Management of Patients with Advanced Prostate Cancer. Part I: Intermediate-/High-risk and Locally Advanced Disease, Biochemical Relapse, and Side Effects of Hormonal Treatment: Report of the Advanced Prostate Cancer Consensus Conference 2022

Gillessen, Silke; Bossi, Alberto; Davis, Ian D.; Bono, Johann de; Fizazi, Karim; James, Nicholas D.; Mottet, Nicolas; Shore, Neal D.; Small, Eric J.; Smith, M. R.; Sweeney, Christopher J.; Tombal, Bertrand; Antonarakis, Emmanuel S.; Aparicio, Ana; Armstrong, Andrew J.; Attard, Gerhardt; Beer, Tomasz M.; Beltran, Himisha; Bjartell, Anders; Blanchard, Pierre; Briganti, Alberto; Bristow, Robert G.; Bulbul, Muhammad; Caffo, Orazio; Castellano, Daniel; Castro, Elena; Cheng, Heather H.; N., Kim; Chowdhury, Simon; Clarke, Caroline; Clarke, Noel W.; Daugaard, Gedske; Santis, Maria De; Durán, Ignacio; Eeles, Ros; Efstathiou, Eleni; Efstathiou, Jason A.; Ekeke, Onyeanunam Ngozi; Evans, Christopher P.; Fanti, Stefano; Feng, Felix Y.; Fonteyne, Valérie; Fossati, Nicola; Frydenberg, Mark; George, Daniel J.; Gleave, Martin; Gravis, G.; Halabi, Susan; Heinrich, Daniel; Herrmann, Ken; Higano, Celestia S.; Hofman, Michael S; Horvath, Lisa G.; Hussain, Maha; Jereczek‐Fossa, Barbara Alicja; Jones, Robert J.; Kanesvaran, Ravindran; Kellokumpu-Lehtinen, Pirkko-Liisa; Khauli, Raja B.; Klotz, Laurence; Kramer, Gero; Leibowitz, Raya; Logothetis, Christopher J.; Mahal, Brandon A.; Maluf, Fernando C.; Mateo, Joaquín; Matheson, David; Mehra, Niven; Merseburger, Axel S.; Morgans, Alicia K.; Morris, Michael J.; Mrabti, Hind; Mukherji, Deborah; Murphy, Declan; Murthy, Vedang; Nguyen, Paul L.; Oh, William; Ost, Piet; O’Sullivan, Joe M.; Padhani, Anwar R.; Pezaro, Carmel; Poon, Darren M.C.; Pritchard, Colin C.; Rabah, Danny; Rathkopf, Dana E.; Reiter, Robert E.; Rubin, Mark A.; Ryan, Charles J.; Saad, Fred; Sade, Juan Pablo; Sartor, Oliver; Scher, Howard I.; Sharifi, Nima; Skoneczna, Iwona; Soule, Howard R.; Spratt, Daniel E.; Srinivas, Sandy; Sternberg, Cora N.; Steuber, Thomas; Suzuki, Hiroyoshi; Sydes, M; Taplin, Mary‐Ellen; Tilki, Derya; Türkeri, Levent; Turco, Fabio; Uemura, Hiroji; Uemura, Hirotsugu; Ürün, Yüksel; Vale, Claire; Oort, Inge M. van; Vapiwala, Neha; Walz, Jochen; Yamoah, Kosj; Ye, Dingwei; Yu, Evan Y.; Zapatero, A.; Zilli, Thomas; Omlin, Aurelius

doi:10.1016/j.eururo.2022.11.002

Cited by 71 publications

(24 citation statements)

