Advanced Prostate Cancer Consensus Questions 2017 Questions... · 2 - Imaging after 6 months (completion of Radium-223 treatment) and every 3-4 months thereafter 3 - Option 3Imaging
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www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
Advanced Prostate Cancer Consensus Questions: Section 5
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
What imaging test is sufficient to “exclude” distant metastases in high-risk and locally-advanced prostate cancer?
0
Management of high-risk and locally-advanced M0 prostate cancer
1 - Bone scintigraphy alone
2 - CT alone
3 - Combination of bone scintigraphy and CT
4 - Whole body MRI
5 – PET-CT (PSMA, Choline or FACBC (Fluciclovine))
6 - Abstain
7 - Unqualified to answer
Opt Votes
1 0
2 0
3 20
4 5
5 18
6 6
7 0
N 49
41%
10%
37%
12%
Option 1
Option 2
Option 3
Option 4
Option 5
Option 6
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
In which men with isolated rising PSA alone after prostatectomy do you recommend imaging (including next generation imaging) before starting salvage radiation therapy?
Salvage Radiation therapy for isolated rising PSA alone after prostatectomy
0
1 - In the majority of patients, independent of PSA level
2 - Only in patients with PSA >0.5 ng/mL
3 - Only in patients with PSA >1 ng/mL
4 - Only in patients with PSA >2 ng/mL
5 - No imaging
6 - Abstain
7 - Unqualified to answer
Opt Votes
1 21
2 14
3 6
4 6
5 0
6 1
7 0
N 48
44%
29%
12%
13%
2%
Option 1
Option 2
Option 3
Option 4
Option 5
Option 6
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
In men with potentially de novo oligometastatic disease what imaging do you recommend to confirm this diagnosis (apart from local staging)?
1 - CT and/or MRI and bone scintigraphy
2 - PET-CT (PSMA, Choline or FACBC (Fluciclovine))
3 - WB-MRI
4 - Either PET-CT or WB-MRI (next generation imaging)
5 - Abstain
6 - Unqualified to answer
De novo oligometastatic disease (no prior prostate treatment)
0
Opt Votes
1 13
2 17
3 2
4 17
5 1
6 0
N 50
26%
34% 4%
34%
2%
Option 1
Option 2
Option 3
Option 4
Option 5
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
What imaging modality do you recommend to diagnose the oligometastatic recurrent state for men with castration-sensitive/naive prostate cancer after local treatment with curative intent (+/- salvage radiation therapy)?
Oligometastatic recurrence in castration-sensitive/naive prostate cancer patients with a rising PSA after local treatment (EBRT or RP ± EBRT) with curative intent (+/- salvage radiation therapy)
0
1 - CT and/or MRI and bone scintigraphy
2 - PET-CT (PSMA, Choline or FACBC (Fluciclovine))
3 - Whole-body MRI
4 - Pelvic MRI + PET-CT (PSMA, Choline or FACBC (Fluciclovine))
5 - Pelvic MRI + whole-body MRI
6 - Abstain (including I do not believe that the oligometastatic recurrent state is a clinically meaningful entity)
7 - Unqualified to answer
Opt Votes
1 11
2 23
3 1
4 12
5 2
6 2
7 0
N 51
Detailed voting
results
22%
47%
2%
25%
4%
Option 1
Option 2
Option 3
Option 4
Option 5
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
In men with oligometastatic CRPC what imaging do you recommend to confirm this diagnosis?
Rising PSA on ADT (mCRPC) and oligometastatic disease
0
1 - CT and/or MRI and bone scintigraphy
2 - PET-CT (PSMA, Choline or FACBC (Fluciclovine))
3 - Whole-body MRI
4 - Pelvic MRI + PET-CT (PSMA, Choline or FACBC (Fluciclovine))
5 - Pelvic MRI + whole-body MRI
6 - Abstain (including I do not believe that oligometastatic prostate cancer is a clinically meaningful entity in mCRPC)
7 - Unqualified to answer
Opt Votes
1 13
2 24
3 3
4 9
5 1
6 1
7 0
N 51
Detailed voting
results
26%
48%
6%
18%
2%
Option 1
Option 2
Option 3
Option 4
Option 5
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Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
All mentioned imaging options are available What monitoring by imaging do you recommend for the majority of men with metastatic castration-sensitive/naive prostate cancer?
0
General imaging
1 - Baseline imaging and regular monitoring by imaging every 3-6 months
2 - Baseline imaging and follow-up imaging at PSA nadir/completion of 6 cycles of Docetaxel as part of chemo-hormonal therapy and again at progression (confirmed PSA rise and/or clinical progression)
3 - Baseline imaging only and monitoring by PSA alone and imaging at progression
4 - Abstain
5 - Unqualified to answer
Opt Votes
1 16
2 26
3 9
4 0
5 0
N 51
31%
51%
18%
Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
What kind of imaging do you recommend for the majority of men with metastatic castration-sensitive/naive prostate cancer?
0
General imaging
1 - CT and bone scintigraphy
2 - CT alone
3 - Bone scintigraphy alone
4 - Next generation imaging for prostate cancer
5 - Abstain
6 - Unqualified to answer
Opt Votes
1 37
2 0
3 0
4 13
5 1
6 0
N 51 73%
25%
2%
Option 1
Option 2
Option 3
Option 4
Option 5
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
What monitoring by imaging do you recommend for the majority of men on first-line mCRPC therapy?
