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52. Synopsis of the PI-RADS v2 Guidelines for Multiparametric Prostate Magnetic Resonance Imaging and Recommendations for Use

Author

Barentsz, J.O., Weinreb, J.C., Verma, S., Thoeny, H.C., Tempany, C.M., Shtern, F., Padhani, A.R., Margolis, D., Macura, K.J., Haider, M.A., Cornud, F., Choyke, P.L., Barentsz, J.O., Weinreb, J.C., Verma, S., Thoeny, H.C., Tempany, C.M., Shtern, F., Padhani, A.R., Margolis, D., Macura, K.J., Haider, M.A., Cornud, F., and Choyke, P.L.

Abstract

Contains fulltext : 165791.pdf (publisher's version ) (Closed access)

Published
2016

53. Reply to Erik Rud and Eduard Baco's Letter to the Editor re: Re: Jeffrey C. Weinreb, Jelle O. Barentsz, Peter L. Choyke, et al. PI-RADS Prostate Imaging - Reporting and Data System: 2015, Version 2. Eur Urol 2016;69:16-40

Author

Barentsz, J.O., Choyke, P.L., Cornud, F., Haider, M.A., Macura, K.J., Margolis, D., Shtern, F., Padhani, A.R., Tempany, C.M., Thoeny, H.C., Verma, S., Weinreb, J.C., Barentsz, J.O., Choyke, P.L., Cornud, F., Haider, M.A., Macura, K.J., Margolis, D., Shtern, F., Padhani, A.R., Tempany, C.M., Thoeny, H.C., Verma, S., and Weinreb, J.C.

Abstract

Contains fulltext : 171392.pdf (publisher's version ) (Closed access)

Published
2016

59. Clinical applications of multiparametric MRI within the prostate cancer diagnostic pathway.

Author

Dickinson, L., Ahmed, H.U., Allen, C., Barentsz, J.O., Carey, B., Futterer, J.J., Heijmink, S.W.T.P.J., Hoskin, P., Kirkham, A.P., Padhani, A.R., Raj Persad, C.h.M., Meulen, J. van der, Villers, A., Emberton, M., Dickinson, L., Ahmed, H.U., Allen, C., Barentsz, J.O., Carey, B., Futterer, J.J., Heijmink, S.W.T.P.J., Hoskin, P., Kirkham, A.P., Padhani, A.R., Raj Persad, C.h.M., Meulen, J. van der, Villers, A., and Emberton, M.

Abstract

1 april 2013, Item does not contain fulltext

Published
2013

60. Scoring systems used for the interpretation and reporting of multiparametric MRI for prostate cancer detection, localization, and characterization: Could standardization lead to improved utilization of imaging within the diagnostic pathway?

Author

Dickinson, L., Ahmed, H.U., Allen, C., Barentsz, J.O., Carey, B., Futterer, J.J., Heijmink, S.W.T.P.J., Hoskin, P., Kirkham, A.P., Padhani, A.R., Persad, R., Puech, P., Punwani, S., Sohaib, A., Tombal, B., Villers, A., Emberton, M., Dickinson, L., Ahmed, H.U., Allen, C., Barentsz, J.O., Carey, B., Futterer, J.J., Heijmink, S.W.T.P.J., Hoskin, P., Kirkham, A.P., Padhani, A.R., Persad, R., Puech, P., Punwani, S., Sohaib, A., Tombal, B., Villers, A., and Emberton, M.

Abstract

Item does not contain fulltext, Multiparametric magnetic resonance imaging (mpMRI) is increasingly being used earlier in the prostate cancer diagnostic pathway in order to detect and localize disease. Its results can be used to help decide on the indication, type, and localization of a prostate biopsy for cancer diagnosis. In addition, mpMRI has the potential to contribute information on the characterization, or aggressiveness, of detected cancers including tumor progression over time. There is considerable variation in the way results of different MRI sequences are reported. We conducted a review of scoring systems that have been used in the detection and characterization of prostate cancer. This revealed that existing scoring and reporting systems differ in purpose, scale, and range. We evaluate these differences in this review. This first step in collating all methods of scoring and reporting mpMRI will ultimately lead to consensus approaches to develop a standardized reporting scheme that can be widely adopted and validated to ensure comparability of research outputs and optimal clinical practice.

Published
2013

61. The diagnostic accuracy and cost-effectiveness of magnetic resonance spectroscopy and enhanced magnetic resonance imaging techniques in aiding the localisation of prostate abnormalities for biopsy: a systematic review and economic evaluation

Author

Mowatt, G., Scotland, G., Boachie, C., Cruickshank, M., Ford, J.A., Fraser, C., Kurban, L., Lam, T.B., Padhani, A.R., Royle, J., Scheenen, T.W.J., Tassie, E., Mowatt, G., Scotland, G., Boachie, C., Cruickshank, M., Ford, J.A., Fraser, C., Kurban, L., Lam, T.B., Padhani, A.R., Royle, J., Scheenen, T.W.J., and Tassie, E.

