Molecular biomarkers in the context of focal therapy for prostate cancer: Recommendations of a delphi consensus from the focal therapy society
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2022Author
Marra, Giancarlodel Pilar Laguna Pes, Maria
Walz, Jochen
Pavlovich, Christian P.
Bianco, Fernando
Gregg, Justin
Lebastchi, Amir H.
Lepor, Herbert
Macek, Petr
Rais-Bahrami, Soroush
Robertson, Cary
Rukstalis, Daniel
Salomon, Georg
Ukimura, Osamu
Abreu, Andre L.
Barbe, Yann
Cathelineau, Xavier
Gandaglia, Giorgio
George, Arvin K.
Gomez Rivas, Juan
Gupta, Rajan T.
Lawrentschuk, Nathan
Kasivisvanathan, Veeru
Lomas, Derek
Malavaud, Bernard
Margolis, Daniel
Matsuoka, Yoh
Mehralivand, Sherif
Moschini, Marco
Oderda, Marco
Orabi, Hazem
Rastinehad, Ardeshir R.
Remzi, Mesut
Schulman, Ariel
Shin, Toshitaka
Shiraishi, Takumi
Sidana, Abhinav
Shoji, Sunao
Stabile, Armando
Valerio, Massimo
Tammisetti, Varaha S.
Phin Tan, Wei
van Den Bos, Willemien
Villers, Arnaud
Willemse, Peter-Paul
de la Rosette, Jean J. M. C. H.
Polascik, Thomas
Sanchez-Salas, Rafael
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Marra, G., del Pilar Laguna Pes, M., Walz, J., Pavlovich, C. P., Bianco, F., Gregg, J. ... Sanchez-Salas, R. (2022). Molecular biomarkers in the context of focal therapy for prostate cancer: Recommendations of a delphi consensus from the focal therapy society. Minerva Urology and Nephrology, 74(5), 581-589. https://doi.org/10.23736/S2724-6051.20.04160-0Abstract
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 localized PCa. 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, 1) the current/present role; 2) the potential/future role; 3) 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 localized 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.