Department of Medical Oncology, Cantonal Hospital St. Gallen and University of Berne, Switzerland.
Department of Medical Oncology, The Institute of Cancer Research/Royal Marsden, London, UK.
Eur Urol. 2018 Feb;73(2):178-211. doi: 10.1016/j.eururo.2017.06.002. Epub 2017 Jun 24.
In advanced prostate cancer (APC), successful drug development as well as advances in imaging and molecular characterisation have resulted in multiple areas where there is lack of evidence or low level of evidence. The Advanced Prostate Cancer Consensus Conference (APCCC) 2017 addressed some of these topics.
To present the report of APCCC 2017.
DESIGN, SETTING, AND PARTICIPANTS: Ten important areas of controversy in APC management were identified: high-risk localised and locally advanced prostate cancer; "oligometastatic" prostate cancer; castration-naïve and castration-resistant prostate cancer; the role of imaging in APC; osteoclast-targeted therapy; molecular characterisation of blood and tissue; genetic counselling/testing; side effects of systemic treatment(s); global access to prostate cancer drugs. A panel of 60 international prostate cancer experts developed the program and the consensus questions.
The panel voted publicly but anonymously on 150 predefined questions, which have been developed following a modified Delphi process.
Voting is based on panellist opinion, and thus is not based on a standard literature review or meta-analysis. The outcomes of the voting had varying degrees of support, as reflected in the wording of this article, as well as in the detailed voting results recorded in Supplementary data.
The presented expert voting results can be used for support in areas of management of men with APC where there is no high-level evidence, but individualised treatment decisions should as always be based on all of the data available, including disease extent and location, prior therapies regardless of type, host factors including comorbidities, as well as patient preferences, current and emerging evidence, and logistical and economic constraints. Inclusion of men with APC in clinical trials should be strongly encouraged. Importantly, APCCC 2017 again identified important areas in need of trials specifically designed to address them.
The second Advanced Prostate Cancer Consensus Conference APCCC 2017 did provide a forum for discussion and debates on current treatment options for men with advanced prostate cancer. The aim of the conference is to bring the expertise of world experts to care givers around the world who see less patients with prostate cancer. The conference concluded with a discussion and voting of the expert panel on predefined consensus questions, targeting areas of primary clinical relevance. The results of these expert opinion votes are embedded in the clinical context of current treatment of men with advanced prostate cancer and provide a practical guide to clinicians to assist in the discussions with men with prostate cancer as part of a shared and multidisciplinary decision-making process.
在晚期前列腺癌（APC）中，药物研发的成功以及影像学和分子特征的进步，导致在多个领域缺乏证据或证据水平较低。2017 年高级前列腺癌共识会议（APCCC）讨论了其中的一些主题。
介绍 2017 年 APCCC 的报告。
设计、地点和参与者：确定了 APC 管理中 10 个有争议的重要领域：高危局限性和局部晚期前列腺癌；“寡转移”前列腺癌；去势敏感和去势抵抗性前列腺癌；影像学在 APC 中的作用；破骨细胞靶向治疗；血液和组织的分子特征；遗传咨询/检测；全身治疗的副作用；全球获得前列腺癌药物。一个由 60 名国际前列腺癌专家组成的小组制定了该方案和共识问题。
小组公开但匿名投票表决了 150 个预先确定的问题，这些问题是在经过修改的 Delphi 过程后制定的。
投票基于小组成员的意见，因此不是基于标准文献综述或荟萃分析。投票结果的支持程度各不相同，这反映在本文的措辞中，以及在补充数据中记录的详细投票结果中。
所提出的专家投票结果可用于支持在没有高级别证据的情况下管理 APC 男性患者，但个体化的治疗决策应始终基于所有可用数据，包括疾病程度和位置、既往治疗（无论类型如何）、宿主因素（包括合并症）以及患者偏好、当前和新兴证据以及逻辑和经济限制。应强烈鼓励将 APC 男性纳入临床试验。重要的是，2017 年 APCCC 再次确定了需要专门设计试验来解决的重要领域。
第二届高级前列腺癌共识会议（APCCC）2017 确实为讨论和辩论目前治疗晚期前列腺癌患者的选择提供了一个论坛。会议的目的是将世界专家的专业知识带给全球照顾者，他们看到的前列腺癌患者较少。会议以小组专家对预先确定的共识问题进行讨论和投票结束，这些问题针对主要临床相关领域。这些专家意见投票的结果嵌入到目前治疗晚期前列腺癌患者的临床背景中，并为临床医生提供了实用指南，以协助与前列腺癌患者进行讨论，作为共同和多学科决策过程的一部分。