Abstract

Contains fulltext : 126103.pdf (publisher's version ) (Open Access), In the UK, prostate cancer (PC) is the most common cancer in men. A diagnosis can be confirmed only following a prostate biopsy. Many men find themselves with an elevated prostate-specific antigen (PSA) level and a negative biopsy. The best way to manage these men remains uncertain.To assess the diagnostic accuracy of magnetic resonance spectroscopy (MRS) and enhanced magnetic resonance imaging (MRI) techniques [dynamic contrast-enhanced MRI (DCE-MRI), diffusion-weighted MRI (DW-MRI)] and the clinical effectiveness and cost-effectiveness of strategies involving their use in aiding the localisation of prostate abnormalities for biopsy in patients with prior negative biopsy who remain clinically suspicious for harbouring malignancy.Databases searched--MEDLINE (1946 to March 2012), MEDLINE In-Process & Other Non-Indexed Citations (March 2012), EMBASE (1980 to March 2012), Bioscience Information Service (BIOSIS; 1995 to March 2012), Science Citation Index (SCI; 1995 to March 2012), The Cochrane Library (Issue 3 2012), Database of Abstracts of Reviews of Effects (DARE; March 2012), Medion (March 2012) and Health Technology Assessment database (March 2012).Types of studies: direct studies/randomised controlled trials reporting diagnostic outcomes. Index tests: MRS, DCE-MRI and DW-MRI. Comparators: T2-weighted magnetic resonance imaging (T2-MRI), transrectal ultrasound-guided biopsy (TRUS/Bx). Reference standard: histopathological assessment of biopsied tissue. A Markov model was developed to assess the cost-effectiveness of alternative MRS/MRI sequences to direct TRUS-guided biopsies compared with systematic extended-cores TRUS-guided biopsies. A health service provider perspective was adopted and the recommended 3.5\% discount rate was applied to costs and outcomes.A total of 51 studies were included. In pooled estimates, sensitivity [95\% confidence interval (CI)] was highest for MRS (92\%; 95\% CI 86\% to 95\%). Specificity was highest for TRUS (imaging test) (81\%; 95

Published
2013

62. Magnetic resonance imaging for the detection, localisation, and characterisation of prostate cancer: recommendations from a European consensus meeting

Author

Dickinson, L., Ahmed, H.U., Allen, C., Barentsz, J.O., Carey, B., Futterer, J.J., Heijmink, S.W.T.P.J., Hoskin, P.J., Kirkham, A., Padhani, A.R., Persad, R., Puech, P., Punwani, S., Sohaib, A.S., Tombal, B., Villers, A., Meulen, J. van der, Emberton, M., Dickinson, L., Ahmed, H.U., Allen, C., Barentsz, J.O., Carey, B., Futterer, J.J., Heijmink, S.W.T.P.J., Hoskin, P.J., Kirkham, A., Padhani, A.R., Persad, R., Puech, P., Punwani, S., Sohaib, A.S., Tombal, B., Villers, A., Meulen, J. van der, and Emberton, M.

Abstract

Item does not contain fulltext, BACKGROUND: Multiparametric magnetic resonance imaging (mpMRI) may have a role in detecting clinically significant prostate cancer in men with raised serum prostate-specific antigen levels. Variations in technique and the interpretation of images have contributed to inconsistency in its reported performance characteristics. OBJECTIVE: Our aim was to make recommendations on a standardised method for the conduct, interpretation, and reporting of prostate mpMRI for prostate cancer detection and localisation. DESIGN, SETTING, AND PARTICIPANTS: A consensus meeting of 16 European prostate cancer experts was held that followed the UCLA-RAND Appropriateness Method and facilitated by an independent chair. MEASUREMENT: Before the meeting, 520 items were scored for "appropriateness" by panel members, discussed face to face, and rescored. RESULTS AND LIMITATIONS: Agreement was reached in 67% of 260 items related to imaging sequence parameters. T2-weighted, dynamic contrast-enhanced, and diffusion-weighted MRI were the key sequences incorporated into the minimum requirements. Consensus was also reached on 54% of 260 items related to image interpretation and reporting, including features of malignancy on individual sequences. A 5-point scale was agreed on for communicating the probability of malignancy, with a minimum of 16 prostatic regions of interest, to include a pictorial representation of suspicious foci. Limitations relate to consensus methodology. Dominant personalities are known to affect the opinions of the group and were countered by a neutral chairperson. CONCLUSIONS: Consensus was reached on a number of areas related to the conduct, interpretation, and reporting of mpMRI for the detection, localisation, and characterisation of prostate cancer. Before optimal dissemination of this technology, these outcomes will require formal validation in prospective trials.