0
General imaging
1 - Baseline imaging and regular monitoring by imaging every 3-6 months
2 - Baseline imaging and follow-up imaging at PSA nadir and again at progression (confirmed PSA rise and/or clinical progression)
3 - Baseline imaging only and monitoring by PSA alone and imaging at progression
4 - Abstain
5 - Unqualified to answer
Opt Votes
1 27
2 14
3 8
4 1
5 0
N 50 54% 28%
16%
2%
Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
What kind of imaging do you recommend for the majority of men with mCRPC on first-line therapy?
0
General imaging
1 - CT and bone scintigraphy
2 - CT alone
3 - Bone scintigraphy alone
4 - Next generation imaging for prostate cancer
5 - Abstain
6 - Unqualified to answer
Opt Votes
1 38
2 1
3 0
4 12
5 0
6 0
N 51
74%
2%
24% Option 1
Option 2
Option 3
Option 4
Option 5
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
How frequently do you repeat imaging for treatment monitoring in men with mCRPC on treatment with Radium-223?
0
In men with mCRPC treated with Radium-223
1 - Every 3-4 months during and after treatment
2 - Imaging after 6 months (completion of Radium-223 treatment) and every 3-4 months thereafter
3 - Imaging after 6 months (completion of Radium-223 treatment) andfollow-up imaging at progression (clinical or biochemical progression)
4 - Only at progression (clinical or biochemical progression)
5 - Abstain
6 - Unqualified to answer
Opt Votes
1 20
2 13
3 12
4 2
5 2
6 0
N 49
41%
27%
24%
4% 4%
Option 1
Option 2
Option 3
Option 4
Option 5
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
What kind of imaging for staging and treatment monitoring do you recommend for the majority of men with mCRPC on treatment with Radium-223?
0
1 - CT and bone scintigraphy
2 - CT alone
3 - Bone scintigraphy alone
4 - Next generation imaging for prostate cancer
5 - Abstain
6 - Unqualified to answer
In men with mCRPC treated with Radium-223
Opt Votes
1 35
2 0
3 0
4 11
5 1
6 0
N 47 75%
23%
2%
Option 1
Option 2
Option 3
Option 4
Option 5
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
Advanced Prostate Cancer Consensus Questions: Section 6
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
Which osteoclast-targeted therapy do you recommend for men with mCRPC and bone metastases for SRE/SSE prevention?
0
Best use of osteoclast-targeted therapy for SRE/SSE prevention for mCRPC (NOT for osteoporosis/bone loss)
1 - Zoledronic acid
2 - Denosumab
3 - Either Zoledronic acid or Denosumab
4 - Another osteoclast-targeted therapy
5 - I do not use osteoclast-targeted therapy in this setting
6 - Abstain
7 - Unqualified to answer
Opt Votes
1 4
2 27
3 12
4 2
5 5
6 0
7 0
N 50
8%
54%
24%
4% 10%
Option 1
Option 2
Option 3
Option 4
Option 5
Option 6
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
When you use osteoclast-targeted therapy (zoledronic acid or denosumab) in men with mCRPC and bone metastases, what treatment duration do you recommend?
0
Best use of osteoclast-targeted therapy for SRE/SSE prevention for mCRPC (NOT for osteoporosis/bone loss)
1 - Approximately 2 years
2 - Indefinitely
3 - Abstain (including I do not use osteoclast-targeted therapy in this setting)
4 - Unqualified to answer
Opt Votes
1 30
2 14
3 6
4 0
N 50
68%
32%
Option 1
Option 2
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
For the majority of asymptomatic men with mCRPC and bone metastases responding to first-line systemic mCRPC treatment, which schedule do you recommend for osteoclast-targeted therapy (zoledronic acid or denosumab) in the absence of significant toxicity?
0
Best use of osteoclast-targeted therapy for SRE/SSE prevention for mCRPC (NOT for osteoporosis/bone loss)
1 - Every 4 weeks
2 - Every 4 weeks until approximately two years, then less frequently
3 - Every 3 months
4 - Every 6-12 months
5 - No osteoclast-targeted therapy while responding to first-line mCRPC therapy
6 - Abstain (including I do not use osteoclast-targeted therapy in this setting)
7 - Unqualified to answer
Opt Votes
1 8
2 18
3 7
4 2
5 13
6 1
7 2
N 51
17%
37% 15%
4%
27% Option 1
Option 2
Option 3
Option 4
Option 5
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
For the majority of asymptomatic men with mCRPC and bone metastases NOT responding to first-line systemic mCRPC treatment, which schedule do you recommend for osteoclast-targeted therapy (zoledronic acid or denosumab) in the absence of significant toxicity?
0
Best use of osteoclast-targeted therapy for SRE/SSE prevention for mCRPC (NOT for osteoporosis/bone loss)
1 - Every 4 weeks
2 - Every 4 weeks until approximately two years, then less frequently
3 - Every 3 months
4 - Every 6-12 months
5 - Abstain (including I do not use osteoclast-targeted therapy in this setting)
6 - Unqualified to answer
Opt Votes
1 12
2 24
3 7
4 2
5 5
6 1
N 51
27%
53%
16%
4%
Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
What do you recommend for the majority of men with mCRPC and multiple bone metastases who develop osteonecrosis of the jaw while on osteoclast-targeted therapy for SRE/SSE prevention?
