Management of patients with advanced prostate cancer: recommendations of the St Gallen Advanced Prostate Cancer Consensus Conference (APCCC) 2015

S Gillessen, A Omlin, G Attard, J S de Bono, E Efstathiou, K Fizazi, S Halabi, P S Nelson, O Sartor, M R Smith, H R Soule, H Akaza, T M Beer, H Beltran, A M Chinnaiyan, G Daugaard, I D Davis, M De Santis, C G Drake, R A Eeles, S Fanti, M E Gleave, A Heidenreich, M Hussain, N D James, F E Lecouvet, C J Logothetis, K Mastris, S Nilsson, W K Oh, D Olmos, A R Padhani, C Parker, M A Rubin, J A Schalken, H I Scher, A Sella, N D Shore, E J Small, C N Sternberg, H Suzuki, C J Sweeney, I F Tannock, B Tombal, S Gillessen, A Omlin, G Attard, J S de Bono, E Efstathiou, K Fizazi, S Halabi, P S Nelson, O Sartor, M R Smith, H R Soule, H Akaza, T M Beer, H Beltran, A M Chinnaiyan, G Daugaard, I D Davis, M De Santis, C G Drake, R A Eeles, S Fanti, M E Gleave, A Heidenreich, M Hussain, N D James, F E Lecouvet, C J Logothetis, K Mastris, S Nilsson, W K Oh, D Olmos, A R Padhani, C Parker, M A Rubin, J A Schalken, H I Scher, A Sella, N D Shore, E J Small, C N Sternberg, H Suzuki, C J Sweeney, I F Tannock, B Tombal

Abstract

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.

Keywords: advanced prostate cancer; castration-naïve prostate cancer; castration-resistant prostate cancer; consensus; therapeutics.

© The Author 2015. Published by Oxford University Press on behalf of the European Society for Medical Oncology.

Figures

Figure 1.
Figure 1.
How the Consensus Process works (modified Delphi process).
Figure 2.
Figure 2.
Conceptual framework: advanced prostate cancer.
Figure 3.
Figure 3.
(A, B and C) Summary of treatment options for advanced prostate cancer, March 2015.
Figure 3.
Figure 3.
(A, B and C) Summary of treatment options for advanced prostate cancer, March 2015.
Figure 4.
Figure 4.
(A and B) Osteoclast-targeted therapies for men with prostate cancer, March 2015.

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