Published
2011

65. Dynamic contrast-enhanced magnetic resonance imaging of radiation therapy-induced microcirculation changes in rectal cancer

Author

de Lussanet, Q.G., de Lussanet, Q.G., Backes, W.H., Griffioen, A.W., Padhani, A.R., Baeten, C.G., van Baardwijk, A.A.W., Lambin, P., Beets, G.L., van Engelshoven, J.M.A., Beets-Tan, R.G.H., de Lussanet, Q.G., de Lussanet, Q.G., Backes, W.H., Griffioen, A.W., Padhani, A.R., Baeten, C.G., van Baardwijk, A.A.W., Lambin, P., Beets, G.L., van Engelshoven, J.M.A., and Beets-Tan, R.G.H.

Abstract

PURPOSE: Dynamic contrast-enhanced T1-weighted magnetic resonance imaging (DCE-MRI) allows noninvasive evaluation of tumor microvasculature characteristics. This study evaluated radiation therapy related microvascular changes in locally advanced rectal cancer by DCE-MRI and histology. METHODS AND MATERIALS: Dynamic contrast-enhanced-MRI was performed in 17 patients with primary rectal cancer. Seven patients underwent 25 fractions of 1.8 Gy radiation therapy (RT) (long RT) before DCE-MRI and 10 did not. Of these 10, 3 patients underwent five fractions of 5 Gy RT (short RT) in the week before surgery. The RT treated and nontreated groups were compared in terms of endothelial transfer coefficient (K(PS), measured by DCE-MRI), microvessel density (MVD) (scored by immunoreactivity to CD31 and CD34), and tumor cell and endothelial cell proliferation (scored by immunoreactivity to Ki67). RESULTS: Tumor K(PS) was 77% (p = 0.03) lower in the RT-treated group. Histogram analyses showed that RT reduced both magnitude and intratumor heterogeneity of K(PS) (p = 0.01). MVD was significantly lower (37%, p = 0.03) in tumors treated with long RT than in nonirradiated tumors, but this was not the case with short RT. Endothelial cell proliferation was reduced with short RT (81%, p = 0.02) just before surgery, but not with long RT (p > 0.8). Tumor cell proliferation was reduced with both long (57%, p < 0.001) and short RT (52%, p = 0.002). CONCLUSION: Dynamic contrast-enhanced-MRI-derived K(PS) values showed significant radiation therapy related reductions in microvessel blood flow in locally advanced rectal cancer. These findings may be useful in evaluating effects of radiation combination therapies (e.g., chemoradiation or RT combined with antiangiogenesis therapy), to account for effects of RT alone.

Published
2005

66. Phase Ib trial of radiotherapy in combination with combretastatin-A4-phosphate in patients with non-small-cell lung cancer, prostate adenocarcinoma, and squamous cell carcinoma of the head and neck

Author

Ng, Q.-S., primary, Mandeville, H., additional, Goh, V., additional, Alonzi, R., additional, Milner, J., additional, Carnell, D., additional, Meer, K., additional, Padhani, A.R., additional, Saunders, M.I., additional, and Hoskin, P.J., additional

Published
2012
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88. Clinical and immunological assessment of Mycobacterium vaccae (SRL172) with chemotherapy in patients with malignant mesothelioma.

Author

Mendes, R., O'Brien, M.E.R., Mitra, A., Norton, A., Gregory, R.K., Padhani, A.R., Bromelow, K.V., Winkley, A.R., Ashley, S., Smith, I.E., and Souberbielle, B.E.

Subjects
MYCOBACTERIUM, DRUG therapy, MESOTHELIOMA
Abstract

The objectives of this study were to determine the toxicity of intratumoural/intrapleural SRL172 in addition to intradermal SRL172 and standard chemotherapy (mitomycin-C, vinblastine and cisplatin) in patients with malignant mesothelioma. Patients received chemotherapy (mitomycin-C: 8 mg m(-2), vinblastine: 6 mg m(-2), cisplatin 50 mg m(-2)) on a 3-weekly basis for up to six courses. IP SRL172 injections were given 3-weekly prior to chemotherapy and escalated in groups of three patients from 1 microg to 1 mg bacilli in 10-fold increments. Patients were also given ID SRL172 at a dose of 1 mg bacilli 4-weekly. Patients were assessed for toxicity after each course of chemotherapy and for response by CT imaging. Immuno-haematological parameters were analyzed pre-treatment and 1 month after completion of treatment. There was no dose limiting toxicity with IP SRL172 although there was greater toxicity at the highest dose (n=13). There were six out of 16 partial responses (37.5%). Haemato-immunological parameters, measured in seven patients pre and post-therapy, revealed that response rate correlated with a decrease in platelet count and there was an increase in activation of natural killer cells and a decrease in the percentage of IL-4 producing T cells in all tested patients post-treatment. SRL172 can be given safely into tumour deposits and the pleural cavity in patients with malignant mesothelioma and we have established the dose for phase II testing. [ABSTRACT FROM AUTHOR]

