M17, Drake CG18, Eeles RA19, Fanti S20, Gleave ME21, Heidenreich A22, Hussain M23, James ND24, Lecouvet FE25, Logothetis CJ26, Mastris K27, Nilsson S28, Oh WK29, Olmos D30, Padhani AR31, Parker C32, Rubin MA33, Schalken JA34, Scher HI35, Sella A36, Shore ND37, Small EJ38, Sternberg CN39, Suzuki H40, Sweeney CJ41, Tannock IF42, Tombal B43.
1 Department of Oncology/Haematology, Kantonsspital St Gallen, St Gallen, Switzerland
2 Department of Oncology/Haematology, Kantonsspital St Gallen, St Gallen, Switzerland.
3 Prostate Cancer Targeted Therapy Group and Drug Development Unit, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK.
4 Department of Genitourinary Medical Oncology, MD Anderson Cancer Centre, Houston Department of Genitourinary Medical Oncology, David H. Koch Centre, The University of Texas M. D. Anderson Cancer Centre, Houston, USA Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.
5 Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Sud, Villejuif, France.
6 Department of Biostatistics and Bioinformatics, Duke University, Durham.
7 Division of Human Biology, Fred Hutchinson Cancer Research Centre, Seattle.
8 Tulane Cancer Centre, Tulane University, New Orleans.
9 Massachusetts General Hospital Cancer Centre, Boston.
10 Prostate Cancer Foundation, Santa Monica, USA.
11 Research Centre for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan.
12 Oregon Health & Science University Knight Cancer Institute, Portland.
13 Department of Medicine, Weill Cornell Medical College, New York.
14 Michigan Centre for Translational Pathology, Department of Pathology Department of Urology, Comprehensive Cancer Centre Howard Hughes Medical Institute, University of Michigan Medical School, Ann Arbor, USA.
15 Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
16 Monash University and Eastern Health, Eastern Health Clinical School, Box Hill, Australia.
17 Cancer Research Centre, University of Warwick, Warwick, UK Ludwig Boltzmann Institute for Applied Cancer Research, Kaiser Franz Josef-Spital, Vienna, Austria.
18 Johns Hopkins Sidney Kimmel Cancer Center and The Brady Urological Institute, Department of Urology, Johns Hopkins University School of Medicine, Baltimore, USA.
19 The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK.
20 Department of Nuclear Medicine, Policlinico S. Orsola, University of Bologna, Bologna, Italy.
21 Urological Sciences, Vancouver Prostate Centre, University of British Columbia, Vancouver, Canada.
22 Klinik und Poliklinik für Urologie, RWTH University Aachen, Aachen, Germany.
23 University of Michigan Comprehensive Cancer Center, Ann Arbor, USA.
24 Cancer Research Centre, University of Warwick, Warwick, UK Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham, Birmingham, UK.
25 Department of Radiology, Centre du Cancer et Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint Luc, Brussels, Belgium.
26 Department of Genitourinary Medical Oncology, MD Anderson Cancer Centre, Houston Department of Genitourinary Medical Oncology, David H. Koch Centre, The University of Texas M. D. Anderson Cancer Centre, Houston, USA.
27 Europa Uomo Prostate Patients, Clayhall Ilford, UK.
28 Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
29 Division of Haematology and Medical Oncology, The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, USA.
30 Prostate Cancer Clinical Research Unit, Spanish National Cancer Research Centre (CNIO), Madrid CNIO-IBIMA Genitourinary Cancer Unit, Hospitales Universitarios Virgen de la Victoria y Regional de Málaga, Málaga Centro Integral Oncológico Clara Campal (CIOCC), Madrid, Spain.
31 Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood.
32 Prostate Cancer Targeted Therapy Group, Academic Urology Unit and Department of Diagnostic Radiology, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, Sutton, UK.
33 Institute for Precision Medicine, Meyer Cancer Center, Department of Pathology and Urology, Weill Cornell Medical College and NewYork Presbyterian, New York, USA.
34 Department of Urology, Radboud University, Medical Centre, Nijmegen, The Netherlands.
35 Department of Medicine, Weill Cornell Medical College, New York Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Centre, New York.
36 Department of Oncology, Assaf Harofeh Medical Centre, Tel-Aviv University, Sackler School of Medicine, Zerifin, Israel.
37 Department of Urology, Carolina Urologic Research Centre, Myrtle Beach.
38 Helen Diller Family Comprehensive Cancer Centre, UCSF, San Francisco, USA.
39 Department of Medical Oncology, San Camillo and Forlanini Hospitals, Rome, Italy.
40 Department of Urology, Toho University Sakura Medical Center, Chiba, Japan.
41 Department of Medical Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
42 Department of Medical Oncology and Haematology, Princess Margaret Cancer Centre, Toronto, Canada.
43 Service D'Urologie, Institut de Recherche Clinique, Université Catholique de Louvain, Brussels, Belgium.