References 151 publications

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“…Die Advanced Prostate Cancer Consensus Conference (APCCC) adressiert alle 2 Jahre klinisch relevante Fragen in der Behandlung des fortgeschrittenen Prostatakarzinoms, für welche keine Evidenz oder divergierende Evidenz bzw. unterschiedliche Interpretationen der vorhandenen Evidenz bestehen [10,11]. Zum Thema Sequenztherapie des kastrationsresistenten Prostatakarzinoms (CRPC) haben die Expert*innen am APCCC 2022 über eine Reihe von Fragen abgestimmt, die Resultate sind in den ▶ Tab.…”

Section: Erstlinien-behandlungsoptionen Des Metastasierten Kastration...unclassified

Sequenztherapie des kastrationsresistenten Prostatakarzinoms: Evidenzbasierte klinische Algorithmen

Peres,

Omlin

2024

Aktuelle Urol

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Wenn sich bei Patienten mit fortgeschrittenem Prostatakarzinom unter der Androgendeprivation (ADT) eine Krankheitsprogredienz abzeichnet, spricht man von Kastrationsresistenz. Die Therapiewahl in dieser Situation richtet sich nach den bereits vorgängig durchgeführten Behandlungen, Ausdehnung und Dynamik der Erkrankung, Faktoren wie Krankheitssymptomatik und Lebensqualität, Komorbiditäten und Komedikationen und nicht zuletzt auch individuellen Wünschen des betroffenen Patienten.

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Section: Erstlinien-behandlungsoptionen Des Metastasierten Kastration...unclassified

Sequenztherapie des kastrationsresistenten Prostatakarzinoms: Evidenzbasierte klinische Algorithmen

Peres,

Omlin

2024

Aktuelle Urol

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“… 18 However, surveys conducted among clinical and scientific PCa experts have revealed a lack of consensus on the role of genomic testing, accompanied by limited confidence in the interpretation of genomic results. 31 , 121 , 122 It is clear that we need increased education and qualified educators to make sure that health care professionals feel able to deliver genomic test-informed precision oncology.…”

Section: Conclusion and Future Considerationsmentioning

confidence: 99%

Toward Informed Selection and Interpretation of Clinical Genomic Tests in Prostate Cancer

Vandekerkhove,

Giri,

Halabi

et al. 2024

JCO Precis Oncol

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Clinical genomic testing of patient germline, tumor tissue, or plasma cell-free DNA can enable a personalized approach to cancer management and treatment. In prostate cancer (PCa), broad genotyping tests are now widely used to identify germline and/or somatic alterations in BRCA2 and other DNA damage repair genes. Alterations in these genes can confer cancer sensitivity to poly (ADP-ribose) polymerase inhibitors, are linked with poor prognosis, and can have potential hereditary cancer implications for family members. However, there is huge variability in genomic tests and reporting standards, meaning that for successful implementation of testing in clinical practice, end users must carefully select the most appropriate test for a given patient and critically interpret the results. In this white paper, we outline key pre- and post-test considerations for choosing a genomic test and evaluating reported variants, specifically for patients with advanced PCa. Test choice must be based on clinical context and disease state, availability and suitability of tumor tissue, and the genes and regions that are covered by the test. We describe strategies to recognize false positives or negatives in test results, including frameworks to assess low tumor fraction, subclonal alterations, clonal hematopoiesis, and pathogenic versus nonpathogenic variants. We assume that improved understanding among health care professionals and researchers of the nuances associated with genomic testing will ultimately lead to optimal patient care and clinical decision making.

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“…However, in patients with high-risk mHSPC, ADT monotherapy is not effective in reducing the risk of progression to CRPC and may increase the likelihood of adverse events such as bone pain and pathological fractures ( 2 ). Therefore, the addition of new medications to ADT therapy has emerged as an important approach to delay disease progression and enhance patient survival ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

Comparative effectiveness of multiple androgen receptor signaling inhibitor medicines with androgen deprivation therapy for metastatic hormone-sensitive prostate cancer: a study in the real world

Lu,

Jiang,

Yang

et al. 2024

Front. Oncol.