Published
2002
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89. Evaluation by magnetic resonance imaging of the inferior vena cava in patients with non-seminomatous germ cell tumours of the testis metastatic to the retroperitoneum.

Author

NG, C.S., HUSBAND, J.E.S., PADHANI, A.R., LONG, M.A., HORWICH, A., HENDRY, W.F., and DEARNALEY, D.P.

Abstract

Objective To assess the role of magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) in evaluating suspected occlusion of the inferior vena cava (IVC) in patients with abdominal nodal metastases from non-seminomatous germ cell tumours, thus giving information that may be helpful in planning surgery and for determining the need for anticoagulant therapy. Patients and methods Five patients with abdominal nodal metastases in whom occlusion of the IVC was suspected on computed tomography (CT) were imaged using a 1.5 T MRI scanner. The MRI findings were compared with those from CT. Results The MR images successfully and clearly detected partial and total occlusions of the IVC by both intraluminal thrombus and extrinsic compression. The technique also clearly detected extensive collateral venous circulation in several cases and in one a cavernous transformation of the IVC. In all patients, the MRI studies provided better information than that from CT. Conclusion MRI, and particularly MRA, is a comparatively new technique that is non-invasive and offers the potential of evaluating vascular structures with no need for ionizing radiation or contrast media. This technique, if available, should be chosen for imaging the IVC in patients suspected of having compression or occlusion of the IVC. [ABSTRACT FROM AUTHOR]

Published
1997
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92. Fracture risk in men with metastatic prostate cancer treated with radium-223

Author

Hijab, A., Curcean, S., Tunariu, N., Tovey, H., Alonzi, R., Staffurth, J., Blackledge, M.D., Padhani, A.R., Tree, A., Stidwill, H., Finch, J., Chatfield, P., Perry, S., Koh, D., Hall, E., and Parker, C.C.

Abstract

•using regular imaging with whole body MRI, 74 new fractures were seen in 20/36 patients treated with radium-223•16 new fractures were seen in 12/36 patients in a reference cohort•Whole body MRI with DWI showed that 67% of fractures occurred in uninvolved bone•Men with mCRPC, treated with radium-223, should receive a bone health agent

Published
2021
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93. Dynamic contrast MRI (DCMRI) assessment of tumour permeability in locally advanced rectal cancer: a prognostic indicator for response to chemoradiotherapy.

Author

George, M.L., Dzik-Jurasz, A.S.K., Brown, G., Padhani, A.R., Husband, J., Leach, M.O., Rowland, I.J., Hill, M.E., Cunningham, D.C., Tait, D., Eccles, S.A., and Swift, R.I.

Subjects
TUMORS, RECTAL cancer, MAGNETIC resonance imaging, NEOVASCULARIZATION
Abstract

Aims: The assessment of angiogenesis by microvessel density, immunostaining and RT-PCR is normally performed on surgically resected specimens. However, noninvasive methods, such as MRI and serum/plasma, are able to indirectly assess angiogenesis both preoperatively and during treatment. This study examines whether tumour vascular permeability, assessed by DCMRI and serum VEGF, may be a useful predictive marker in locally advanced rectal cancers undergoing chemoradiotherapy. Methods: 31 patients with locally advanced adenocarcinoma of the rectum (T3/T4) were assessed. All examinations were carried out on a 1.5 T magnet using a pelvic phase array coil. A 10 mm slice through the main bulk of the tumour was defined after imaging the full extent of the tumour, and tumour permeability measured using Tofts model. Serum and plasma VEGF samples were taken from the patients just prior to entering the magnet and measured by ELISA. 16 patients underwent chemoradiotherapy prior to surgical resection. Subsequent MRI scans were used to assess the response of the tumour to chemoradiotherapy according to WHO criteria. Results: At presentation, there was a significant correlation (r = 0.48, P = 0.0099) between DCMRI tumour permeability and serum VEGF. Seven patients responded (8 SD and 1 PD). There was a significant difference in tumour permeability at presentation between responders and non-responders, with responsive tumours being more permeable (-0.41 and -0.77, P = 0.0012 respectively). There was no significant difference in tumour permeability in either group after 12 weeks chemoradiotherapy compared with the initial tumour (P = 0.012). Conclusion: Rectal cancers that are highly angiogenic, as assessed by DCMRI tumour permeability, are more sensitive to chemoradiotherapy than tumours with lower permeability. This may allow for improvement in the selection of rectal cancer patients planned to receive preoperative adjuvant therapy. [ABSTRACT FROM AUTHOR]

Published
2001
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94. A0726 - A new approach to data integration with AI to enhance the specificity of prostate cancer diagnosis.

