AUA 2017: Worldwide Variation In Determinants For Inclusion And Follow-up In Active Surveillance For Low-risk Prostate Cancer: Results Of The Movember Foundation’s Global Action Plan Prostate Cancer Active Surveillance (GAP3) Initiative

Boston, MA (UroToday.com) In August 2014, the Movember Foundation launched the GAP3 initiative, which covers the largest centralized prostate cancer (PCa) active surveillance (AS) database to date. Its main goal is to create a global consensus on the selection and monitoring of men with low risk PCa. Eventually, worldwide uniform guidelines will be developed.

The global database was created by combining patient data from established AS cohorts worldwide including 25 centers located in 15 countries in 4 continents. The database contains information on clinical and demographic characteristics at time of PCa diagnosis for all men included in the GAP3 cohort, their clinical follow-up, and information on discontinuation of AS and potential following treatments. Descriptive analyses were performed by a team of statisticians from the five Movember regions around the world.

The GAP3 database demonstrates variability in inclusion criteria and follow-up on 14,024 patients from 25 centers. At time of diagnosis, median age was 65 yr (IQR 60-70); median PSA was 5.4 ng/ml (IQR 4.0-7.3); median PSA density was 0.12 ng/ml (IQR 0.09-0.17); and median prostate volume was 44 cc (IQR 33-59). The majority of men had a clinical stage T1 (71%), a biopsy Gleason score of 6 (87%), one tumor-positive biopsy core (61%) and no comorbidity (64%). Men on AS had a median follow-up time of 2.4 years (IQR 1.1-4.7 years), and a maximum follow-up time was 21.3 years. After 5, 10 and 15 years of follow-up, respectively, 57%, 37% and 22% of men were still on AS; 23%, 30% and 35% discontinued due to protocol-based progression. Of the 88% that discontinued AS, 40% switched due to progression, 7% due to anxiety, 4% due to WW and the rest due to death or unknown reasons.

In summary, GAP3 is the largest worldwide data effort to date integrating patient data from men with PCa on AS protocols. The results of GAP3 will allow individual patients and clinicians to have greater confidence in the personalized decision to either delay or proceed with active treatment.

Presented by: Sophie Bruinsma, Rotterdam, Netherlands

Written By: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre

Twitter: @Goldberghanan

at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA
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