Optimizing outcomes for patients with metastatic prostate cancer: Insights from South East Asia Expert Panel

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.

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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.

Item Type: Article
Funders: Dr Reddy's Laboratories Ltd.
Uncontrolled Keywords: Abiraterone;Chemotherapy;Docetaxel;Enzalutamide;Metastatic prostate cancer
Subjects: R Medicine
R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
R Medicine > RD Surgery
Divisions: Faculty of Medicine
Depositing User: Ms Zaharah Ramly
Date Deposited: 15 Sep 2022 08:01
Last Modified: 15 Sep 2022 08:01
URI: http://eprints.um.edu.my/id/eprint/34657

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