Management of Patients with Advanced Prostate Cancer: The Report of the Advanced Prostate Cancer Consensus Conference APCCC 2017
Authors: Silke Gillessen, Gerhardt Attard, Tomasz M. Beer, Himisha Beltran, Alberto Bossi, Rob Bristow, Brett Carver, Daniel Castellano, Byung Ha Chung, Noel Clarke, Gedske Daugaard, Ian D. Davis, Johann de Bono, Rodolfo Borges dos Reis, Charles G. Drake, Ros Eeles, Eleni Efstathiou, Christopher P. Evans, Stefano Fanti, Felix Feng, Karim Fizazi, Mark Frydenberg, Martin Gleave, Susan Halabi, Axel Heidenreich, Celestia S. Higano, Nicolas James, Philip Kantoff, Pirkko-Liisa Kellokumpu-Lehtinen, Raja B. Khauli, Gero Kramer, Chris Logothetis, Fernando Maluf, Alicia K. Morgans, Michael J. Morris, Nicolas Mottet, Vedang Murthy, William Oh, Piet Ost, Anwar R. Padhani, Chris Parker, Colin C. Pritchard, Mack Roach, Mark A. Rubin, Charles Ryan, Fred Saad, Oliver Sartor, Howard Scher, Avishay Sella, Neal Shore, Matthew Smith, Howard Soule, Cora N. Sternberg, Hiroyoshi Suzuki, Christopher Sweeney, Matthew R. Sydes, Ian Tannock, Bertrand Tombal, Riccardo Valdagni, Thomas Wiegel, Aurelius Omlin
Journal: European Urology (2017)

In advanced prostate cancer (APC), successful drug development as well as advances in imaging and molecular characterisation have resulted in multiple areas where there is lack of evidence or low level of evidence. The Advanced Prostate Cancer Consensus Conference (APCCC) 2017 addressed some of these topics. To present the report of APCCC 2017. Ten important areas of controversy in APC management were identified: high-risk localised and locally advanced prostate cancer; “oligometastatic” prostate cancer; castration-naïve and castration-resistant prostate cancer; the role of imaging in APC; osteoclast-targeted therapy; molecular characterisation of blood and tissue; genetic counselling/testing; side effects of systemic treatment(s); global access to prostate cancer drugs. A panel of 60 international prostate cancer experts developed the program and the consensus questions. The panel voted publicly but anonymously on 150 predefined questions, which have been developed following a modified Delphi process. Voting is based on panellist opinion, and thus is not based on a standard literature review or meta-analysis. The outcomes of the voting had varying degrees of support, as reflected in the wording of this article, as well as in the detailed voting results recorded in Supplementary data. The presented expert voting results can be used for support in areas of management of men with APC where there is no high-level evidence, but individualised treatment decisions should as always be based on all of the data available, including disease extent and location, prior therapies regardless of type, host factors including comorbidities, as well as patient preferences, current and emerging evidence, and logistical and economic constraints. Inclusion of men with APC in clinical trials should be strongly encouraged. Importantly, APCCC 2017 again identified important areas in need of trials specifically designed to address them. The second Advanced Prostate Cancer Consensus Conference APCCC 2017 did provide a forum for discussion and debates on current treatment options for men with advanced prostate cancer. The aim of the conference is to bring the expertise of world experts to care givers around the world who see less patients with prostate cancer. The conference concluded with a discussion and voting of the expert panel on predefined consensus questions, targeting areas of primary clinical relevance. The results of these expert opinion votes are embedded in the clinical context of current treatment of men with advanced prostate cancer and provide a practical guide to clinicians to assist in the discussions with men with prostate cancer as part of a shared and multidisciplinary decision-making process.