0
Best use of osteoclast-targeted therapy for SRE/SSE prevention for mCRPC (NOT for osteoporosis/bone loss)
1 - Continue osteoclast-targeted therapy
2 - Discontinue osteoclast-targeted therapy permanently
3 - Discontinue osteoclast-targeted therapy and re-start after complete wound healing
4 - Abstain
5 - Unqualified to answer
Opt Votes
1 0
2 41
3 8
4 0
5 1
N 50
84%
16%
Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
Advanced Prostate Cancer Consensus Questions: Section 7
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
In your opinion, is AR-V7 testing ready for use in daily routine clinical practice for the majority of men with mCRPC?
0
AR-V7/AR amplification/mutation
1 - Yes
2 - No
3 - Abstain
4 - Unqualified to answer
Opt Votes
1 2
2 50
3 0
4 0
N 52
4%
96%
Option 1
Option 2
Option 3
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
In your opinion, are cell-free DNA AR amplification and AR mutation testing ready for use in daily routine clinical practice for the majority of men with mCRPC?
0
AR-V7/AR amplification/mutation
1 - Yes
2 - No
3 - Abstain
4 - Unqualified to answer
Opt Votes
1 4
2 47
3 0
4 0
N 51
8%
92%
Option 1
Option 2
Option 3
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
In routine daily clinical practise do you recommend DNA sequencing of tumour biopsies in the majority of men with mCRPC?
0
Tumour biopsy reporting
1 - Yes, whole genome or exome sequencing
2 - Yes, targeted/panel sequencing
3 - No
4 - Abstain
5 - Unqualified to answer
Opt Votes
1 2
2 19
3 30
4 0
5 0
N 51
4%
37%
59%
Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
As a clinician, which factors do you want to have reported back to you in men with mCRPC who undergo a metastatic tumour biopsy apart from tumour morphology and differentiation? The question is only about management for a specific patient not about familial implications and based on knowledge March 2017 in terms of test accuracy/validity and available treatments. PSA IHC
0
1 - Yes, useful test for majority of patients (influences your management decision)
2 - Only for minority of selected patients
3 - No
4 - Abstain
5 - Unqualified to answer
Advanced Prostate Cancer Tumour Biopsy
Opt Votes
1 37
2 9
3 5
4 0
5 1
N 52
72%
18%
10%
Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
As a clinician, which factors do you want to have reported back to you in men with mCRPC who undergo a metastatic tumour biopsy apart from tumour morphology and differentiation? The question is only about management for a specific patient not about familial implications and based on knowledge March 2017 in terms of test accuracy/validity and available treatments. Prostate acid phosphatase
0
1 - Yes, useful test for majority of patients (influences your management decision)
2 - Only for minority of selected patients
3 - No
4 - Abstain
5 - Unqualified to answer
Advanced Prostate Cancer Tumour Biopsy
Opt Votes
1 13
2 9
3 27
4 1
5 1
N 51
26%
18% 54%
2%
Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
As a clinician, which factors do you want to have reported back to you in men with mCRPC who undergo a metastatic tumour biopsy apart from tumour morphology and differentiation? The question is only about management for a specific patient not about familial implications and based on knowledge March 2017 in terms of test accuracy/validity and available treatments. NKX3.1
0
1 - Yes, useful test for majority of patients (influences your management decision)
2 - Only for minority of selected patients
3 - No
4 - Abstain
5 - Unqualified to answer
Advanced Prostate Cancer Tumour Biopsy
Opt Votes
1 6
2 16
3 24
4 3
5 2
N 51
12%
33% 49%
6%
Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
As a clinician, which factors do you want to have reported back to you in men with mCRPC who undergo a metastatic tumour biopsy apart from tumour morphology and differentiation? The question is only about management for a specific patient not about familial implications and based on knowledge March 2017 in terms of test accuracy/validity and available treatments. AR-V7
0
1 - Yes, useful test for majority of patients (influences your management decision)
2 - Only for minority of selected patients
3 - No
4 - Abstain
5 - Unqualified to answer
Advanced Prostate Cancer Tumour Biopsy
Opt Votes
1 17
2 13
3 19
4 2
5 1
N 52
33%
26%
37%
4%
Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
As a clinician, which factors do you want to have reported back to you in men with mCRPC who undergo a metastatic tumour biopsy apart from tumour morphology and differentiation? The question is only about management for a specific patient not about familial implications and based on knowledge March 2017 in terms of test accuracy/validity and available treatments. Nuclear AR
0
1 - Yes, useful test for majority of patients (influences your management decision)
2 - Only for minority of selected patients
3 - No
4 - Abstain
5 - Unqualified to answer
Advanced Prostate Cancer Tumour Biopsy
Opt Votes
1 17
2 9
3 23
4 1
5 2
N 52
34%
18%
46%
2%
Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
As a clinician, which factors do you want to have reported back to you in men with mCRPC who undergo a metastatic tumour biopsy apart from tumour morphology and differentiation? The question is only about management for a specific patient not about familial implications and based on knowledge March 2017 in terms of test accuracy/validity and available treatments. AR amplification and/or AR mutation
0
1 - Yes, useful test for majority of patients (influences your management decision)
2 - Only for minority of selected patients
3 - No
4 - Abstain
5 - Unqualified to answer
Advanced Prostate Cancer Tumour Biopsy
Opt Votes
1 21
2 9
3 18
4 1
5 2
N 51
43%
18%
37%
2%
Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
