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. 2021 Apr:7:545-549.
doi: 10.1200/GO.20.00507.

Consensus on the Treatment and Follow-Up for the Nonmetastatic Castration-Resistant Prostate Cancer: A Report From the First Prostate Cancer Consensus Conference for Developing Countries

Felipe Moraes Toledo Pereira  1   2 , Adriano Gonçalves E Silva  3 , Aldo Lourenço Abbade Dettino  4 , Ana Paula Garcia Cardoso  2   5 , Andre Deeke Sasse  6 , Ariel Galapo Kann  2   7   8 , Carlos Dzik  1   2 , Daniel Herchenhorn  2   9 , Denis Leonardo Fontes Jardim  10 , Diego Lopera  11 , Mouna Ayadi  12   13 , Pamela Salman  14 , Ray Antonio Manneh Kopp  15 , Ricardo Saraiva De Carvalho  16 , Sandro Roberto De Araujo Cavallero  17 , Sergio Aguiar  18 , Vinicius Carrera Souza  2   19 , Pedro Luiz Serrano Uson Junior  20 , Andrey Soares  2   5   8
Affiliations

Consensus on the Treatment and Follow-Up for the Nonmetastatic Castration-Resistant Prostate Cancer: A Report From the First Prostate Cancer Consensus Conference for Developing Countries

Felipe Moraes Toledo Pereira et al. JCO Glob Oncol. 2021 Apr.

Abstract

Purpose: To present a summary of the recommendations for the treatment and follow-up for the biochemical recurrence of castration-resistant prostate cancer (PCa) as acquired through a questionnaire administered at the Prostate Cancer Consensus Conference for Developing Countries.

Methods: A total of 27 questions were identified as relating to this topic. Responses from the clinician were tallied and are presented in percentage format. Topics included the use of imaging in staging, treatment recommendations across different patient scenarios of life expectancy and prostate-specific antigen (PSA) doubling time, and follow-up for nonmetastatic castration-resistant PCa.

Results: A consensus agreed that in optimal conditions, positron emission tomography-computed tomography with prostate-specific membrane antigen would be used although in limited resource situations the combined use of CT of the abdomen and pelvic (or pelvic MRI), a bone scan, and a CT of the thorax or chest x-ray was recommended. In cases when PSA levels double in < 10 months, more than 90% of clinicians agreed on the use of apalutamide or enzalutamide, regardless of life expectancy. With a doubling time of more than 10 months, > 54% of experts recommended no treatment independent of life expectancy. More than half of the experts, regardless of resources, recommended follow-up with a physical examination and PSA levels every 3-6 months and imaging only in the case of symptoms.

Conclusion: The voting results and recommendations presented in this document can be used by physicians to support management for biochemical recurrence of castration-resistant PCa in areas of limited resources. Individual clinical decision making should be supported by available data.

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Conflict of interest statement

