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Management of advanced prostate cancer in a middle‐income country: real‐world consideration of the Advanced Prostate Cancer Consensus Conference 2017
Author(s) -
Saad Marniza,
Alip Adlinda,
Lim Jasmine,
Abdullah Matin Mellor,
Chong Flora Li Tze,
Chua Chong Beng,
Ismail Fuad,
Khong Rachael KitTsan,
Lim Chun Sen,
Loh Chit Sin,
Malek Rohan,
Mohd Ghani Khairul Asri,
Md Noor Ibtisam,
Md Yusoff Noor Ashani,
Nasuha Noor Azam,
Razack Azad,
Soo Hoo Hwoei Fen,
Sundram Murali,
Tan Hui Meng,
Thiagarajan Muthukkumaran,
Teh Guan Chou,
Voon Pei Jye,
Ong Teng Aik
Publication year - 2019
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.14807
Subject(s) - prostate cancer , medicine , consensus conference , voting , family medicine , generalizability theory , management of prostate cancer , oncology , cancer , gynecology , political science , psychology , developmental psychology , politics , law
Objective To examine the results of the Malaysian Advanced Prostate Cancer Consensus Conference (My APCCC ) 2018, held for assessing the generalizability of consensus reached at the Advanced Prostate Cancer Consensus Conference ( APCCC 2017) to Malaysia, a middle‐income country. Methods Six key sections were chosen: (1) high‐risk localized and locally advanced prostate cancer, (2) oligometastatic prostate cancer, (3) castration‐naïve prostate cancer, (4) castrate resistant prostate cancer, (5) use of osteoclast‐targeted therapy and (6) global access to prostate cancer drugs. There were 101 consensus questions, consisting of 91 questions from APCCC 2017 and 10 new questions from MyAPCCC 2018, selected and modified by the steering committee; of which, 23 questions were assessed in both ideal world and real‐world settings. A panel of 22 experts, comprising of 11 urologists and 11 oncologists, voted on 101 predefined questions anonymously. Final voting results were compared with the APCCC 2017 outcomes. Results Most voting results from the My APCCC 2018 were consistent with the APCCC 2017 outcomes. No consensus was achieved for controversial topics with little level I evidence, such as management of oligometastatic disease. No consensus was reached on using high‐cost drugs in castration‐naïve or castration‐resistant metastatic prostate cancer in real‐world settings. All panellists recommended using generic drugs when available. Conclusions The My APCCC 2018 voting results reflect the management of advanced prostate cancer in a middle‐income country in a real‐world setting. These results may serve as a guide for local clinical practices and highlight the financial challenges in modern healthcare.