Abstract
Background and objective: Innovations have improved outcomes in advanced prostate cancer (PC). Nonetheless, we continue to lack high-level evidence on a variety of topics that greatly impact daily practice. The 2024 Advanced Prostate Cancer Consensus Conference (APCCC) surveyed experts on key questions in clinical management in order to supplement evidence-based guidelines. Here we present voting results for questions from APCCC 2024. Methods: Before the conference, a panel of 120 international PC experts used a modified Delphi process to develop 183 multiple-choice consensus questions on eight different topics. Before the conference, these questions were administered via a web-based survey to the voting panel members (“panellists”). Key findings and limitations: Consensus was a priori defined as ≥75% agreement, with strong consensus defined as ≥90% agreement. The voting results show varying degrees of consensus, as discussed in this article and detailed in the Supplementary material. These findings do not include a formal literature review or meta-analysis. Conclusions and clinical implications: The voting results can help physicians and patients navigate controversial areas of clinical management for which high-level evidence is scant or conflicting. The findings can also help funders and policymakers in prioritising areas for future research. Diagnostic and treatment decisions should always be individualised on the basis of patient and cancer characteristics, and should incorporate current and emerging clinical evidence, guidelines, and logistic and economic factors. Enrolment in clinical trials is always strongly encouraged. Importantly, APCCC 2024 once again identified important gaps (areas of nonconsensus) that merit evaluation in specifically designed trials.
Original language | English (US) |
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Pages (from-to) | 157-216 |
Number of pages | 60 |
Journal | European urology |
Volume | 87 |
Issue number | 2 |
DOIs | |
State | Published - Feb 2025 |
Funding
We would like to extend special thanks to Dr. A.E. Karon for editorial assistance with the manuscript, which was sponsored by UroToday.com. We thank the APC Society, namely Thomas Cerny and Ruth Lyner, for their support. Ian D. Davis is supported in part by an Australian NHMRC Investigator Grant (2016274). Michael S. Hofman is supported by grants from the Prostate Cancer Foundation, Peter MacCallum Foundation, and an NHMRC Investigator Grant. RE is supported by a National Institute of Health and Care Research grant to the Biomedical Research Centre at the Institute of Cancer Research and Royal Marsden NHS Foundation Trust. We gratefully acknowledge the following organisations for providing financial support for APCCC 2024: The City of Lugano and Movember Foundation, Prostate Cancer Foundation, and ESOF.
Keywords
- Adjuvant therapy
- Biochemical recurrence
- Bone protection
- Genetics and genomics
- Hormonal treatment
- Next-generation imaging
- Positron emission tomography
- Prostate cancer
- Prostate-specific membrane antigen
- Salvage therapy
ASJC Scopus subject areas
- Urology