Felipe Moraes Toledo PereiraHonoraria: Janssen, Zodiac Pharma, MSD, Libbs, Bayer, AmgenConsulting or Advisory Role: Janssen Adriano Gonçalves e SilvaHonoraria: MSD Oncology, Janssen Oncology, Astellas Pharma, Roche, Pfizer/EMD Serono, Bayer, Bristol-Myers Squibb BrazilConsulting or Advisory Role: Janssen Oncology, Astellas Pharma, Pfizer/EMD Serono, MSD OncologyResearch Funding: MSD Oncology, Janssen OncologyTravel, Accommodations, Expenses: Janssen Oncology, Astellas Pharma, MSD Oncology, Roche Aldo Lourenço Abbade DettinoHonoraria: Janssen-Cilag, Bayer, Astellas Pharma, RocheConsulting or Advisory Role: NovartisResearch Funding: Janssen, RocheTravel, Accommodations, Expenses: MSD Oncology Ana Paula Garcia CardosoConsulting or Advisory Role: Janssen Oncology, Pfizer, Astellas PharmaSpeakers' Bureau: Janssen Oncology, Novartis, MSD Oncology, Astellas Pharma, AstraZeneca, BayerTravel, Accommodations, Expenses: Ipsen, Janssen Oncology, Bristol-Myers Squibb Andre Deeke SasseHonoraria: Roche, Astellas Pharma, Janssen-Cilag, Bristol-Myers Squibb, Merck KGaA, MSD Oncology, NovartisConsulting or Advisory Role: Astellas Pharma, Janssen-Cilag, Merck KGaA, Novartis, RocheResearch Funding: Bristol-Myers SquibbTravel, Accommodations, Expenses: MSD Oncology, Janssen-Cilag Ariel Galapo KannConsulting or Advisory Role: Janssen OncologySpeakers' Bureau: Janssen Oncology, GlaxoSmithKline, Roche Carlos DzikConsulting or Advisory Role: Janssen-Cilag, IPSEN, NovartisSpeakers' Bureau: Janssen OncologyTravel, Accommodations, Expenses: Astellas Pharma, Janssen Oncology Daniel HerchenhornConsulting or Advisory Role: Janssen-Cilag Denis Leonardo Fontes JardimHonoraria: Janssen-Cilag, Roche/Genentech, Astellas Pharma, MSD Oncology, Bristol-Myers Squibb Brazil, Pfizer, Libbs, MerckConsulting or Advisory Role: Janssen-Cilag, Pfizer, MSDTravel, Accommodations, Expenses: MSD, Bristol-Myers Squibb Brazil, Janssen-Cilag Diego LoperaConsulting or Advisory Role: Bristol-Myers Squibb, Pfizer, NovartisSpeakers' Bureau: Dr Reddy's Laboratories, Bristol-Myers Squibb, Boehringer Ingelheim, PfizerTravel, Accommodations, Expenses: MSD Oncology Pamela SalmanConsulting or Advisory Role: Roche/Genentech, Novartis, Lilly, Merck SeronoSpeakers' Bureau: Roche/Genentech, Novartis, Lilly Ray Antonio Manneh KoppHonoraria: Astellas Scientific and Medical Affairs Inc, Janssen-Cilag, Bayer, Merck Sharp & Dohme, Roche, Bristol-Myers Squibb, Sanofi, AstraZeneca, PfizerConsulting or Advisory Role: Astellas Pharma, Janssen-Cilag, Roche, Merck Serono, Merck Sharp & Dohme, AstraZeneca, Sanofi, PfizerSpeakers' Bureau: San Jorge Foundation, ACHOResearch Funding: Pfizer, Merck Sharp & Dohme, NovartisTravel, Accommodations, Expenses: Merck Sharp & Dohme Sandro Roberto De Araujo CavalleroHonoraria: Pfizer, Astellas Pharma, Janssen Oncology, AstraZenecaConsulting or Advisory Role: Janssen Oncology, MSD Oncology, Astellas PharmaSpeakers' Bureau: Pfizer, Janssen-Cilag, Astellas PharmaTravel, Accommodations, Expenses: Pfizer, Roche/Genentech, Janssen-Cilag, Astellas Pharma Vinicius Carrera SouzaConsulting or Advisory Role: Janssen, Astellas Pharma, Bayer, Bristol-Myers Squibb BrazilResearch Funding: JanssenTravel, Accommodations, Expenses: Janssen Andrey SoaresHonoraria: Janssen, Pfizer, Bayer, Novartis, AstraZeneca, Astellas Pharma, Pierre Fabre, Merck Serono, Sanofi, Roche, MSDConsulting or Advisory Role: Astellas Pharma, Janssen, Roche, Bayer, Lilly, AstraZeneca, Novartis, MSD, Bristol-Myers SquibbResearch Funding: Bristol-Myers SquibbTravel, Accommodations, Expenses: AstraZeneca, Pfizer, Astellas Pharma, Bristol-Myers Squibb, Bayer, Roche, Janssen, Merck Serono, Sanofi, Ipsen, MSDNo other potential conflicts of interest were reported.

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