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Minerva Urologica e Nefrologica 2021 Jan 13

DOI: 10.23736/S0393-2249.20.04160-0

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Molecular biomarkers in the context of focal therapy for prostate cancer: recommendations of a Delphi Consensus from the Focal Therapy Society

Giancarlo MARRA 1, 2, Maria Pilar LAGUNA 7, Jochen WALZ 3, Christian P. PAVLOVICH 12, Fernando BIANCO 36, Justin GREGG 41, Amir H. LEBASTCHI 37, Herbert LEPOR 38, Petr MACEK 1, Soroush RAIS-BAHRAMI 9, Cary ROBERTSON 15, Daniel RUKSTALIS 39, Georg SALOMON 40, Osamu UKIMURA 25, Andre L. ABREU 22, Yann BARBE 1, Xavier CATHELINEAU 1, Giorgio GANDAGLIA 13, Arvin K. GEORGE 11, Juan Gomez RIVAS 5, Rajan T.Gupta 18 , Nathan LAWRENTSCHUK 21, Veeru KASIVISVANATHAN 29, Derek LOMAS 27, Bernard MALAVAUD 8, Daniel MARGOLIS 31, Yoh MATSUOKA 19, Sherif MEHRALIVAND 28, Marco MOSCHINI 13, 14, Marco ODERDA 2, Hazem ORABI 15, Ardeshir R. RASTINEHAD 17 , Mesut REMZI 24, Ariel SCHULMAN 6, Toshitaka SHIN 34, Takumi SHIRAISHI 25, Abhinav SIDANA 32, Sunao SHOJI 20, Armando STABILE 13, Massimo VALERIO 23, Varaha S. TAMMISETTI 30, Wei Phin TAN 15, Willemien Van Den BOS 35, Arnaud VILLERS 16, Peter-Paul WILLEMSE 26, Jean de la ROSETTE 7, Thomas POLASCIK 15, Rafael SANCHEZ-SALAS 1 , on behalf of the Focal Therapy Society

1 Department of Urology, Institut Mutualiste Montsouris, Paris, France; 2 Department of Urology, Città della Salute e della Scienza, University of Turin, Turin, Italy; 3 Department of Urology, Institut Paoli-Calmettes, Marseille, France; 5 Department of Urology, La Paz University Hospital, Madrid, Spain; 6 Department of Urology, Maimonides Medical Center, Brooklyn, NY, USA; 7 Department of Urology, Medipol Mega University Hospital, Istanbul, Turkey; 8 Department of Urology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France; 9 Department of Urology, University of Alabama at Birmingham, Birmingham, AL, USA; 10 Department of Urology, Oita University Faculty of Medicine, Yufu-shi Oita, Japan; 11 Department of Urology, Division of Urologic Oncology, Michigan Medicine, MI, USA; 12 Johns Hopkins University School of Medicine, Baltimore, MD, USA; 13 Department of Urology, San Raffaele Hospital, Milan, Italy; 14 Department of Urology, Lucerne Kanton Hospital, Lucerne, Switzerland; 15 Department of Urology, Duke University, Durham, NC, USA; 16 Department of Urology, CHU de Lille, Lille, France; 17 Department of Urology, Lenox Hill Urology, NY, USA; 18 Department of Radiology, Duke University, Durham, NC, USA; 19 Urology at Tokyo Medical and Dental University, Tokyo, Japan; 20 Department of Urology, Tokai University Hachioji Hospital, Hachioji, Tokyo, Japan; 21 Department of Urology, Peter MacCallum Cancer Center, Melbourne, VIC, Australia; 22 Department of Urology, Keck School of Medicine and University of South California, CA, USA; 23 Department of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; 24 Department of Urology, Döbling Hospital, Vienna, Austria; 25 Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan; 26 Department of Urology, Erasmus Medical Center, Rotterdam, The Netherlands; 27 Department of Urology, Mayo Clinic, Rochester, MN, USA; 28 Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA; 29 Department of Urology, University College London Hospitals, London, UK; 30 Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA; 31 Department of Radiology, Weill Cornell Imaging, Cornell University, New York, NY, USA; 32 Division of Urology, University of Cincinnati College of Medicine, Cincinnati, OH, USA; 34 Department of Urology, Oita University, Oita, Japan; 35 Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands; 36 Urological Research Network, Nova University, Miami, FL, USA; 37 Department of Urology, University of Michigan, Ann Arbor, MI, USA; 38 Department of Urology, NYU Langone Medical Center, New York, NY, USA; 39 Department of Urology, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA; 40 Martini Clinic, Prostate Cancer Center, Hamburg, Germany; 41 Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA


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BACKGROUND: Focal Therapy (FT) for Prostate Cancer (PCa) is promising. However, long-term oncological results are awaited and there is no consensus on follow-up strategies. Molecular biomarkers (MB) may be useful in selecting, treating and following up men undergoing FT, though there is limited evidence in this field to guide practice. We aimed to conduct a consensus meeting, endorsed by the Focal Therapy Society, amongst a large group of experts, to understand the potential utility of MB in FT for localised PCa.
MATERIALS AND METHODS: A 38-item questionnaire was built following a literature search. The authors then performed three rounds of a Delphi Consensus using DelphiManager, using the GRADE grid scoring system, followed by a face-to-face expert meeting. Three areas of interest were identified and covered concerning MB for FT, i) the current/present role; ii) the potential/future role; iii) the recommended features for future studies. Consensus was defined using a 70% agreement threshold.
RESULTS: Of 95 invited experts, 42 (44.2%) completed the three Delphi rounds. Twenty-four items reached a consensus and they were then approved at the meeting involving (n=15) experts. Fourteen items reached a consensus on uncertainty, or they did not reach a consensus. They were re-discussed, resulting in a consensus
(n=3), a consensus on a partial agreement (n=1), and a consensus on uncertainty (n=10). A final list of statements were derived from the approved and discussed items, with the addition of three generated statements, to provide guidance regarding MB in the context of FT for localised PCa. Research efforts in this field should be considered a priority.
CONCLUSIONS: The present study detailed an initial consensus on the use of MB in FT for PCa. This is until evidence becomes available on the subject.


KEY WORDS: Prostate cancer; Localised; Focal therapy; Molecular biomarker; Delphi

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