ADVANCED PROSTATE CANCER CONSENSUS CONFERENCE (APCCC): ASIA-PACIFIC (APAC) SATELLITE SYMPOSIUM In advanced prostate cancer, fast and effective drug development has resulted in many treatment options and these all require careful decision-making for each patient. Clinicians face the progressively challenging task of selecting from multiple potentially effective treatments that are also costly and possibly toxic. Further developments in novel nextgeneration imaging methods, biomarkers, molecular characterisation, and genetic testing have led to many questions and areas for which there is little evidence to support clinical decision-making. On Monday 26 October 2020 ANZUP hosted the 2nd Advanced Prostate Cancer Consensus Conference (APCCC), Asia-Pacific (APAC) Satellite Symposium virtual meeting - a meeting developed to help ensure the treatment decisions made are relevant and can be implemented in the Asia Pacific region. The meeting involved 25 multidisciplinary clinicians from 14 countries: Australia, Hong Kong, India, Indonesia, Japan, Malaysia, New Zealand, Philippines, Singapore, South Korea, Taiwan, Thailand, Turkey and Vietnam. Participants were selected based on their expertise in the management of advanced prostate cancer in their respective region. There is great diversity in the Asia-Pacific region from a disease, epidemiological, genetics, social, and health-economic perspective. This leads to differences in views of each local key opinion leader who attended the symposium. The purpose of APAC APCCC 2020 was to: • provide an opportunity for real-world consideration of the consensus recommendations from APCCC 2019 as they apply in the Asia-Pacific region; • consider any additional evidence published since APCCC 2019 that may influence consensus recommendations; • provide an opportunity to consider the impact of COVID-19 on management of advanced prostate cancer in the Asia-Pacific region. The meeting focused on five topics discussed at APCCC viewed as most critical for the Asia-Pacific region, as well as an additional discussion about the impact of COVID-19.
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APAC APCCC 2020 did not set out to develop a revised set of consensus recommendations, but used in-meeting and post-meeting polling to gain insights into key issues relevant to the Asia-Pacific region. Overall the panellist feedback at the APAC APCCC meeting largely aligned with the areas of consensus from APCCC 2019. However, variations in practice were noted and this demonstrated that the reality of practice cannot always conform with best practice recommendations because of resource constraints. Key issues for the Asia-Pacific region which continue to influence management of advanced prostate cancer include: • differences in access to and cost of therapeutic agents, including the availability of generics • differences in access to and cost of novel imaging technologies and indications for use • toxicity profile of chemotherapy among Asian populations • later stage at diagnosis of prostate cancer among some Asian populations – while not discussed specifically during the meeting, this was presented as background context and was highlighted as an issue which is at risk of being further exacerbated by the pandemic. We are in the process of preparing a paper from the discussions to be submitted for publication in the BJUI. ANZUP hopes this symposium continues as an ongoing series of meetings to provide a platform to discuss the real-world application of evidence to the management of patients in the Asia Pacific region. The commitment and interest of all involved demonstrates the importance of working together to consider topics applicable and significant to the region.
