Sophie M Bruinsma1, Liying Zhang2, Monique J Roobol1, Chris H Bangma1, Ewout W Steyerberg3, Daan Nieboer1,3, Mieke Van Hemelrijck4. 1. Department of Urology, Erasmus University Medical Centre, Rotterdam, The Netherlands. 2. Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada. 3. Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands. 4. Division of Cancer Studies, Translational Oncology and Urology Research, King's College London, London, UK.
Abstract
OBJECTIVES: The Movember Foundation launched the Global Action Plan Prostate Cancer Active Surveillance (GAP3) initiative to create a global consensus on the selection and monitoring of men with low-risk prostate cancer (PCa) on active surveillance (AS). The aim of this study is to present data on inclusion and follow-up for AS in this unique global AS database. PATIENTS AND METHODS: Between 2014 and 2016, the database was created by combining patient data from 25 established AS cohorts worldwide (USA, Canada, Australasia, UK and Europe). Data on a total of 15 101 patients were included. Descriptive statistics were used to report patients' clinical and demographic characteristics at the time of PCa diagnosis, clinical follow-up, discontinuation of AS and subsequent treatment. Cumulative incidence curves were used to report discontinuation rates over time. RESULTS: At diagnosis, the median (interquartile range [IQR]) patient age was 65 (60-70) years and the median prostate-specific antigen level was 5.4 (4.0-7.3) ng/mL. Most patients had clinical stage T1 disease (71.8%), a biopsy Gleason score of 6 (88.8%) and one tumour-positive biopsy core (60.3%). Patients on AS had a median follow-up time of 2.2 (1.0-5.0) years. After 5, 10 and 15 years of follow-up, respectively, 58%, 39% and 23% of patients were still on AS. The current version of GAP3 has limited data on magnetic resonance imaging (MRI), quality of life and genomic testing. CONCLUSIONS: GAP3 is the largest worldwide collaboration integrating patient data from men with PCa on AS. The results will allow individual patients and clinicians to have greater confidence in the personalized decision to either delay or proceed with active treatment. Longer follow-up and the evaluation of MRI, new genomic markers and patient-related outcomes will result in even more valuable data and eventually in better patient outcomes.
OBJECTIVES: The Movember Foundation launched the Global Action Plan Prostate Cancer Active Surveillance (GAP3) initiative to create a global consensus on the selection and monitoring of men with low-risk prostate cancer (PCa) on active surveillance (AS). The aim of this study is to present data on inclusion and follow-up for AS in this unique global AS database. PATIENTS AND METHODS: Between 2014 and 2016, the database was created by combining patient data from 25 established AS cohorts worldwide (USA, Canada, Australasia, UK and Europe). Data on a total of 15 101 patients were included. Descriptive statistics were used to report patients' clinical and demographic characteristics at the time of PCa diagnosis, clinical follow-up, discontinuation of AS and subsequent treatment. Cumulative incidence curves were used to report discontinuation rates over time. RESULTS: At diagnosis, the median (interquartile range [IQR]) patient age was 65 (60-70) years and the median prostate-specific antigen level was 5.4 (4.0-7.3) ng/mL. Most patients had clinical stage T1 disease (71.8%), a biopsy Gleason score of 6 (88.8%) and one tumour-positive biopsy core (60.3%). Patients on AS had a median follow-up time of 2.2 (1.0-5.0) years. After 5, 10 and 15 years of follow-up, respectively, 58%, 39% and 23% of patients were still on AS. The current version of GAP3 has limited data on magnetic resonance imaging (MRI), quality of life and genomic testing. CONCLUSIONS: GAP3 is the largest worldwide collaboration integrating patient data from men with PCa on AS. The results will allow individual patients and clinicians to have greater confidence in the personalized decision to either delay or proceed with active treatment. Longer follow-up and the evaluation of MRI, new genomic markers and patient-related outcomes will result in even more valuable data and eventually in better patient outcomes.
Authors: Roman Sosnowski; Hubert Kamecki; Siamak Daneshmand; Jan K Rudzinski; Marc A Bjurlin; Francesco Giganti; Monique J Roobol; Laurence Klotz Journal: Cent European J Urol Date: 2020-06-25
Authors: Lisa M Lowenstein; Spyridon P Basourakos; Michelle D Williams; Patricia Troncoso; Justin R Gregg; Timothy C Thompson; Jeri Kim Journal: Nat Rev Clin Oncol Date: 2019-03 Impact factor: 66.675
Authors: Lauren Folgosa Cooley; Adaeze A Emeka; Travis J Meyers; Phillip R Cooper; Daniel W Lin; Antonio Finelli; James A Eastham; Christopher J Logothetis; Leonard S Marks; Danny Vesprini; S Larry Goldenberg; Celestia S Higano; Christian P Pavlovich; June M Chan; Todd M Morgan; Eric A Klein; Daniel A Barocas; Stacy Loeb; Brian T Helfand; Denise M Scholtens; John S Witte; William J Catalona Journal: J Urol Date: 2021-09-10 Impact factor: 7.600