Thomas, C., Boegemann, M., Koenig, F., Machtens, S., Schostak, M., Steuber, T. and Heidenreich, A. (2016). Advanced Prostate Cancer Consensus Conference (APCCC) 2015 in St. Gallen. Critical review of the recommendations on diagnosis and therapy of metastatic prostate cancer by a German expert panel. Urologe, 55 (6). S. 772 - 783. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1433-0563

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Abstract

In March 2015, the first Advanced Prostate Cancer Consensus Conference (APCC) took place in St. Gallen. 41 experts from 17 countries reviewed important areas of controversy in advanced hormone-naive and castration-resistant prostate cancer and gave therapy recommendations. These results have been recently published in Annals of Oncology. While most of the recommendations from St. Gallen are comprehensible, some of them need to be further discussed. Therefore, we as a German expert panel will critically debate the St. Gallen recommendations. For metastatic hormone-naive prostate cancer, continuous androgen deprivation remains the standard. There is no evidence for superiority of primary maximal androgen deprivation. Patients suitable for chemotherapy, especially in the presence of high tumour burden, should receive androgen deprivation plus taxanes upfront. In metastatic castration resistant prostate cancer, novel hormonal agents like abiraterone or enzalutamid should be the treatment of choice in the majority of patients. Taxanes should be used first-line in patients with unfavourable prognostic markers. Radium-223 is an option in symptomatic patients with bone metastases. There is first evidence that second-line hormonal treatment after first-line failure of a novel endocrine agent has a high failure rate. Cabazitaxel should be part of the treatment sequence in patients with a good performance status. Baseline staging for castration-resistant prostate cancer should include CT-abdomen/-chest and bone scan. Radiographic monitoring should be performed 2 to 3 times a year. Determination of PSA and ALP is to take place every 2 to 4 months.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Thomas, C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Boegemann, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Koenig, F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Machtens, S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schostak, M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Steuber, T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Heidenreich, A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-273310
DOI: 10.1007/s00120-016-0030-8
Journal or Publication Title: Urologe
Volume: 55
Number: 6
Page Range: S. 772 - 783
Date: 2016
Publisher: SPRINGER HEIDELBERG
Place of Publication: HEIDELBERG
ISSN: 1433-0563
Language: German
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
MITOXANTRONE PLUS PREDNISONE; COMBINED ANDROGEN BLOCKADE; CONTROLLED-TRIAL; ZOLEDRONIC ACID; FREE SURVIVAL; CASTRATION; DOCETAXEL; ENZALUTAMIDE; MEN; METAANALYSISMultiple languages
Urology & NephrologyMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/27331

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