Optimizing outcomes for patients with metastatic prostate cancer: Insights from South East Asia Expert Panel
Clinical decision making is challenging in men with metastatic prostate cancer (mPC), as heterogeneity in treatment options and patient characteristics have resulted in multiple scenarios with little or no evidence. The South East Asia Expert Panel 2019 addressed some of these challenges. Methods: B...
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my.um.eprints.346572022-09-15T08:01:48Z http://eprints.um.edu.my/34657/ Optimizing outcomes for patients with metastatic prostate cancer: Insights from South East Asia Expert Panel Schutz, Fabio Augusto Barros Sirachainan, Ekaphop Kuppusamy, Shanggar Hoa, Nguyen Thi Thai Dejthevaporn, Thitiya Bahadzor, Badrulhisham Toan, Vu Quang Chansriwong, Phichai Alip, Adlinda Hue, Nguyen Thi Minh Parinyanitikul, Napa Tan, Ai Lian Hoang, Vu Dinh Khanh Tienchaiananda, Piyawan Chinchapattanam, Sai Naga Deepak Garg, Amit R Medicine RC0254 Neoplasms. Tumors. Oncology (including Cancer) RD Surgery Clinical decision making is challenging in men with metastatic prostate cancer (mPC), as heterogeneity in treatment options and patient characteristics have resulted in multiple scenarios with little or no evidence. The South East Asia Expert Panel 2019 addressed some of these challenges. Methods: Based on evidence in the literature and expert interviews, 19 statements were formulated for key challenges in the treatment of men with castration-sensitive and -resistant prostate cancer in clinical practice. A modified Delphi process was used to reach consensus among experts in the panel and develop clinical practice recommendations. Results: The majority of the panel preferred a risk-based stratification and recommended abiraterone or enzalutamide as first-line therapy for symptomatic chemotherapy naive patients. Abiraterone is preferred over enzalutamide as a first-line treatment in these patients. However, the panel did not support the use of abiraterone in high risk lymph-node positive only (N+M0) or in non-metastatic (N0M0) patients. In select patients, low dose abiraterone with food may be used to optimize clinical outcomes. Androgen receptor gene splice variant status may be a useful guide to therapy. In addition, generic versions of approved therapies may improve access to treatment to a broader patient population. The choice of treatment, as well as sequencing are guided by both patient and disease characteristics, preferences, drug access, cost, and compliance. Conclusion: Expert recommendations are key to guidance for the optimal management of mPC. Appropriate choice, timing, and sequence of treatment options can help to tailor therapy to maximize outcomes in men with mPC. Sage 2021-02 Article PeerReviewed Schutz, Fabio Augusto Barros and Sirachainan, Ekaphop and Kuppusamy, Shanggar and Hoa, Nguyen Thi Thai and Dejthevaporn, Thitiya and Bahadzor, Badrulhisham and Toan, Vu Quang and Chansriwong, Phichai and Alip, Adlinda and Hue, Nguyen Thi Minh and Parinyanitikul, Napa and Tan, Ai Lian and Hoang, Vu Dinh Khanh and Tienchaiananda, Piyawan and Chinchapattanam, Sai Naga Deepak and Garg, Amit (2021) Optimizing outcomes for patients with metastatic prostate cancer: Insights from South East Asia Expert Panel. Therapeutic Advances in Medical Oncology, 13. ISSN 1758-8340, DOI https://doi.org/10.1177/1758835920985464 <https://doi.org/10.1177/1758835920985464>. 10.1177/1758835920985464 |
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R Medicine RC0254 Neoplasms. Tumors. Oncology (including Cancer) RD Surgery Schutz, Fabio Augusto Barros Sirachainan, Ekaphop Kuppusamy, Shanggar Hoa, Nguyen Thi Thai Dejthevaporn, Thitiya Bahadzor, Badrulhisham Toan, Vu Quang Chansriwong, Phichai Alip, Adlinda Hue, Nguyen Thi Minh Parinyanitikul, Napa Tan, Ai Lian Hoang, Vu Dinh Khanh Tienchaiananda, Piyawan Chinchapattanam, Sai Naga Deepak Garg, Amit Optimizing outcomes for patients with metastatic prostate cancer: Insights from South East Asia Expert Panel |
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Clinical decision making is challenging in men with metastatic prostate cancer (mPC), as heterogeneity in treatment options and patient characteristics have resulted in multiple scenarios with little or no evidence. The South East Asia Expert Panel 2019 addressed some of these challenges. Methods: Based on evidence in the literature and expert interviews, 19 statements were formulated for key challenges in the treatment of men with castration-sensitive and -resistant prostate cancer in clinical practice. A modified Delphi process was used to reach consensus among experts in the panel and develop clinical practice recommendations. Results: The majority of the panel preferred a risk-based stratification and recommended abiraterone or enzalutamide as first-line therapy for symptomatic chemotherapy naive patients. Abiraterone is preferred over enzalutamide as a first-line treatment in these patients. However, the panel did not support the use of abiraterone in high risk lymph-node positive only (N+M0) or in non-metastatic (N0M0) patients. In select patients, low dose abiraterone with food may be used to optimize clinical outcomes. Androgen receptor gene splice variant status may be a useful guide to therapy. In addition, generic versions of approved therapies may improve access to treatment to a broader patient population. The choice of treatment, as well as sequencing are guided by both patient and disease characteristics, preferences, drug access, cost, and compliance. Conclusion: Expert recommendations are key to guidance for the optimal management of mPC. Appropriate choice, timing, and sequence of treatment options can help to tailor therapy to maximize outcomes in men with mPC. |
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Schutz, Fabio Augusto Barros Sirachainan, Ekaphop Kuppusamy, Shanggar Hoa, Nguyen Thi Thai Dejthevaporn, Thitiya Bahadzor, Badrulhisham Toan, Vu Quang Chansriwong, Phichai Alip, Adlinda Hue, Nguyen Thi Minh Parinyanitikul, Napa Tan, Ai Lian Hoang, Vu Dinh Khanh Tienchaiananda, Piyawan Chinchapattanam, Sai Naga Deepak Garg, Amit |
author_facet |
Schutz, Fabio Augusto Barros Sirachainan, Ekaphop Kuppusamy, Shanggar Hoa, Nguyen Thi Thai Dejthevaporn, Thitiya Bahadzor, Badrulhisham Toan, Vu Quang Chansriwong, Phichai Alip, Adlinda Hue, Nguyen Thi Minh Parinyanitikul, Napa Tan, Ai Lian Hoang, Vu Dinh Khanh Tienchaiananda, Piyawan Chinchapattanam, Sai Naga Deepak Garg, Amit |
author_sort |
Schutz, Fabio Augusto Barros |
title |
Optimizing outcomes for patients with metastatic prostate cancer: Insights from South East Asia Expert Panel |
title_short |
Optimizing outcomes for patients with metastatic prostate cancer: Insights from South East Asia Expert Panel |
title_full |
Optimizing outcomes for patients with metastatic prostate cancer: Insights from South East Asia Expert Panel |
title_fullStr |
Optimizing outcomes for patients with metastatic prostate cancer: Insights from South East Asia Expert Panel |
title_full_unstemmed |
Optimizing outcomes for patients with metastatic prostate cancer: Insights from South East Asia Expert Panel |
title_sort |
optimizing outcomes for patients with metastatic prostate cancer: insights from south east asia expert panel |
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Sage |
publishDate |
2021 |
url |
http://eprints.um.edu.my/34657/ |
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1744649192187363328 |
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13.18916 |