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Canadian consensus forum of key controversial areas in the management of advanced prostate cancer

Recommendations for Canadian healthcare providers

Authors

  • Fred Saad Centre Hospitalier de l’Université de Montréal, University of Montreal, Montreal, QC, Canada
  • Sebastien J Hotte Juravinski Cancer Centre, McMaster University, Hamilton, ON, Canada
  • Antonio Finelli Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
  • Shawn Malone The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
  • Tamim Niazi Jewish General Hospital, McGill University, Montreal, QC, Canada
  • Krista Noonan BC Cancer Agency, University of British Columbia, Surrey, BC, Canada
  • Bobby Shayegan St. Joseph’s Healthcare, McMaster University, Hamilton, ON, Canada
  • Alan I So Prostate Centre at Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada
  • Brita Danielson Cross Cancer Institute, University of Alberta, Edmonton, AB, Canada
  • Naveen S Basappa Cross Cancer Institute, University of Alberta, Edmonton, AB, Canada
  • Ilias Cagiannos London Health Sciences Centre, Western University, London, ON, Canada
  • Christina Canil The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
  • Guila Delouya Centre Hospitalier de l’Université de Montréal, University of Montreal, Montreal, QC, Canada
  • Ricardo Fernandes London Health Sciences Centre, Western University, London, ON, Canada
  • Cristiano Ferrario Jewish General Hospital, McGill University, Montreal, QC, Canada
  • Geoffrey T Gotto Southern Alberta Institute of Urology, University of Calgary, Calgary, AB, Canada
  • Robert J Hamilton Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
  • Jason P Izard Kingston Health Sciences Centre, Queen’s University, Kingston, ON
  • Anil Kapoor St. Joseph’s Healthcare, McMaster University, Hamilton, ON, Canada
  • Daniel Khalaf BC Cancer Agency, University of British Columbia, Vancouver, BC, Canada
  • Michael Kolinsky Cross Cancer Institute, University of Alberta, Edmonton, AB, Canada
  • Aly-Khan Lalani Juravinski Cancer Centre, McMaster University, Hamilton, ON, Canada
  • Luke T Lavallée The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
  • Christopher Morash The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
  • Scott C Morgan The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
  • Michael Ong The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
  • Frédéric Pouliot Quebec City University Hospital Center & Centre de Recherche of Quebec City University Hospital Center, University of Laval, QC, Canada
  • Ricardo A Rendon 15Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, NS, Canada
  • Steven Yip Tom Baker Cancer Centre, University of Calgary, Calgary, AB, Canada
  • Anousheh Zardan Medical Affairs, Janssen Inc, Toronto, ON, Canada
  • Laura Park-Wyllie Medical Affairs, Janssen Inc, Toronto, ON, Canada
  • Kim Chi BC Cancer Agency, University of British Columbia, Vancouver, BC, Canada

DOI:

https://doi.org/10.5489/cuaj.7347

Keywords:

Advanced prostate cancer, Consensus statement, Treatment, Management

Abstract

Introduction: Rapid progress in diagnostics and therapeutics for the management of prostate cancer (PCa) have created areas where high-level evidence to guide practice is lacking. The Genitourinary Research Consortium (GURC) conducted its second Canadian consensus forum to address areas of controversy in the management of PCa and provide recommendations to guide treatment.

Methods: A panel of PCa specialists discussed topics related to the management of PCa. The core scientific committee finalized the design, questions and the analysis of the consensus results. Attendees then voted to indicate their management choice regarding each statement/topic. Questions for voting were adapted from the 2019 Advanced Prostate Cancer Consensus Conference. The thresholds for agreement were set at ≥ 75% for ‘consensus agreement’, > 50% for “near-consensus”, and ≤ 50% for “no consensus”.

Results: The panel was comprised of 29 PCa experts including urologists (n=12), medical oncologists (n= 12), and radiation oncologists (n= 5). Voting took place for 65 pre-determined questions and three ad hoc questions. Consensus was reached for 34 questions, spanning a variety of areas including biochemical recurrence, treatment of metastatic castration-sensitive PCa, management of non-metastatic and metastatic castration-resistant PCa, bone health, and molecular profiling.

Conclusions: The consensus forum identified areas of consensus or near-consensus in more than half of the questions discussed. Areas of consensus typically aligned with available evidence, and areas of variability may indicate a lack of high-quality evidence and point to future opportunities for further research and education.

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Published

2021-06-08

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How to Cite

Saad, F., Hotte, S. J., Finelli, A., Malone, S., Niazi, T., Noonan, K., Shayegan, B., So, A. I., Danielson, B., Basappa, N. S., Cagiannos, I., Canil, C., Delouya, G., Fernandes, R., Ferrario, C., Gotto, G. T., Hamilton, R. J., Izard, J. P., Kapoor, A., Khalaf, D., Kolinsky, M., Lalani, A.-K., Lavallée, L. T., Morash, C., Morgan, S. C., Ong, M., Pouliot, F., Rendon, R. A., Yip, S., Zardan, A., Park-Wyllie, L., & Chi, K. (2021). Canadian consensus forum of key controversial areas in the management of advanced prostate cancer: Recommendations for Canadian healthcare providers. Canadian Urological Association Journal, 15(10). https://doi.org/10.5489/cuaj.7347

Issue

Vol. 15 No. 10 (2021): CUAJ October

Section

Review

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