Bryce Alan H, Crawford E David, Agarwal Neeraj, Hussain Maha H, Beltran Himisha, Cooperberg Matthew R, Petrylak Daniel P, Shore Neal, Spratt Daniel E, Tagawa Scott T, Antonarakis Emmanuel S, Aparicio Ana M, Armstrong Andrew J, Boike Thomas P, Calais Jeremie, Carducci Michael A, Chapin Brian F, Cookson Michael S, Davis John W, Dorff Tanya, Eggener Scott E, Feng Felix Y, Gleave Martin, Higano Celestia, Iagaru Andrei, Morgans Alicia K, Morris Michael, Murray Katie S, Poage Wendy, Rettig Matthew B, Sartor Oliver, Scher Howard I, Sieber Paul, Small Eric, Srinivas Sandy, Yu Evan Y, Zhang Tian, Koo Phillip J
Division of Hematology and Medical Oncology, Mayo Clinic, Phoenix, Arizona.
Department of Urology, University of California San Diego, La Jolla, California.
JU Open Plus. 2024 Apr;2(4). doi: 10.1097/ju9.0000000000000138. Epub 2024 Apr 15.
Management strategies for metastatic castration-resistant prostate cancer (mCRPC) have rapidly shifted in recent years. As novel imaging and therapeutic approaches have made their way to the clinic, providers are encountering increasingly challenging clinical scenarios, with limited guidance from the current literature.
The US Prostate Cancer Conference (USPCC) is a multidisciplinary meeting of prostate cancer experts intended to address the many challenges of prostate cancer management. At the first annual USPCC meeting, areas of controversy and consensus were identified during a 2-day meeting that included expert presentations, full-panel discussions, and postdiscussion responses to questions developed by the USPCC cochairs and session moderators.
This narrative review covers the USPCC expert discussion and perspectives relevant to mCRPC, including neuroendocrine/aggressive-variant prostate cancer (NEPC/AVPC). Areas of broad agreement identified among USPCC experts include the benefits of poly (ADP-ribose) polymerase (PARP) inhibitors for patients with mutations, the use of radioligand therapy in patients with prostate-specific membrane antigen (PSMA)-positive mCRPC, and the need for clinical trials that address real-world clinical questions, including the performance of novel therapies when compared with modern standard-of-care treatment. Ongoing areas of controversy and uncertainty included the appropriateness of PARP inhibitors in patients with non- mutations, the optimal definition of PSMA positivity, and systemic therapies for patients with NEPC/AVPC after progression on platinum-based therapies.
The first annual USPCC meeting identified several areas of controversy in the management of mCRPC, highlighting the urgent need for clinical trials designed to facilitate treatment selection and sequencing in this heterogeneous disease state.
近年来，转移性去势抵抗性前列腺癌（mCRPC）的管理策略迅速转变。随着新型成像和治疗方法进入临床，医疗服务提供者面临着越来越具有挑战性的临床情况，而当前文献提供的指导有限。
美国前列腺癌会议（USPCC）是前列腺癌专家的多学科会议，旨在应对前列腺癌管理的诸多挑战。在第一届年度USPCC会议上，在为期两天的会议期间确定了争议和共识领域，会议包括专家报告、全体小组讨论以及对USPCC联合主席和会议主持人提出的问题的讨论后回应。
本叙述性综述涵盖了与mCRPC相关的USPCC专家讨论和观点，包括神经内分泌/侵袭性变异前列腺癌（NEPC/AVPC）。USPCC专家确定的广泛共识领域包括聚（ADP - 核糖）聚合酶（PARP）抑制剂对有 突变患者的益处、放射性配体疗法在前列腺特异性膜抗原（PSMA）阳性mCRPC患者中的应用，以及开展解决实际临床问题的临床试验的必要性，包括与现代标准治疗相比新型疗法的疗效。持续存在的争议和不确定性领域包括PARP抑制剂在无 突变患者中的适用性、PSMA阳性的最佳定义，以及铂类疗法进展后NEPC/AVPC患者的全身治疗。
第一届年度USPCC会议确定了mCRPC管理中的几个争议领域，突出了迫切需要开展旨在促进这种异质性疾病状态下治疗选择和排序的临床试验。