As a clinician, which factors do you want to have reported back to you in men with mCRPC who undergo a metastatic tumour biopsy apart from tumour morphology and differentiation? The question is only about management for a specific patient not about familial implications and based on knowledge March 2017 in terms of test accuracy/validity and available treatments. PSMA
0
1 - Yes, useful test for majority of patients (influences your management decision)
2 - Only for minority of selected patients
3 - No
4 - Abstain
5 - Unqualified to answer
Advanced Prostate Cancer Tumour Biopsy
Opt Votes
1 16
2 11
3 22
4 1
5 2
N 52
32%
22%
44%
2%
Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
As a clinician, which factors do you want to have reported back to you in men with mCRPC who undergo a metastatic tumour biopsy apart from tumour morphology and differentiation? The question is only about management for a specific patient not about familial implications and based on knowledge March 2017 in terms of test accuracy/validity and available treatments. Ki67/MiB1
0
1 - Yes, useful test for majority of patients (influences your management decision)
2 - Only for minority of selected patients
3 - No
4 - Abstain
5 - Unqualified to answer
Advanced Prostate Cancer Tumour Biopsy
Opt Votes
1 14
2 13
3 21
4 2
5 2
N 52
28%
26%
42%
4%
Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
As a clinician, which factors do you want to have reported back to you in men with mCRPC who undergo a metastatic tumour biopsy apart from tumour morphology and differentiation? The question is only about management for a specific patient not about familial implications and based on knowledge March 2017 in terms of test accuracy/validity and available treatments. Chromogranin, Synaptophysin, CD56/NSE
0
1 - Yes, useful test for majority of patients (influences your management decision)
2 - Only for minority of selected patients
3 - No
4 - Abstain
5 - Unqualified to answer
Advanced Prostate Cancer Tumour Biopsy
Opt Votes
1 24
2 15
3 8
4 1
5 2
N 50
50%
31%
17%
2%
Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
As a clinician, which factors do you want to have reported back to you in men with mCRPC who undergo a metastatic tumour biopsy apart from tumour morphology and differentiation? The question is only about management for a specific patient not about familial implications and based on knowledge March 2017 in terms of test accuracy/validity and available treatments. ERG IHC
0
1 - Yes, useful test for majority of patients (influences your management decision)
2 - Only for minority of selected patients
3 - No
4 - Abstain
5 - Unqualified to answer
Advanced Prostate Cancer Tumour Biopsy
Opt Votes
1 6
2 15
3 28
4 1
5 2
N 52
12%
30%
56%
2%
Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
As a clinician, which factors do you want to have reported back to you in men with mCRPC who undergo a metastatic tumour biopsy apart from tumour morphology and differentiation? The question is only about management for a specific patient not about familial implications and based on knowledge March 2017 in terms of test accuracy/validity and available treatments. ERG FISH
0
1 - Yes, useful test for majority of patients (influences your management decision)
2 - Only for minority of selected patients
3 - No
4 - Abstain
5 - Unqualified to answer
Advanced Prostate Cancer Tumour Biopsy
Opt Votes
1 5
2 11
3 30
4 1
5 2
N 49
11%
23%
64%
2%
Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
As a clinician, which factors do you want to have reported back to you in men with mCRPC who undergo a metastatic tumour biopsy apart from tumour morphology and differentiation? The question is only about management for a specific patient not about familial implications and based on knowledge March 2017 in terms of test accuracy/validity and available treatments. Loss of PTEN
0
1 - Yes, useful test for majority of patients (influences your management decision)
2 - Only for minority of selected patients
3 - No
4 - Abstain
5 - Unqualified to answer
Advanced Prostate Cancer Tumour Biopsy
Opt Votes
1 22
2 13
3 13
4 2
5 2
N 52
44%
26%
26%
4%
Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
As a clinician, which factors do you want to have reported back to you in men with mCRPC who undergo a metastatic tumour biopsy apart from tumour morphology and differentiation? The question is only about management for a specific patient not about familial implications and based on knowledge March 2017 in terms of test accuracy/validity and available treatments. BRCA1, BRCA2 and ATM mutation
0
1 - Yes, useful test for majority of patients (influences your management decision)
2 - Only for minority of selected patients
3 - No
4 - Abstain
5 - Unqualified to answer
Advanced Prostate Cancer Tumour Biopsy
Opt Votes
1 39
2 10
3 1
4 0
5 2
N 52 78%
20%
2%
Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
As a clinician, which factors do you want to have reported back to you in men with mCRPC who undergo a metastatic tumour biopsy apart from tumour morphology and differentiation? The question is only about management for a specific patient not about familial implications and based on knowledge March 2017 in terms of test accuracy/validity and available treatments. Other DNA repair genes (e.g. CHEK2, PALB2 and others)
0
1 - Yes, useful test for majority of patients (influences your management decision)
2 - Only for minority of selected patients
3 - No
4 - Abstain
5 - Unqualified to answer
Advanced Prostate Cancer Tumour Biopsy
Opt Votes
1 32
2 11
3 6
4 1
5 2
N 52 64%
22%
12%
2%
Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
As a clinician, which factors do you want to have reported back to you in men with mCRPC who undergo a metastatic tumour biopsy apart from tumour morphology and differentiation? The question is only about management for a specific patient not about familial implications and based on knowledge March 2017 in terms of test accuracy/validity and available treatments. TP53 and RB1