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BackgroundThe current treatment strategy for metastatic Hormone-Sensitive Prostate Cancer (mHSPC) is the combination of Androgen Receptor Signaling Inhibitors (ARSIs) medicines with androgen deprivation therapy (ADT). However, there is a lack of real-world data comparing the efficacy of different ARSI pharmaceuticals. Therefore, the objective of this study was to compare the effectiveness and safety of bicalutamide, abiraterone, enzalutamide, and apalutamide in combination with ADT for patients with mHSPC.MethodsWe retrospectively analyzed 82 patients diagnosed with mHSPC, including 18 patients treated with abiraterone acetate with prednisone, 21 patients with enzalutamide, 20 patients with apalutamide, and 23 patients with bicalutamide. We evaluated PSA progression-free survival (PSA-PFS), imaging progression-free survival (r PFS), castration resistance progression-free survival (CRPC-PFS), and overall survival (OS) using Kaplan-Meier survival analyses. Additionally, we explored relevant factors affecting prognosis through univariate and multivariate Cox risk-proportionality models. PSA response rates at 3, 6, and 12 months, nadir PSA levels (nPSA), and time to nadir (TTN) in different medication subgroups after treatment were documented, and we used one-way ANOVA to determine the effect of these measures on patient prognosis.ResultsIn comparison with bicalutamide, both enzalutamide and apalutamide have shown significant advantages in delaying disease progression among mHSPC patients. Specifically, enzalutamide has been found to significantly prolong PSA-PFS (HR 2.244; 95% CI 1.366-3.685, p=0.001), rPFS (HR 2.539; 95% CI 1.181-5.461; p= 0.007), CRPC-PFS (HR 2.131; 95% CI 1.295-3.506; p= 0.003), and OS (HR 2.06; 95% CI 1.183-3.585; P=0.005). Similarly, apalutamide has significantly extended PSA-PFS (HR 5.071; 95% CI 1.711-15.032; P= 0.003) and CRPC-PFS (HR 6.724; 95% CI 1.976-22.878; P=0.002) among patients. On the other hand, the use of abiraterone in combination with ADT did not demonstrate a significant advantage in delaying diseases progression when compared with the other three agents in mHSPC patients. There were no significant differences in overall adverse event rates among the four pharmaceuticals in terms of safety. Additionally, the observation of PSA kinetics revealed that enzalutamide, apalutamide, and abiraterone acetate had a significant advantage in achieving deep PSA response (PSA ≤ 0.2 ng/ml) compared with bicalutamide (p=0.007 at 12 months). Enzalutamide and apalutamide exhibited preeminence efficacy, with no substantial difference observed between the two medications.ConclusionsAbiraterone, enzalutamide, and apalutamide were found to significantly reduce and stabilize PSA levels in mHSPC patients more quickly and thoroughly than bicalutamide. Furthermore, enzalutamide and apalutamide were found to significantly prolong survival and delay disease progression in mHSPC patients compared with bicalutamide. It should be noted that abiraterone did not demonstrate a significant advantage in delaying disease compared with enzalutamide and apalutamide. After conducting drug toxicity analyses, it was determined that there were no significant differences among the four drugs.

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Management of Patients with Advanced Prostate Cancer. Part I: Intermediate-/High-risk and Locally Advanced Disease, Biochemical Relapse, and Side Effects of Hormonal Treatment: Report of the Advanced Prostate Cancer Consensus Conference 2022

Cited by 71 publications

References 151 publications

Sequenztherapie des kastrationsresistenten Prostatakarzinoms: Evidenzbasierte klinische Algorithmen

Sequenztherapie des kastrationsresistenten Prostatakarzinoms: Evidenzbasierte klinische Algorithmen

Toward Informed Selection and Interpretation of Clinical Genomic Tests in Prostate Cancer

Comparative effectiveness of multiple androgen receptor signaling inhibitor medicines with androgen deprivation therapy for metastatic hormone-sensitive prostate cancer: a study in the real world

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