Optimizing outcomes for patients with metastatic prostate cancer: insights from South East Asia Expert Panel

Abstract

Aims: Clinical decision making is challenging in men with metastatic prostate cancer (mPC), as heterogeneity in treatment options and patient characteristics have resulted in multiple scenarios with little or no evidence. The South East Asia Expert Panel 2019 addressed some of these challenges. Methods: Based on evidence in the literature and expert interviews, 19 statements were formulated for key challenges in the treatment of men with castration-sensitive and -resistant prostate cancer in clinical practice. A modified Delphi process was used to reach consensus among experts in the panel and develop clinical practice recommendations. Results: The majority of the panel preferred a risk-based stratification and recommended abiraterone or enzalutamide as first-line therapy for symptomatic chemotherapy naïve patients. Abiraterone is preferred over enzalutamide as a first-line treatment in these patients. However, the panel did not support the use of abiraterone in high risk lymph-node positive only (N+M0) or in non-metastatic (N0M0) patients. In select patients, low dose abiraterone with food may be used to optimize clinical outcomes. Androgen receptor gene splice variant status may be a useful guide to therapy. In addition, generic versions of approved therapies may improve access to treatment to a broader patient population. The choice of treatment, as well as sequencing are guided by both patient and disease characteristics, preferences, drug access, cost, and compliance. Conclusion: Expert recommendations are key to guidance for the optimal management of mPC. Appropriate choice, timing, and sequence of treatment options can help to tailor therapy to maximize outcomes in men with mPC.

Long Noncoding RNA TCONS_00027385 Acts as a miR-874-5p Sponge to Suppress the Progression of Prostate Cancer Through Regulating ASCC2 Expression

“…Prostate cancer (PCa) is the one of most frequent malignancy involving uncontrolled cell growth, and its high mortality imposes a heavy burden to patients, family and society (1)(2)(3). Furthermore, in some geographical regions such as North America, Africa and East Asia, the mortality rate of PCa has increased for at least two decades (4)(5)(6). Despite signi cant advance has been made in early diagnosis, it is often unable to be detected in a timely manner.…”