0
1 - Yes, useful test for majority of patients (influences your management decision)
2 - Only for minority of selected patients
3 - No
4 - Abstain
5 - Unqualified to answer
Advanced Prostate Cancer Tumour Biopsy
Opt Votes
1 17
2 11
3 20
4 2
5 2
N 52
34%
22%
40%
4%
Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
As a clinician, which factors do you want to have reported back to you in men with mCRPC who undergo a metastatic tumour biopsy apart from tumour morphology and differentiation? The question is only about management for a specific patient not about familial implications and based on knowledge March 2017 in terms of test accuracy/validity and available treatments. PD-1/PD-L1
0
1 - Yes, useful test for majority of patients (influences your management decision)
2 - Only for minority of selected patients
3 - No
4 - Abstain
5 - Unqualified to answer
Advanced Prostate Cancer Tumour Biopsy
Opt Votes
1 11
2 15
3 22
4 1
5 2
N 51
22%
31%
45%
2%
Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
As a clinician, which factors do you want to have reported back to you in men with mCRPC who undergo a metastatic tumour biopsy apart from tumour morphology and differentiation? The question is only about management for a specific patient not about familial implications and based on knowledge March 2017 in terms of test accuracy/validity and available treatments. MMR gene alterations (MSI, MMR protein IHC, or by direct sequencing)
0
1 - Yes, useful test for majority of patients (influences your management decision)
2 - Only for minority of selected patients
3 - No
4 - Abstain
5 - Unqualified to answer
Advanced Prostate Cancer Tumour Biopsy
Opt Votes
1 27
2 11
3 10
4 2
5 2
N 52
54%
22%
20%
4%
Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
If you recommend testing for somatic alterations involving DNA repair defects for men with mCRPC and no recent mCRPC tissue biopsy is available what do you recommend?
0
DNA repair testing in daily routine clinical practice
1 - Test in archival primary tumour tissue
2 - A fresh mCRPC tumour biopsy is needed
3 - Test in circulating tumour DNA
4 - Abstain (including I do not recommend testing in this situation)
5 - Unqualified to answer
Opt Votes
1 7
2 30
3 6
4 7
5 1
N 51
16%
70%
14%
Option 1
Option 2
Option 3
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
If the substances were available and approved: Would you recommend treatment with Olaparib or another PARP inhibitor in men with mCRPC and presence of DNA repair defects (germline or somatic) based on the Phase II data with Olaparib?
0
DNA repair testing in daily routine clinical practice
1 - Yes, in the majority patients
2 - In a minority of selected patients
3 - No
4 - Abstain
5 - Unqualified to answer
Opt Votes
1 33
2 15
3 2
4 1
5 0
N 51
65%
29%
4% 2%
Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
In men with mCRPC and presence of DNA repair defects (germline or somatic) is it appropriate to extrapolate the Phase II data from Olaparib to Platinum agents?
0
DNA repair testing in daily routine clinical practice
1 - Yes, in the majority patients
2 - In a minority of selected patients
3 - No
4 - Abstain
5 - Unqualified to answer
Opt Votes
1 23
2 7
3 18
4 3
5 0
N 51
45%
14%
35%
6%
Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
In men with mCRPC and a presence of DNA repair defects (germline or somatic) progressing on ADT (castration-resistance), which first-line mCRPC treatment do you recommend?
0
DNA repair testing in daily routine clinical practice
1 - Standard mCRPC first-line treatment option
2 - Platinum based combination chemotherapy
3 - Platinum monotherapy
4 - PARP inhibitor
5 - Abstain
6 - Unqualified to answer
Opt Votes
1 34
2 11
3 0
4 5
5 1
6 1
N 52 67%
21%
10%
2%
Option 1
Option 2
Option 3
Option 4
Option 5
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
In men with mCRPC and presence of DNA repair defects (germline or somatic) progressing on/after standard first-line mCRPC therapy, which second-line treatment do you recommend?
0
DNA repair testing in daily routine clinical practice
1 - Standard CRPC second-line treatment option
2 - Platinum based combination chemotherapy
3 - Platinum monotherapy
4 - PARP inhibitor
5 - Abstain (including I do not use standard mCRPC treatment in these men)
6 - Unqualified to answer
Opt Votes
1 16
2 19
3 2
4 10
5 1
6 1
N 49
Detailed voting
results
33%
40%
4%
21%
2%
Option 1
Option 2
Option 3
Option 4
Option 5
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
Advanced Prostate Cancer Consensus Questions: Section 8
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
Do you recommend genetic counselling and testing for men with newly diagnosed metastatic (M1) prostate cancer?
0
Germline and genetic counselling in daily clinical practice
1 - Yes, in the majority of patients
2 - In a minority of selected patients
3 - No
4 - Abstain
5 - Unqualified to answer
Opt Votes
1 10
2 31
3 9
4 0
5 0
N 50
20%
62%
18%
Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
If you voted for a minority of selected patients, which factors influence your selection? Positive family history for prostate cancer?
0
1 - Yes
2 - No
3 - Abstain (including I did not vote for a minority of patients)
4 - Unqualified to answer
Germline and genetic counselling in daily clinical practice
Opt Votes
1 37
2 2
3 9
4 0
N 48
95%
5%
Option 1
Option 2
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
If you voted for a minority of selected patients, which factors influence your selection? Positive family history for other cancer syndromes (e.g. hereditary breast and ovarian cancer syndrome and/or pancreatic cancer, or Lynch syndrome)?