Author

Moreira Da Silva, N.S., Vasdev, N., Budd, J., Yeung, M., Giganti, F., Davies, L., Burn, P.R., Hindley, R.G., Ibrahim, M., Bradley, A.J., Maskell, G., Andreou, A., Liyanage, S., Persad, R., Aning, J., Barrett, T.J., Hinton, M.D.B., Padhani, A.R., Sala, E., and Rix, A.W.

Subjects
*CANCER diagnosis, *DATA integration, *PROSTATE cancer, *ARTIFICIAL intelligence
Published
2024
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95. A0065 - Targeted with perilesional biopsy should be considered as the new standard for the diagnosis of clinically significant prostate cancer. A systemic review & meta-analysis.

Author

Sanguedolce, F., Tedde, A., Lauwers, C.N.G., Panarello, M., Basile, G., Gallioli, A., Berquin, C., Pecoraro, A., Robalino, J., Bravo, A., Massimo, M., Baboudjian, M., Schoots, I.G., Padhani, A.R., Palou, J., and Breda, A.

Subjects
*PROSTATE cancer, *BIOPSY, *DIAGNOSIS
Published
2024
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96. What experts think about prostate cancer management during the COVID-19 pandemic: report from The Advanced Prostate Cancer Consensus Conference 2021

Author

Fabio Turco, Andrew Armstrong, Gerhardt Attard, Tomasz M. Beer, Himisha Beltran, Anders Bjartell, Alberto Bossi, Alberto Briganti, Rob G. Bristow, Muhammad Bulbul, Orazio Caffo, Kim N. Chi, Caroline Clarke, Noel Clarke, Ian D. Davis, Johann de Bono, Ignacio Duran, Ros Eeles, Eleni Efstathiou, Jason Efstathiou, Christopher P. Evans, Stefano Fanti, Felix Y. Feng, Karim Fizazi, Mark Frydenberg, Dan George, Martin Gleave, Susan Halabi, Daniel Heinrich, Celestia Higano, Michael S. Hofman, Maha Hussain, Nicholas James, Rob Jones, Ravindran Kanesvaran, Raja B. Khauli, Laurence Klotz, Raya Leibowitz, Christopher Logothetis, Fernando Maluf, Robin Millman, Alicia K. Morgans, Michael J. Morris, Nicolas Mottet, Hind Mrabti, Declan G. Murphy, Vedang Murthy, William K. Oh, Ngozi Ekeke Onyeanunam, Piet Ost, Joe M. O'Sullivan, Anwar R. Padhani, Christopher Parker, Darren M.C. Poon, Colin C. Pritchard, Danny M. Rabah, Dana Rathkopf, Robert E. Reiter, Mark Rubin, Charles J. Ryan, Fred Saad, Juan Pablo Sade, Oliver Sartor, Howard I. Scher, Neal Shore, Iwona Skoneczna, Eric Small, Matthew Smith, Howard Soule, Daniel Spratt, Cora N. Sternberg, Hiroyoshi Suzuki, Christopher Sweeney, Matthew Sydes, Mary-Ellen Taplin, Derya Tilki, Bertrand Tombal, Levent Türkeri, Hiroji Uemura, Hirotsugu Uemura, Inge van Oort, Kosj Yamoah, Dingwei Ye, Almudena Zapatero, Silke Gillessen, Aurelius Omlin, Tilki, Derya, Turco, F., Armstrong, A., Attard, G., Beer, T.M., Beltran, H., Bjartell, A., Bossi, A., Briganti, A., Bristow, R.G., Bulbul, M., Caffo, O., Chi, K.N., Clarke, C.S., Clarke, N., Davis, I.D., de Bono, J., Duran, I., Eeles, R., Efstathiou, E., Efstathiou, J., Evans, C.P., Fanti, S., Feng, F.Y., Fizazi, K., Frydenberg, M., George, D., Gleave, M., Halabi, S., Heinrich, D., Higano, C., Hofman, M.S., Hussain, M., James, N., Jones, R., Kanesvaran, R., Khauli, R.B., Klotz, L., Leibowitz, R., Logothetis, C., Maluf, F., Millman, R., Morgans, A.K., Morris, M.J., Mottet, N., Mrabti, H., Murphy, D.G., Murthy, V., Oh, W.K., Ekeke, O.N., Ost, P., O'Sullivan, J.M., Padhani, A.R., Parker, C., Poon, D.M.C., Pritchard, C.C., Rabah, D.M., Rathkopf, D., Reiter, R.E., Rubin, M., Ryan, C.J., Saad, F., Sade, J.P., Sartor, O., Scher, H.I., Shore, N., Skoneczna, I., Small, E., Smith, M., Soule, H., Spratt, D.E., Sternberg, C.N., Suzuki, H., Sweeney, C., Sydes, M.R., Taplin, M.-E., Tombal, B., Türkeri, L., Uemura, H., van Oort, I., Yamoah, K., Ye, D., Zapatero, A., Gillessen, S., Omlin, A., Koç University Hospital, School of Medicine, Acibadem University Dspace, UCL - SSS/IREC/CHEX - Pôle de chirgurgie expérimentale et transplantation, and UCL - (SLuc) Service d'urologie

