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. 2017 May-Jun;43(3):407-415.
doi: 10.1590/S1677-5538.IBJU.2016.0490.

First Brazilian Consensus of Advanced Prostate Cancer: Recommendations for Clinical Practice

Andre Deeke Sasse  1 , Evanius Garcia Wiermann  2 , Daniel Herchenhorn  3 , Diogo Assed Bastos  4   5 , Fabio A Schutz  6 , Fernando Cotait Maluf  6   7 , George Coura Filho  8 , Igor Alexandre Protzner Morbeck  9 , Juliano J Cerci  10 , Oren Smaletz  7 , Volney Soares Lima  11 , Ari Adamy Jr  12 , Franz Santos de Campos  3 , Gustavo Franco Carvalhal  13 , Leandro Casemiro Cezar  14 , Marcos Francisco Dall'Oglio  15 , Marcus Vinicius Sadi  16 , Rodolfo Borges Dos Reis  17 , Lucas Nogueira  18
Affiliations

First Brazilian Consensus of Advanced Prostate Cancer: Recommendations for Clinical Practice

Andre Deeke Sasse et al. Int Braz J Urol. 2017 May-Jun.

Abstract

Introduction: Prostate cancer still represents a major cause of morbidity, and still about 20% of men with the disease are diagnosed or will progress to the advanced stage without the possibility of curative treatment. Despite the recent advances in scientific and technological knowledge and the availability of new therapies, there is still considerable heterogeneity in the therapeutic approaches for metastatic prostate cancer.

Objectives: This article presents a summary of the I Brazilian Consensus on Advanced Prostate Cancer, conducted by the Brazilian Society of Urology and Brazilian Society of Clinical Oncology.

Materials and methods: Experts were selected by the medical societies involved. Forty issues regarding controversial issues in advanced disease were previously elaborated. The panel met for consensus, with a threshold established for 2/3 of the participants.

Results and conclusions: The treatment of advanced prostate cancer is complex, due to the existence of a large number of therapies, with different response profiles and toxicities. The panel addressed recommendations on preferred choice of therapies, indicators that would justify their change, and indicated some strategies for better sequencing of treatment in order to maximize the potential for disease control with the available therapeutic arsenal. The lack of consensus on some topics clearly indicates the absence of strong evidence for some decisions.

Keywords: Diagnosis; Practice Guideline [Publication Type]; Prostatic Neoplasms.

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Conflict of interest statement

Andre Deeke Sasse: Received fees from Bayer, Astellas and Janssen (Consulting); Daniel Herchenhorn: Received fees from Bayer, Astellas, Janssen and Sanofi (Consulting and Lectures); Diogo Assed Bastos: Received fees from Bayer, Astellas, Janssen and Sanofi (Consulting); Fabio Augusto Barros Schutz: Received fees from Bayer, Astellas, Janssen and Sanofi (Consulting); Fernando Cotait Maluf: Received fees from Bayer, Astellas, Janssen and Sanofi (Con-sulting); Igor Alexandre Protzner Morbeck: Received fees from Bayer, Astellas and Janssen (Consulting and Lectures); Oren Smaletz: Received fees from Bayer, Astellas, Janssenand Sanofi (Consulting); Volney Soares Lima: Received fees from Janssen (Consulting) and Bayer (Lectures); Ari Adamy Jr. received fees from Janssen (Consulting); Gustavo Franco Carvalhal received fees from Bayer, Astellas, Astra-Zeneca, Pfizer and Janssen due to Lectures in scientific events; Lucas Mendes Nogueira received fees from Bayer, Astellas and Janssen, and Sanofi Aventis (Consulting). He was researcher in clinical trial sponsored by Bayer, Astellas, Janssen and GSK; Rodolfo Borges dos Reis received fees from Bayer and Janssen (Consulting), and Astra Zeneca and Janssen (Lectures); Other authors: None declared

Figures

Figure 1
Figure 1. Is there any indication for the use of ciproterone in the treatment of metastatic prostate cancer?
Figure 2
Figure 2. Is it recommended to use intermittent androgen deprivation instead of continous androgen suppression in patients with radiologically documented metastasis that reach adequate PSA lowering?
Figure 3
Figure 3. In patients with biochemical progression and negative scintigraphy and computorized tomography, which other diagnostic method should be used?
Figure 4
Figure 4. In an environment without any restrict access to other therapeutic options, is there indication of re-treatment with docetaxel?
See this image and copyright information in PMC

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