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Lack of consensus identifies important areas for future clinical research: Advanced Prostate Cancer Consensus Conference (APCCC) 2019 findings

Journal Paper/Review - Nov 26, 2021

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Citation
Vogl U, Mottet N, Padhani A, Roach M, Rubin M, Sartor O, Small E, Smith M, Soule H, Sydes M, Tombal B, Omlin A, Gillessen S, James N, Halabi S, Beer T, Davis I, Shore N, Sweeney C, Ost P, Attard G, Bossi A, de Bono J, Drake C, Efstathiou E, Fanti S, Fizazi K, APCCC 2019 expert panel. Lack of consensus identifies important areas for future clinical research: Advanced Prostate Cancer Consensus Conference (APCCC) 2019 findings. Eur J Cancer 2021; 160:24-60.
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Journal Paper/Review (English)
Journal
Eur J Cancer 2021; 160
Publication Date
Nov 26, 2021
Issn Print
Issn Electronic
1879-0852
Pages
24-60
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BACKGROUND
Innovations in treatments, imaging and molecular characterisation have improved outcomes for people with advanced prostate cancer; however, many aspects of clinical management are devoid of high-level evidence. At the Advanced Prostate Cancer Consensus Conference (APCCC) 2019, many of these topics were addressed, and consensus was not always reached. The results from clinical trials will most reliably plus the gaps.

METHODS
An invited panel of 57 experts voted on 123 multiple-choice questions on clinical management at APCCC 2019. No consensus was reached on 88 (71.5%) questions defined as <75% of panellists voting for the same answer option. We reviewed clinicaltrials.gov to identify relevant ongoing phase III trials in these areas of non-consensus.

RESULTS
A number of ongoing phase III trials were identified that are relevant to these non-consensus issues. However, many non-consensus issues appear not to be addressed by current clinical trials. Of note, no phase III but only phase II trials were identified, investigating side effects of hormonal treatments and their management.

CONCLUSIONS
Lack of consensus almost invariably indicates gaps in existing evidence. The high percentage of questions lacking consensus at APCCC 2019 highlights the complexity of advanced prostate cancer care and the need for robust, clinically relevant trials that can fill current gaps with high-level evidence. Our review of these areas of non-consensus and ongoing trials provides a useful summary, indicating areas in which future consensus may soon be reached. This review may facilitate academic investigators to identify and prioritise topics for future research.