Optimal management of metastatic castration-resistant prostate cancer: highlights from a European Expert Consensus Panel

Publication

Optimal management of metastatic castration-resistant prostate cancer: highlights from a European Expert Consensus Panel

Journal Paper/Review - Apr 3, 2014

Fitzpatrick John M, Fosså Sophie, Gillessen Sommer Silke, Kellokumpu-Lehtinen Pirkko-Liisa, Lecouvet Frédéric E, Oudard Stephane, de Reijke Theo M, Robson Craig N, De Santis Maria, Seruga Bostjan, Finn Stephen P, Efstathiou Eleni, Bellmunt Joaquim, Fizazi Karim, Heidenreich Axel, Sternberg Cora N, Tombal Bertrand, Alcaraz Antonio, Bahl Amit, Bracarda Sergio, Di Lorenzo Giuseppe, de Wit Ronald

Citation

Fitzpatrick J, Fosså S, Gillessen Sommer S, Kellokumpu-Lehtinen P, Lecouvet F, Oudard S, de Reijke T, Robson C, De Santis M, Seruga B, Finn S, Efstathiou E, Bellmunt J, Fizazi K, Heidenreich A, Sternberg C, Tombal B, Alcaraz A, Bahl A, Bracarda S, Di Lorenzo G, de Wit R. Optimal management of metastatic castration-resistant prostate cancer: highlights from a European Expert Consensus Panel. Eur J Cancer 2014; 50:1617-27.

Type

Journal Paper/Review (English)

Journal

Eur J Cancer 2014; 50

Publication Date

Apr 3, 2014

Issn Electronic

1879-0852

Pages

1617-27

Brief description/objective

The exponential growth of novel therapies for the treatment of metastatic castration-resistant prostate cancer (mCRPC) over the last decade has created an acute need for education and guidance of clinicians regarding optimal strategies for patient management. A multidisciplinary panel of 21 European experts in mCRPC assembled for comprehensive discussion and consensus development, seeking to move the field forward and provide guidance and perspectives on optimal selection and sequencing of therapeutic agents and monitoring of response to treatment and disease progression. A total of 110 clinically-relevant questions were addressed and a modified Delphi method was utilised to obtain a consensus. The panel reached a consensus on several important issues, providing recommendations on appropriate phase III clinical trial end-points and optimal strategies for imaging and monitoring of bone metastases. Guidance regarding selection and sequencing of therapy in patients with newly diagnosed or progressive mCRPC is emphasised, including the use of novel bone-targeted agents, chemotherapy, androgen receptor pathway-targeted agents and immunotherapy. The impact of drug resistance and prostate-specific antigen flare on treatment decisions was also addressed. Ultimately, individualised therapy for patients with mCRPC is dependent on continued refinement of clinical decision-making based on patient and disease characteristics. This consensus statement offers clinicians expert guidance on the implementation of recent advances to improve patient outcome, focusing on the future of prostate cancer care.