Subjects
Male, COVID-19 Vaccines, Prostate cancer, Urology, COVID-19 boost injection, COVID-19 pandemic, COVID-19 vaccine, Prostate cancer management, Telemedicine, COVID-19, Prostatic Neoplasms, Androgen Antagonists, 610 Medicine & health, Urology and nephrology, SDG 3 - Good Health and Well-being, Urological cancers Radboud Institute for Molecular Life Sciences [Radboudumc 15], Humans, Pandemics
Abstract

Patients with advanced prostate cancer (APC) may be at greater risk for severe illness, hospitalisation, or death from coronavirus disease 2019 (COVID-19) due to male gender, older age, potential immunosuppressive treatments, or comorbidities. Thus, the optimal management of APC patients during the COVID-19 pandemic is complex. In October 2021, during the Advanced Prostate Cancer Consensus Conference (APCCC) 2021, the 73 voting members of the panel members discussed and voted on 13 questions on this topic that could help clinicians make treatment choices during the pandemic. There was a consensus for full COVID-19 vaccination and booster injection in APC patients. Furthermore, the voting results indicate that the expert's treatment recommendations are influenced by the vaccination status: the COVID-19 pandemic altered management of APC patients for 70% of the panellists before the vaccination was available but only for 25% of panellists for fully vaccinated patients. Most experts (71%) were less likely to use docetaxel and abiraterone in unvaccinated patients with metastatic hormone-sensitive prostate cancer. For fully vaccinated patients with high-risk localised prostate cancer, there was a consensus (77%) to follow the usual treatment schedule, whereas in unvaccinated patients, 55% of the panel members voted for deferring radiation therapy. Finally, there was a strong consensus for the use of telemedicine for monitoring APC patients. Patient summary: In the Advanced Prostate Cancer Consensus Conference 2021, the panellists reached a consensus regarding the recommendation of the COVID-19 vaccine in prostate cancer patients and use of telemedicine for monitoring these patients., NA

Published
2022

97. Management of Patients with Advanced Prostate Cancer: Report from the Advanced Prostate Cancer Consensus Conference 2021

