• Eur. J. Cancer · Jun 2014

    Optimal management of metastatic castration-resistant prostate cancer: highlights from a European Expert Consensus Panel.

    • John M Fitzpatrick, Joaquim Bellmunt, Karim Fizazi, Axel Heidenreich, Cora N Sternberg, Bertrand Tombal, Antonio Alcaraz, Amit Bahl, Sergio Bracarda, Giuseppe Di Lorenzo, Eleni Efstathiou, Stephen P Finn, Sophie Fosså, Silke Gillessen, Pirkko-Liisa Kellokumpu-Lehtinen, Frédéric E Lecouvet, Stephane Oudard, Theo M de Reijke, Craig N Robson, Maria De Santis, Bostjan Seruga, and Ronald de Wit.
    • Irish Cancer Society and University College, Dublin, Ireland. Electronic address: jfitzpatrick@irishcancer.ie.
    • Eur. J. Cancer. 2014 Jun 1; 50 (9): 1617-27.

    AbstractThe exponential growth of novel therapies for the treatment of metastatic castration-resistant prostate cancer (mCRPC) over the last decade has created an acute need for education and guidance of clinicians regarding optimal strategies for patient management. A multidisciplinary panel of 21 European experts in mCRPC assembled for comprehensive discussion and consensus development, seeking to move the field forward and provide guidance and perspectives on optimal selection and sequencing of therapeutic agents and monitoring of response to treatment and disease progression. A total of 110 clinically-relevant questions were addressed and a modified Delphi method was utilised to obtain a consensus. The panel reached a consensus on several important issues, providing recommendations on appropriate phase III clinical trial end-points and optimal strategies for imaging and monitoring of bone metastases. Guidance regarding selection and sequencing of therapy in patients with newly diagnosed or progressive mCRPC is emphasised, including the use of novel bone-targeted agents, chemotherapy, androgen receptor pathway-targeted agents and immunotherapy. The impact of drug resistance and prostate-specific antigen flare on treatment decisions was also addressed. Ultimately, individualised therapy for patients with mCRPC is dependent on continued refinement of clinical decision-making based on patient and disease characteristics. This consensus statement offers clinicians expert guidance on the implementation of recent advances to improve patient outcome, focusing on the future of prostate cancer care. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

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