0
1 - Yes
2 - No
3 - Abstain (including I did not vote for a minority of patients)
4 - Unqualified to answer
Germline and genetic counselling in daily clinical practice
Opt Votes
1 42
2 3
3 7
4 0
N 52
93%
7%
Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
If you voted for a minority of selected patients, which factors influence your selection? Younger age (≤60 years) at diagnosis?
0
1 - Yes
2 - No
3 - Abstain (including I did not vote for a minority of patients)
4 - Unqualified to answer
Germline and genetic counselling in daily clinical practice
Opt Votes
1 32
2 11
3 9
4 0
N 52
74%
26%
Option 1
Option 2
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
If you ever recommend germline genetic testing, what do you test in men with prostate cancer?
0
Germline and genetic counselling in daily clinical practice
1 - BRCA1 and BRCA2 testing only
2 - BRCA1, BRCA2 and ATM testing only
3 - Large panel testing including homologous recombination DNA repair (e.g. panels that are also used to assess breast cancer risk)
4 - Large panel testing including homologous recombination AND mismatch DNA repair (e.g. comprehensive cancer risk assessment panels)
5 - Abstain (including I do not recommend germline genetic testing)
6 - Unqualified to answer
Opt Votes
1 7
2 7
3 4
4 28
5 3
6 2
N 51
15%
15%
9% 61%
Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
Do you recommend a prophylactic prostatectomy in the presence of a germline BRCA1, BRCA2 or ATM mutation?
0
Germline and genetic counselling in daily clinical practice
1 - Yes, in the majority patients
2 - In a minority of selected patients
3 - No
4 - Abstain
5 - Unqualified to answer
Opt Votes
1 0
2 4
3 48
4 0
5 0
N 52
8%
92%
Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
Does the presence of a germline BRCA1, BRCA2 or ATM mutation in men with intermediate or high-risk localized prostate cancer influence your treatment decision?
0
Germline and genetic counselling in daily clinical practice
1 - Yes, recommend radical prostatectomy over radiation therapy
2 - Yes, recommend radiation therapy over radical prostatectomy
3 - No, standard treatment recommendation
4 - Abstain (including other treatment recommendation)
5 - Unqualified to answer
Opt Votes
1 26
2 2
3 22
4 0
5 2
N 52
52%
4%
44% Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
Does the presence of a germline BRCA1, BRCA2 or ATM mutation in men with low-risk localized prostate cancer influence your treatment decision?
0
Germline and genetic counselling in daily clinical practice
1 - Yes, not recommend active surveillance
2 - Yes, other treatment recommendation
3 - No, standard treatment recommendation
4 - Abstain
5 - Unqualified to answer
Opt Votes
1 23
2 10
3 18
4 0
5 0
N 51
45%
20%
35% Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
Does the presence of DNA repair defects (germline or somatic) in men with newly-diagnosed metastatic castration-sensitive/naive prostate cancer influence your upfront treatment decision for men with metastatic disease?
0
Germline and genetic counselling in daily clinical practice
1 - Yes, more likely to recommend addition of Docetaxel to ADT
2 - Yes, include Platinum in the chemo-hormonal therapy
3 - Yes, other treatment recommendation
4 - No, standard treatment recommendation
5 - Abstain
6 - Unqualified to answer
Opt Votes
1 12
2 11
3 2
4 25
5 1
6 0
N 51
23%
22%
4%
49%
2%
Option 1
Option 2
Option 3
Option 4
Option 5
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
Advanced Prostate Cancer Consensus Questions: Section 9
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
What do you advise patients about the relationship between ADT and risk of bone loss and/or fractures?
0
Side effects of systemic treatment: Prevention and management
1 - There is strong evidence that ADT increases risk of bone loss and/or fractures
2 - There is moderate evidence that ADT increases risk of bone loss and/or fractures
3 - There is weak evidence that ADT increases risk of bone loss and/or fractures
4 - ADT does not change the risk of bone loss and/or fractures
5 - Abstain
6 - Unqualified to answer
Opt Votes
1 45
2 7
3 0
4 0
5 0
6 0
N 52 87%
13% Option1Option2Option3
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
Do you recommend a baseline measurement of Vitamin D in men with prostate cancer starting on ADT?
0
Side effects of systemic treatment: Prevention and management
1 - Yes, in the majority of patients
2 - In a minority of selected patients
3 - No
4 - Abstain
5 - Unqualified to answer
Opt Votes
1 22
2 13
3 16
4 0
5 0
N 51
43%
26%
31% Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
Do you recommend routine supplementation of calcium and Vitamin D in the majority of men with prostate cancer starting on ADT?
0
Side effects of systemic treatment: Prevention and management
1 - Yes both (Calcium + Vitamin D)
2 - Only Vitamin D
3 - Only Calcium
4 - No
5 - Abstain
6 - Unqualified to answer
Opt Votes
1 38
2 7
3 1
4 6
5 0
6 0
N 52 73%
13%
2% 12%
Option 1
Option 2
Option 3
Option 4
Option 5
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
Do you recommend a baseline measurement of bone mineral density in men with prostate cancer starting on ADT?