Author

Silke Gillessen, Andrew Armstrong, Gert Attard, Tomasz M. Beer, Himisha Beltran, Anders Bjartell, Alberto Bossi, Alberto Briganti, Robert G. Bristow, Muhammad Bulbul, Orazio Caffo, Kim N. Chi, Caroline S. Clarke, Noel Clarke, Ian D. Davis, Johann S. de Bono, Ignacio Duran, Ros Eeles, Eleni Efstathiou, Jason Efstathiou, Onyeanunam Ngozi Ekeke, Christopher P. Evans, Stefano Fanti, Felix Y. Feng, Karim Fizazi, Mark Frydenberg, Dan George, Martin Gleave, Susan Halabi, Daniel Heinrich, Celesta Higano, Michael S. Hofman, Maha Hussain, Nick James, Robert Jones, Ravindran Kanesvaran, Raja B. Khauli, Laurence Klotz, Raya Leibowitz, Chris Logothetis, Fernando Maluf, Robin Millman, Alicia K. Morgans, Michael J. Morris, Nicolas Mottet, Hind Mrabti, Declan G. Murphy, Vedang Murthy, William K. Oh, Piet Ost, Joe M. O'Sullivan, Anwar R. Padhani, Chris Parker, Darren M.C. Poon, Colin C. Pritchard, Danny M. Rabah, Dana Rathkopf, Rob E. Reiter, Mark Rubin, Charles J. Ryan, Fred Saad, Juan P. Sade, Oliver Sartor, Howard I. Scher, Neal Shore, Iwona Skoneczna, Eric Small, Matthew Smith, Howard Soule, Daniel E. Spratt, Cora N. Sternberg, Hiroyoshi Suzuki, Christopher Sweeney, Matthew R. Sydes, Mary-Ellen Taplin, Derya Tilki, Bertrand Tombal, Levent Türkeri, Hiroji Uemura, Hirotsugu Uemura, Inge van Oort, Kosj Yamoah, Dingwei Ye, Almudena Zapatero, Aurelius Omlin, UCL - SSS/IREC/CHEX - Pôle de chirgurgie expérimentale et transplantation, UCL - (SLuc) Service d'urologie, Acibadem University Dspace, Gillessen, Silke, Armstrong, Andrew, Attard, Gert, Beer, Tomasz M, Beltran, Himisha, Bjartell, Ander, Bossi, Alberto, Briganti, Alberto, Bristow, Robert G, Bulbul, Muhammad, Caffo, Orazio, Chi, Kim N, Clarke, Caroline S, Clarke, Noel, Davis, Ian D, de Bono, Johann S, Duran, Ignacio, Eeles, Ro, Efstathiou, Eleni, Efstathiou, Jason, Ekeke, Onyeanunam Ngozi, Evans, Christopher P, Fanti, Stefano, Feng, Felix Y, Fizazi, Karim, Frydenberg, Mark, George, Dan, Gleave, Martin, Halabi, Susan, Heinrich, Daniel, Higano, Celesta, Hofman, Michael S, Hussain, Maha, James, Nick, Jones, Robert, Kanesvaran, Ravindran, Khauli, Raja B, Klotz, Laurence, Leibowitz, Raya, Logothetis, Chri, Maluf, Fernando, Millman, Robin, Morgans, Alicia K, Morris, Michael J, Mottet, Nicola, Mrabti, Hind, Murphy, Declan G, Murthy, Vedang, Oh, William K, Ost, Piet, O'Sullivan, Joe M, Padhani, Anwar R, Parker, Chri, Poon, Darren M C, Pritchard, Colin C, Rabah, Danny M, Rathkopf, Dana, Reiter, Rob E, Rubin, Mark, Ryan, Charles J, Saad, Fred, Sade, Juan P, Sartor, Oliver, Scher, Howard I, Shore, Neal, Skoneczna, Iwona, Small, Eric, Smith, Matthew, Soule, Howard, Spratt, Daniel E, Sternberg, Cora N, Suzuki, Hiroyoshi, Sweeney, Christopher, Sydes, Matthew R, Taplin, Mary-Ellen, Tilki, Derya, Tombal, Bertrand, Türkeri, Levent, Uemura, Hiroji, Uemura, Hirotsugu, van Oort, Inge, Yamoah, Kosj, Ye, Dingwei, Zapatero, Almudena, Omlin, Aurelius, Gillessen, S., Armstron, A., Attard, G., Beer, T.M., Beltran, H., Bjartell, A., Bossi, A., Briganti, A., Bristow, R.G., Bulbul, M., Caffo, O., Chi, K.N., Clarke, C.S., Clarke, N., Davis, I.D., de Bono, J.S., Duran, I., Eeles, R., Efstathiou, E., Efstathiou, J., Ekeke, O.N., Evans, C.P., Fanti, S., Feng, F.Y., Fizazi, K., Frydenberg, M., George, D., Gleave, M., Halabi, S., Heinrich, D., Higano, C., Hofman, M.S., Hussain, M., James, N., Jones, R., Kanesvaran, R., Khauli, R.B., Klotz, L., Leibowitz, R., Logothetis, C., Maluf, F., Millman, R., Morgans, A.K., Morris, M.J., Mottet, N., Mrabti, H., Murphy, D.G., Murthy, V., Oh, W.K., Ost, P., O'Sullivan, J.M., Padhani, A.R., Parker, C., Poon, D.M.C., Pritchard, C.C., Rabah, D.M., Rathkopf, D., Reiter, R.E., Rubin, M., Ryan, C.J., Saad, F., Sade, J.P., Sartor, O., Scher, H.I., Shore, N., Skoneczna, I., Small, E., Smith, M., Soule, H., Spratt, D.E., Sternberg, C.N., Suzuki, H., Sweeney, C., Sydes, M.R., Taplin, M.E., Tombal, B., Türkeri, L., Uemura, H., van Oort, I., Yamoah, K., Ye, D., Zapatero, A., Omlin, A., Koç University Hospital, and School of Medicine

