Management of Patients with Advanced Prostate Cancer. Report from the 2024 Advanced Prostate Cancer Consensus Conference (APCCC)
Silke Gillessen, Fabio Turco, Ian D. Davis, Jason A. Efstathiou, Karim Fizazi, Nicholas D. James, Neal D. Shore, Eric J. Small, Matthew R. Smith, Christopher J. Sweeney, Bertrand Tombal, Thomas Zilli, Neeraj Agarwal, Emmanuel S. Antonarakis, Ana M. Aparicio, Andrew J. Armstrong, Diogo Assed Bastos, Gerhardt Attard, Karol Axcrona, Mouna Ayadi, Himisha Beltran, Anders Bjartell, Pierre Blanchard, María T. Bourlon, Alberto Briganti, Muhammad Bulbul, Consuelo Buttigliero, Orazio Caffo, Daniel Castellano, Elena Castro, Heather H. Cheng, Kim N., Caroline S. Clarke, Noel W. Clarke, Johann S. de Bono, Maria De Santis, Ignacio Durán, Eleni Efstathiou, Onyeanunam Ngozi Ekeke, Tamer I H El Nahas, Louise Emmett, Stefano Fanti, Omolara Fatiregun, Felix Y. Feng, Peter C.C. Fong, Valérie Fonteyne, Nicola Fossati, Daniel J. George, Martin Gleave, Gwénaëlle Gravis, Susan Halabi, Daniel Heinrich, Ken Herrmann, Michael S. Hofman, Thomas A. Hope, Lisa G. Horvath, Maha Hussain, Barbara Alicja Jereczek‐Fossa, Robert J. Jones, Anthony M. Joshua, R. Kanesvaran, Daniel Keizman, Raja B. Khauli, Gero Kramer, Stacy Loeb, Brandon A. Mahal, Fernando Cotait Maluf, Joaquı́n Mateo, David Matheson, Mika 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 Oh, Piet Ost, Joe M. O’Sullivan, Anwar R. Padhani, Chris Parker, Darren M.C. Poon, Colin C. Pritchard, Danny Rabah, Dana E. Rathkopf, Robert E. Reiter, Raphaële Renard‐Penna, Charles J. Ryan, Fred Saad, Juan Pablo Sade, Shahneen Sandhu, Oliver A. Sartor, Edward M. Schaeffer, Howard I. Scher
Abstract
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.