0
Side effects of systemic treatment: Prevention and management
1 - Yes, in the majority of patients
2 - Only in patients with non-metastatic disease
3 - No
4 - Abstain
5 - Unqualified to answer
Opt Votes
1 32
2 8
3 11
4 1
5 0
N 52
62% 15%
21%
2%
Option 1
Option 2
Option 3
Option 4
Option 5
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
Do you recommend drug therapy to prevent bone loss and/or fractures with denosumab or a bisphosphonate in the dose and schedule for osteoporosis prophylaxis in men with prostate cancer starting on ADT?
0
Side effects of systemic treatment: Prevention and management
1 - Yes, in the majority of patients
2 - Only in patients with documented osteopenia or osteoporosis
3 - No
4 - Abstain
5 - Unqualified to answer
Opt Votes
1 8
2 36
3 6
4 1
5 0
N 51
16%
70%
12%
2%
Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
What do you advise patients about the relationship between ADT and risk of diabetes?
0
Side effects of systemic treatment: Prevention and management
1 - There is strong evidence that ADT increases risk of diabetes
2 - There is moderate evidence that ADT increases risk of diabetes
3 - There is weak evidence that ADT increases risk of diabetes
4 - ADT does not change the risk of diabetes
5 - Abstain
6 - Unqualified to answer
Opt Votes
1 18
2 24
3 9
4 1
5 0
6 0
N 52
35%
46%
17%
2%
Option 1
Option 2
Option 3
Option 4
Option 5
Detailed voting
results
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
What do you advise patients about the relationship between ADT and risk of cardiovascular disease?
0
Side effects of systemic treatment: Prevention and management
1 - There is strong evidence that ADT increases risk of cardiovascular disease
2 - There is moderate evidence that ADT increases risk of cardiovascular disease
3 - There is weak evidence that ADT increases risk of cardiovascular disease
4 - ADT does not change the risk of cardiovascular disease
5 - Abstain
6 - Unqualified to answer
Opt Votes
1 6
2 20
3 23
4 2
5 0
6 0
N 51
12%
39%
45%
4%
Option 1
Option 2
Option 3
Option 4
Option 5
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
Does a history of recent/severe cardiovascular disease influence your choice of ADT in men with metastatic prostate cancer?
0
Side effects of systemic treatment: Prevention and management
1 - Yes, in the majority of patients
2 - In a minority of selected patients
3 - No
4 - Abstain
5 - Unqualified to answer
Opt Votes
1 15
2 21
3 14
4 1
5 0
N 51
29%
41%
28%
2%
Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
If you voted yes that a history of recent/severe cardiovascular disease influences your choice of ADT, what modality of ADT do you recommend in these men?
0
Side effects of systemic treatment: Prevention and management
1 - LHRH agonist
2 - LHRH antagonist
3 - Orchiectomy
4 - Any form of intermittent ADT
5 - I avoid ADT and prescribe Bicalutamide 150 mg/day
6 - Abstain (including I did not vote yes)
7 - Unqualified to answer
Opt Votes
1 4
2 18
3 2
4 7
5 4
6 15
7 1
N 51
11%
52% 6%
20%
11%
Option 1
Option 2
Option 3
Option 4
Option 5
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
What do you advise patients about the relationship between ADT and risk of cognitive changes and/or dementia?
0
Side effects of systemic treatment: Prevention and management
1 - There is strong evidence that ADT increases risk of cognitive changes and/or dementia
2 - There is moderate evidence that ADT increases risk of cognitive changes and/or dementia
3 - There is weak evidence that ADT increases risk of cognitive changes and/or dementia
4 - ADT does not change the risk of cognitive changes and/or dementia
5 - Abstain
6 - Unqualified to answer
Opt Votes
1 4
2 15
3 26
4 7
5 0
6 0
N 52
8%
29%
50%
13%
Option 1
Option 2
Option 3
Option 4
Option 5
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
What do you advise patients about the relationship between ADT and risk of depression?
0
Side effects of systemic treatment: Prevention and management
1 - There is strong evidence that ADT increases risk of depression
2 - There is moderate evidence that ADT increases risk of depression
3 - There is weak evidence that ADT increases risk of depression
4 - ADT does not change the risk of depression
5 - Abstain
6 - Unqualified to answer
Opt Votes
1 3
2 24
3 23
4 2
5 0
6 0
N 52
6%
46% 44%
4%
Option 1
Option 2
Option 3
Option 4
Option 5
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
Do you recommend regular physical exercise in men with prostate cancer starting on ADT?
0
Side effects of systemic treatment: Prevention and management
1 - Yes, in the majority of patients
2 - In a minority of selected patients
3 - No
4 - Abstain
5 - Unqualified to answer
Opt Votes
1 50
2 1
3 0
4 0
5 0
N 51
98%
2%
Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
Do you recommend to routinely involve a multidisciplinary team for prevention or management of ADT related adverse effects?
0
Side effects of systemic treatment: Prevention and management
1 - Yes, in the majority of patients
2 - In a minority of selected patients
3 - No
4 - Abstain
5 - Unqualified to answer
Opt Votes
1 22
2 20
3 9
4 1
5 0
N 52
42%
39%
17%
2%
Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
In men with mCRPC do you recommend early access to an expert in symptom palliation or a dedicated palliative care service?
0
Supportive care
1 - Yes
2 - No
3 - Abstain
4 - Unqualified to answer
Opt Votes
1 31
2 20
3 0
4 0
N 51 61%
39% Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
Do you recommend access to opiate pain medication for men with metastatic prostate cancer and severe pain when their lower level pain medication is not sufficient?
