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Addressing controversial areas in the management of advanced prostate cancer in Canada Areas of consensus and controversy from the third Canadian consensus forum.
Saad, Fred; Hotte, Sebastien J; Noonan, Krista; Malone, Shawn; Morash, Christopher; Niazi, Tamim; Rendon, Ricardo A; Shayegan, Bobby; Basappa, Naveen S; Cagiannos, Ilias; Danielson, Brita; Delouya, Guila; Fernandes, Ricardo; Ferrario, Cristiano; Finelli, Antonio; Gotto, Geoffrey T; Hamilton, Robert J; Izard, Jason P; Kapoor, Anil; Lalani, Aly-Khan; Lavallée, Luke T; Ong, Michael; Pouliot, Frédéric; So, Alan I; Yip, Steven; Chi, Kim N.
Affiliation
  • Saad F; Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal, QC, Canada.
  • Hotte SJ; Juravinski Cancer Centre, McMaster University, Hamilton, ON, Canada.
  • Noonan K; BC Cancer Agency, University of British Columbia, Surrey, BC, Canada.
  • Malone S; The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.
  • Morash C; Jewish General Hospital, McGill University, Montreal, QC, Canada.
  • Niazi T; Jewish General Hospital, McGill University, Montreal, QC, Canada.
  • Rendon RA; Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, NS, Canada.
  • Shayegan B; St. Joseph's Healthcare, McMaster University, Hamilton, ON, Canada.
  • Basappa NS; Cross Cancer Institute, University of Alberta, Edmonton, AB, Canada.
  • Cagiannos I; The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.
  • Danielson B; Cross Cancer Institute, University of Alberta, Edmonton, AB, Canada.
  • Delouya G; Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal, QC, Canada.
  • Fernandes R; London Health Science Centre, Western University, London, ON, Canada.
  • Ferrario C; Jewish General Hospital, McGill University, Montreal, QC, Canada.
  • Finelli A; Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.
  • Gotto GT; Southern Alberta Institute of Urology, University of Calgary, Calgary, AB, Canada.
  • Hamilton RJ; Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.
  • Izard JP; Kingston Health Sciences Centre, Queen's University, Kingston, ON.
  • Kapoor A; St. Joseph's Healthcare, McMaster University, Hamilton, ON, Canada.
  • Lalani AK; Juravinski Cancer Centre, McMaster University, Hamilton, ON, Canada.
  • Lavallée LT; The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.
  • Ong M; The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.
  • Pouliot F; Quebec City University Hospital Center & Centre de Recherche of Quebec City University Hospital Center, University of Laval, QC, Canada.
  • So AI; Prostate Centre at Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada.
  • Yip S; Tom Baker Cancer Centre, University of Calgary, Calgary, AB, Canada.
  • Chi KN; BC Cancer Agency, University of British Columbia, Vancouver, BC, Canada.
Can Urol Assoc J ; 18(4): E127-E137, 2024 Apr.
Article in En | MEDLINE | ID: mdl-38381937
ABSTRACT

INTRODUCTION:

The management of prostate cancer (PCa) is rapidly evolving. Treatment and diagnostic options grow annually, however, high-level evidence for the use of new therapeutics and diagnostics is lacking. In November 2022, the Genitourinary Research Consortium held its 3rd Canadian Consensus Forum (CCF3) to provide guidance on key controversial areas for management of PCa.

METHODS:

A steering committee of eight multidisciplinary physicians identified topics for discussion and adapted questions from the Advanced Prostate Cancer Consensus Conference 2022 for CCF3. Questions focused on management of metastatic castration-sensitive prostate cancer (mCSPC); use of novel imaging, germline testing, and genomic profiling; and areas of non-consensus from CCF2. Fifty-eight questions were voted on during a live forum, with threshold for "consensus agreement" set at 75%.

RESULTS:

The voting panel consisted of 26 physicians 13 urologists/uro-oncologists, nine medical oncologists, and four radiation oncologists. Consensus was reached for 32 of 58 questions (one ad-hoc). Consensus was seen in the use of local treatment, to not use metastasis-directed therapy for low-volume mCSPC, and to use triplet therapy for synchronous high-volume mCSPC (low prostate-specific antigen). Consensus was also reached on sufficiency of conventional imaging to manage disease, use of germline testing and genomic profiling for metastatic disease, and poly (ADP-ribose) polymerase (PARP) inhibitors for BRCA-positive prostate cancer.

CONCLUSIONS:

CCF3 identified consensus agreement and provides guidance on >30 practice scenarios related to management of PCa and nine areas of controversy, which represent opportunities for research and education to improve patient care. Consensus initiatives provide valuable guidance on areas of controversy as clinicians await high-level evidence.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Can Urol Assoc J Year: 2024 Document type: Article
Fulltext
Print
XML
PubMed Links
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Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Can Urol Assoc J Year: 2024 Document type: Article