The incidence of prostate cancer in Japan continues to increase, necessitating the continued development of effective therapies and strategies. Recent advances in treatments have improved the prognosis of metastatic disease and highlighted the importance of treating bone metastases to reduce the incidence of skeletal complications and improve patients' quality of life. With the increasing number of treatment options that have become available, including bone-targeted therapy with the alpha emitter radium-223 dichloride (Ra-223), Japanese clinicians are faced with making difficult decisions on the choice of optimal treatment strategy. In such situations, guidance based on expert opinions can be beneficial.
A panel meeting of 27 Japanese experts in the management of prostate cancer was held to share opinions and to establish consensus recommendations on key clinical questions. Panelists were asked to vote on more than 40 questions pertinent to prostate cancer, and the answers helped guide a comprehensive discussion.
The panel reached a consensus on key topics related to the optimal treatment strategy for Ra-223 therapy, namely, that patients with symptomatic, metastatic castration-resistant prostate cancer (CRPC) would benefit most from the use of this agent and that this treatment therapy should be provided before chemotherapy. Other topics that achieved consensus included: monitoring for osteoporosis and providing treatment if necessary during androgen deprivation therapy; performing magnetic resonance imaging in the presence of discrepancies in bone scintigram and computed tomography scans; monitoring alkaline phosphatase during CRPC treatment; using osteoclast-targeting in patients with CRPC with bone metastases; and using osteoclast-targeted agents combined with Ra-223.
These consensus recommendations and the updated information which became available subsequent to the panel meeting included here provide useful information for clinicians to aid in designing optimal treatment strategies for their patients.
Bayer Yakuhin Ltd.
Oncology and therapy. 2018 Dec 11 [Epub]
Shunji Takahashi, Seigo Kinuya, Norio Nonomura, Nobuo Shinohara, Kazuhiro Suzuki, Hiroyoshi Suzuki, Katsumasa Nakamura, Takefumi Satoh, Ukihide Tateishi, Toshiyuki Yoneda, Hiroyuki Horikoshi, Tsukasa Igawa, Takao Kamai, Mitsuru Koizumi, Takeo Kosaka, Nobuaki Matsubara, Hideaki Miyake, Atsushi Mizokami, Takashi Mizowaki, Naoki Nakamura, Masahiro Nozawa, Takeo Takahashi, Hiroji Uemura, Motohide Uemura, Akira Yokomizo, Mana Yoshimura, Yoshiyuki Kakehi
The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan. ., Kanazawa University, Kanazawa, Ishikawa, Japan., Osaka University, Yamadaoka, Suita, Osaka, Japan., Hokkaido University, Sapporo, Hokkaido, Japan., Gunma University, Maebashi, Gunma, Japan., Toho University Sakura Medical Center, Sakura, Chiba, Japan., Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan., Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan., Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan., Osaka University Graduate School of Dentistry, Suita, Osaka, Japan., Gunma Prefectural Cancer Center, Ohta, Gunma, Japan., Kurume University, Fukuoka, Fukuoka, Japan., Dokkyo Medical University, Shimotsuga-gun, Tochigi, Japan., The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan., Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan., National Cancer Center Hospital East, Kashiwa, Chiba, Japan., Kyoto University, Sakyo, Kyoto, Japan., Faculty of Medicine, Kindai University, Osaka-Sayama, Osaka, Japan., Saitama Medical University, Kawagoe, Saitama, Japan., Yokohama City University Medical Center, Yokohama, Kanagawa, Japan., Harasanshin Hospital, Fukuoka, Fukuoka, Japan., Tokyo Medical University, Shinjuku-ku, Tokyo, Japan., Kagawa University, Kita-gun, Kagawa, Japan.