Subjects
Male, Consensus, Urology, education, Lu-177-PSMA therapy, Consensu, Hormone-sensitive prostate cancer, Imaging, SDG 3 - Good Health and Well-being, Genetic, Lu-PSMA therapy, Urological cancers Radboud Institute for Molecular Life Sciences [Radboudumc 15], Genetics, Humans, Castration-resistant prostate cancer, Tumour genomic profiling, Manchester Cancer Research Centre, Advanced prostate cancer, ResearchInstitutes_Networks_Beacons/mcrc, PARP inhibition, 177Lu-PSMA therapy, Next-generation sequencing, Prostate cancer treatment, Prostatic Neoplasms, Urology and nephrology, (177)Lu-PSMA therapy, Human
Abstract

Background: innovations in treatments, imaging, and molecular characterisation in advanced prostate cancer have improved outcomes, but various areas of management still lack high-level evidence to inform clinical practice. The 2021 Advanced Prostate Cancer Consensus Conference (APCCC) addressed some of these questions to supplement guidelines that are based on level 1 evidence. Objective: to present the voting results from APCCC 2021. Design, setting, and participants: the experts identified three major areas of controversy related to management of advanced prostate cancer: newly diagnosed metastatic hormone-sensitive prostate cancer (mHSPC), the use of prostate-specific membrane antigen ligands in diagnostics and therapy, and molecular characterisation of tissue and blood. A panel of 86 international prostate cancer experts developed the programme and the consensus questions. Outcome measurements and statistical analysis: The panel voted publicly but anonymously on 107 pre-defined questions, which were developed by both voting and non-voting panel members prior to the conference following a modified Delphi process. Results and limitations: the voting reflected the opinions of panellists and did not incorporate a standard literature review or formal meta-analysis. The answer options for the consensus questions received varying degrees of support from panellists, as reflected in this article and the detailed voting results reported in the Supplementary material. Conclusions: these voting results from a panel of experts in advanced prostate cancer can help clinicians and patients to navigate controversial areas of management for which high-level evidence is scant. However, diagnostic and treatment decisions should always be individualised according to patient characteristics, such as the extent and location of disease, prior treatment(s), comorbidities, patient preferences, and treatment recommendations, and should also incorporate current and emerging clinical evidence and logistic and economic constraints. Enrolment in clinical trials should be strongly encouraged. Importantly, APCCC 2021 once again identified salient questions that merit evaluation in specifically designed trials. Patient summary: the Advanced Prostate Cancer Consensus Conference is a forum for discussing current diagnosis and treatment options for patients with advanced prostate cancer. An expert panel votes on predefined questions focused on the most clinically relevant areas for treatment of advanced prostate cancer for which there are gaps in knowledge. The voting results provide a practical guide to help clinicians in discussing treatment options with patients as part of shared decision-making., National Health and Medical Research Council (NHMRC) Practitioner Fellowship; Prostate Cancer Foundation; Peter MacCallum Foundation; NHMRC Investigator Grant

Published
2022

98. The pathway study: results of a pilot feasibility study in patients suspected of having lung carcinoma investigated in a conventional chest clinic setting compared to a centralised two-stop pathway

Author

Murray, P.V., O’Brien, M.E.R., Sayer, R., Cooke, N., Knowles, G., Miller, A.C., Varney, V., Rowell, N.P., Padhani, A.R., MacVicar, D., Norton, A., Ashley, S., and Smith, I.E.

Subjects
*LUNG cancer diagnosis, *CLINICAL trials, *PATHOLOGY
Abstract

The best chance of cure in non-small cell lung cancer (NSCLC) is surgical resection, but UK rates of 8% compare poorly to 25% in the USA and Europe. Delays in diagnosis in the current UK system may be one reason for such discrepancy. To address this problem we set up a rapid diagnostic system and compared it to the conventional method of investigations in a pilot randomised trial. Methods: Eighty-eight patients were prospectively enrolled from three District General Hospitals and randomised to either investigation locally or to the rapid system at The Royal Marsden Hospital. The pilot end-points were feasibility and audit of radical treatment rates to enable estimates for patient numbers for the full study. Results: Forty-five and 43 patients were in the central and conventional arms, respectively (65% male, median age 69 years). There was a 4-week improvement in time to first treatment in those in the central arm (P=0.0025) with 13/30 (43%) and 9/27 (33%) patients having radical treatment in the central and conventional arms, respectively. Patients in the conventional arm felt the diagnostic process was too slow (P=0.02) while those in the central arm seemed to have a better care experience (P=0.01). There were significantly less visits to the general practitioner (GP) in the central arm (P=0.02). Conclusions: This pilot study demonstrates that the full study is feasible but would require the commitment and involvement of a large number of patients and physicians. The results show several advantages to investigations and diagnosis in the central arm, particularly in time to treatment initiation, patient satisfaction and rate of radical treatments. The improved rate of radical treatment could lead to an improved survival rate. [Copyright &y& Elsevier]

Published
2003
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