0
Supportive care
1 - Yes
2 - No
3 - Abstain
4 - Unqualified to answer
Opt Votes
1 48
2 3
3 0
4 0
N 51
94%
6%
Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
Do you recommend a health status assessment in men with advanced prostate cancer ≥70 years before treatment decision?
0
Supportive care
1 - Yes, in the majority of patients
2 - In a minority of selected patients
3 - No
4 - Abstain
5 - Unqualified to answer
Opt Votes
1 15
2 21
3 12
4 2
5 0
N 50
30%
42%
24%
4%
Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
If you recommend a health status assessment in men with advanced prostate cancer ≥70 years which one do you recommend?
0
Supportive care
1 - Health status assessment by Comprehensive Geriatric Assessment (CGA)
2 - Screening by G8 (followed by further assessment if score ≤14) and Mini-COG
3 - Screening by G8 only (followed by further assessment if score ≤14)
4 - Other assessment tools
5 - No
6 - Abstain (including I do not recommend a health status assessment)
7 - Unqualified to answer
Opt Votes
1 7
2 8
3 8
4 4
5 3
6 18
7 4
N 52
Detailed voting
results
26%
29%
30%
15%
Option 1
Option 2
Option 3
Option 4
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
Advanced Prostate Cancer Consensus Questions: Section 10
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
If you lived in a country with limited resources available for healthcare, what would you recommend as ADT in the metastatic setting?
0
Global access to prostate cancer drugs and treatment in countries with limited resources
1 - LHRH agonist
2 - LHRH antagonist
3 - Orchiectomy
4 - First generation AR antagonist as single agent
5 - Abstain
6 - Unqualified to answer
Opt Votes
1 5
2 0
3 46
4 0
5 0
6 0
N 51
10%
90%
Option 1
Option 2
Option 3
Option 4
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
What is your preferred treatment choice for second-line endocrine manipulations when Abiraterone and/or Enzalutamide are NOT available?
0
Global access to prostate cancer drugs and treatment in countries with limited resources
1 - Estramustine
2 - First generation AR antagonist
3 - Ketoconazole
4 - Oestrogens
5 - Steroid monotherapy (e.g. Dexamethasone)
6 - Abstain
7 - Unqualified to answer
Opt Votes
1 2
2 22
3 10
4 4
5 12
6 0
7 0
N 50
4%
44%
20%
8%
24% Option 1
Option 2
Option 3
Option 4
Option 5
Option 6
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
Each of the following drugs is on the WHO essential medicines list and/or you are able to source them at an affordable price from generic manufacturer. Which do you consider to be appropriate treatment options in the setting of limited healthcare resources and in men with mCRPC who are progressing on or after Docetaxel? Platinum (Carboplatin/Cisplatin)
0
Global access to prostate cancer drugs and treatment in countries with limited resources
1 - Yes
2 - No
3 - Abstain
4 - Unqualified to answer
Opt Votes
1 40
2 10
3 2
4 0
N 52
77%
19%
4%
Option 1
Option 2
Option 3
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
Cyclophosphamide
0
Global access to prostate cancer drugs and treatment in countries with limited resources
1 - Yes
2 - No
3 - Abstain
4 - Unqualified to answer
Opt Votes
1 20
2 27
3 4
4 1
N 52
39%
53%
8%
Option 1
Option 2
Option 3
Each of the following drugs is on the WHO essential medicines list and/or you are able to source them at an affordable price from generic manufacturer. Which do you consider to be appropriate treatment options in the setting of limited healthcare resources and in men with mCRPC who are progressing on or after Docetaxel?
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
Paclitaxel
0
Global access to prostate cancer drugs and treatment in countries with limited resources
1 - Yes
2 - No
3 - Abstain
4 - Unqualified to answer
Opt Votes
1 8
2 39
3 3
4 1
N 51
16%
78%
6%
Option 1
Option 2
Option 3
Each of the following drugs is on the WHO essential medicines list and/or you are able to source them at an affordable price from generic manufacturer. Which do you consider to be appropriate treatment options in the setting of limited healthcare resources and in men with mCRPC who are progressing on or after Docetaxel?
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
Doxorubicin
0
Global access to prostate cancer drugs and treatment in countries with limited resources
1 - Yes
2 - No
3 - Abstain
4 - Unqualified to answer
Opt Votes
1 6
2 42
3 2
4 1
N 51
12%
84%
4%
Option 1
Option 2
Option 3
Each of the following drugs is on the WHO essential medicines list and/or you are able to source them at an affordable price from generic manufacturer. Which do you consider to be appropriate treatment options in the setting of limited healthcare resources and in men with mCRPC who are progressing on or after Docetaxel?
Detailed voting
results
www.apccc.org
Published open access in European Urology
http://dx.doi.org/10.1016/j.eururo.2017.06.002
Mitoxantrone
0
Global access to prostate cancer drugs and treatment in countries with limited resources
1 - Yes
2 - No
3 - Abstain
4 - Unqualified to answer
Opt Votes
1 35
2 16
3 0
4 0
N 51
69%
31% Option 1
Option 2
Option 3
Each of the following drugs is on the WHO essential medicines list and/or you are able to source them at an affordable price from generic manufacturer. Which do you consider to be appropriate treatment options in the setting of limited healthcare resources and in men with mCRPC who are progressing on or after Docetaxel?
Detailed voting
results
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