Fred Saad1, Christina Canil2, Antonio Finelli3, Sebastien J Hotte4, Shawn Malone2, Bobby Shayegan5, Alan I So6, Lorne Aaron7, Naveen S Basappa8, Henry J Conter9, Brita Danielson8, Geoffrey Gotto10, Robert J Hamilton3, Jason P Izard11, Anil Kapoor5, Michael Kolinsky8, Aly-Khan A Lalani4, Jean-Baptiste Lattouf1, Christopher Morash2, Scott C Morgan2, Tamim Niazi12, Krista L Noonan13, Michael Ong2, Ricardo A Rendon14, Sandeep Sehdev2, Huong Hew15, Laura Park-Wyllie15, Kim N Chi13. 1. Centre Hospitalier de l'Université de Montréal, Université de Montréal, Montreal, QC, Canada. 2. The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada. 3. Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada. 4. Juravinski Cancer Centre, McMaster University, Hamilton, ON, Canada. 5. St. Joseph's Healthcare, McMaster University, Hamilton, ON, Canada. 6. Prostate Centre at Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada. 7. Service d-Urologie and Centre de la Prostate, Longueuil, QC, Canada. 8. Cross Cancer Institute, University of Alberta, Edmonton, AB, Canada. 9. William Osler Health System, University of Western Ontario, Brampton, ON, Canada. 10. Southern Alberta Institute of Urology, University of Calgary, Calgary, AB, Canada. 11. Kingston Health Sciences Centre, Queen's University, Kingston, ON, Canada. 12. Jewish General Hospital, McGill University, Montreal, QC, Canada. 13. BC Cancer Agency, University of British Columbia, Vancouver, BC, Canada. 14. Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, NS, Canada. 15. Medical Affairs, Janssen Inc, Toronto, ON, Canada.
Abstract
INTRODUCTION: The management of advanced prostate cancer (PCa) continues to evolve with the emergence of new diagnostic and therapeutic strategies. As a result, there are multiple areas in this landscape with a lack of high-level evidence to guide practice. Consensus initiatives are an approach to establishing practice guidance in areas where evidence is unclear. We conducted a Canadian-based consensus forum to address key controversial areas in the management of advanced PCa. METHODS: As part of a modified Delphi process, a core scientific group of PCa physicians (n=8) identified controversial areas for discussion and developed an initial set of questions, which were then reviewed and finalized with a larger group of 29 multidisciplinary PCa specialists. The main areas of focus were non-metastatic castration-resistant prostate cancer (nmCRPC), metastatic castration-sensitive prostate cancer (mCSPC), metastatic castration-resistant prostate cancer (mCRPC), oligometastatic prostate cancer, genetic testing in prostate cancer, and imaging in advanced prostate cancer. The predetermined threshold for consensus was set at 74% (agreement from 20 of 27 participating physicians). RESULTS: Consensus participants included uro-oncologists (n=13), medical oncologists (n=10), and radiation oncologists (n=4). Of the 64 questions, consensus was reached in 30 questions (n=5 unanimously). Consensus was more common for questions related to biochemical recurrence, sequencing of therapies, and mCRPC. CONCLUSIONS: A Canadian consensus forum in PCa identified areas of agreement in nearly 50% of questions discussed. Areas of variability may represent opportunities for further research, education, and sharing of best practices. These findings reinforce the value of multidisciplinary consensus initiatives to optimize patient care.
INTRODUCTION: The management of advanced prostate cancer (PCa) continues to evolve with the emergence of new diagnostic and therapeutic strategies. As a result, there are multiple areas in this landscape with a lack of high-level evidence to guide practice. Consensus initiatives are an approach to establishing practice guidance in areas where evidence is unclear. We conducted a Canadian-based consensus forum to address key controversial areas in the management of advanced PCa. METHODS: As part of a modified Delphi process, a core scientific group of PCa physicians (n=8) identified controversial areas for discussion and developed an initial set of questions, which were then reviewed and finalized with a larger group of 29 multidisciplinary PCa specialists. The main areas of focus were non-metastatic castration-resistant prostate cancer (nmCRPC), metastatic castration-sensitive prostate cancer (mCSPC), metastatic castration-resistant prostate cancer (mCRPC), oligometastatic prostate cancer, genetic testing in prostate cancer, and imaging in advanced prostate cancer. The predetermined threshold for consensus was set at 74% (agreement from 20 of 27 participating physicians). RESULTS: Consensus participants included uro-oncologists (n=13), medical oncologists (n=10), and radiation oncologists (n=4). Of the 64 questions, consensus was reached in 30 questions (n=5 unanimously). Consensus was more common for questions related to biochemical recurrence, sequencing of therapies, and mCRPC. CONCLUSIONS: A Canadian consensus forum in PCa identified areas of agreement in nearly 50% of questions discussed. Areas of variability may represent opportunities for further research, education, and sharing of best practices. These findings reinforce the value of multidisciplinary consensus initiatives to optimize patient care.
Authors: Sebastien J Hotte; Antonio Finelli; Kim N Chi; Christina Canil; Neil Fleshner; Anil Kapoor; Michael Kolinsky; Shawn Malone; Christopher Morash; Tamim Niazi; Krista L Noonan; Michael Ong; Frederic Pouliot; Bobby Shayegan; Alan I So; Delna Sorabji; Huong Hew; Laura Park-Wyllie; Fred Saad Journal: Can Urol Assoc J Date: 2021-02 Impact factor: 1.862
Authors: Peter K F Chiu; Eric K C Lee; Marco T Y Chan; Wilson H C Chan; M H Cheung; Martin H C Lam; Edmond S K Ma; Darren M C Poon Journal: Front Oncol Date: 2022-07-18 Impact factor: 5.738
Authors: Roderick Clark; Miran Kenk; Kristen McAlpine; Emily Thain; Kirsten M Farncombe; Colin C Pritchard; Robert Nussbaum; Alexander W Wyatt; Johann de Bono; Danny Vesprini; Yvonne Bombard; Justin Lorentz; Steven Narod; Raymond Kim; Neil Fleshner Journal: Can Urol Assoc J Date: 2021-12 Impact factor: 1.862