Consistent Biopsy Quality and Gleason Grading Within the Global Active Surveillance Global Action Plan 3 Initiative: A Prerequisite for Future Studies.

Within the Movember Foundation's Global Action Plan Prostate Cancer Active Surveillance (GAP3) initiative, 25 centers across the globe collaborate to standardize active surveillance (AS) protocols for men with low-risk prostate cancer (PCa). A centralized PCa AS database, comprising data of more than 15000 patients worldwide, was created. Comparability of the histopathology between the different cohorts was assessed by a centralized pathology review of 445 biopsies from 15 GAP3 centers. Grade group 1 (Gleason score 6) in 85% and grade group ≥2 (Gleason score ≥7) in 15% showed 89% concordance at review with moderate agreement (κ=0.56). Average biopsy core length was similar among the analyzed cohorts. Recently established highly adverse pathologies, including cribriform and/or intraductal carcinoma, were observed in 3.6% of the reviewed biopsies. In conclusion, the centralized pathology review of 445 biopsies revealed comparable histopathology among the 15 GAP3 centers with a low frequency of high-risk features. This enables further data analyses-without correction-toward uniform global AS guidelines for men with low-risk PCa. PATIENT SUMMARY: Movember Foundation's Global Action Plan Prostate Cancer Active Surveillance (GAP3) initiative combines data from 15000 men with low-risk prostate cancer (PCa) across the globe to standardize active surveillance protocols. Histopathology review confirmed that the histopathology was consistent with low-risk PCa in most men and comparable between different centers.

The future of prostate cancer research: bringing data together, looking back and forward.

The use of digital data in large data sets will be of pivotal importance to unravel the biological basis of prostate cancer, and to improve on prevention and treatment. For the screening of asymptomatic tumors, their identification, and their treatment with better and targeted therapies, the integration of information from imaging, genomics, and biomarkers is needed. To bring these (un)structured data together, block chain technology is required, while knowledgeable analysts should be available. Therefore, it is of utmost importance to 'team up' and provide a common strategy for innovation. Its implementation needs the involvement of all stakeholders (patients, industries, professionals, scientists, governments). This article provides thoughts on how initial steps in urology have been taken, and how to proceed.