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Review
. 2021 Feb 23:13:1758835920985464.
doi: 10.1177/1758835920985464. eCollection 2021.

Optimizing outcomes for patients with metastatic prostate cancer: insights from South East Asia Expert Panel

Fabio Augusto Barros Schutz  1 , Ekaphop Sirachainan  2 , Shanggar Kuppusamy  3 , Nguyen Thi Thai Hoa  4 , Thitiya Dejthevaporn  5 , Badrulhisham Bahadzor  6 , Vu Quang Toan  4 , Phichai Chansriwong  5 , Adlinda Alip  7 , Nguyen Thi Minh Hue  8 , Napa Parinyanitikul  9 , Ai Lian Tan  10 , Vu Dinh Khanh Hoang  11 , Piyawan Tienchaiananda  12 , Sai Naga Deepak Chinchapattanam  13 , Amit Garg  14
Affiliations
Review

Optimizing outcomes for patients with metastatic prostate cancer: insights from South East Asia Expert Panel

Fabio Augusto Barros Schutz et al. Ther Adv Med Oncol. .

Abstract

Aims: Clinical decision making is challenging in men with metastatic prostate cancer (mPC), as heterogeneity in treatment options and patient characteristics have resulted in multiple scenarios with little or no evidence. The South East Asia Expert Panel 2019 addressed some of these challenges.

Methods: Based on evidence in the literature and expert interviews, 19 statements were formulated for key challenges in the treatment of men with castration-sensitive and -resistant prostate cancer in clinical practice. A modified Delphi process was used to reach consensus among experts in the panel and develop clinical practice recommendations.

Results: The majority of the panel preferred a risk-based stratification and recommended abiraterone or enzalutamide as first-line therapy for symptomatic chemotherapy naïve patients. Abiraterone is preferred over enzalutamide as a first-line treatment in these patients. However, the panel did not support the use of abiraterone in high risk lymph-node positive only (N+M0) or in non-metastatic (N0M0) patients. In select patients, low dose abiraterone with food may be used to optimize clinical outcomes. Androgen receptor gene splice variant status may be a useful guide to therapy. In addition, generic versions of approved therapies may improve access to treatment to a broader patient population. The choice of treatment, as well as sequencing are guided by both patient and disease characteristics, preferences, drug access, cost, and compliance.

Conclusion: Expert recommendations are key to guidance for the optimal management of mPC. Appropriate choice, timing, and sequence of treatment options can help to tailor therapy to maximize outcomes in men with mPC.

Keywords: abiraterone; chemotherapy; docetaxel; enzalutamide; metastatic prostate cancer.

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Conflict of interest statement

Conflict of interest statement: Sai Naga Deepak Chinchapattanam is an employee of Dr Reddy’s Laboratories Ltd and Amit Garg was an employee of Dr Reddy’s Laboratories Ltd, Hyderabad at the time of meeting.

Figures

Figure 1.
Figure 1.
Modified Delphi method for development of expert recommendations.
Figure 2.
Figure 2.
Abiraterone versus docetaxel in mCSPC. mCSPC, metastatic castration-sensitive prostate cancer.
See this image and copyright information in PMC

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