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Lookup NU author(s): Dr Pasquale RescignoORCiD
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).
© 2024 The Author(s)Background: Prostate cancer (PCa) treatments are associated with a detrimental impact on bone health (BH) and body composition. However, the evidence on these issues is limited and contradictory. This consensus, based on the Delphi method, provides further guidance on BH management in PCa. Materials and methods: In May 2023, a survey made up of 37 questions and 74 statements was developed by a group of oncologists and endocrinologists with expertise in PCa and BH. In June 2023, 67 selected Italian experts, belonging to the Italian scientific societies Italian Association of Medical Oncology and Italian Network for Research in Urologic-Oncology (Meet-URO), were invited by e-mail to complete it, rating their strength of agreement with each statement on a 5-point scale. An agreement ≥75% defined the statement as accepted. Results: In non-metastatic hormone-sensitive PCa, the panel agreed that androgen deprivation therapy (ADT) alone implies sufficient fracture risk to warrant antifracture therapy with bone-targeting agents (BTAs) for cancer treatment-induced bone loss (CTIBL) prevention (79%). Therefore, no consensus was reached (48%) for the treatment with BTAs of patients receiving short-term ADT (<6 months). All patients receiving active treatment for metastatic hormone-sensitive PCa (75%), non-metastatic castration-resistant PCa (89%) and metastatic castration-resistant PCa (mCRPC) without bone metastases (84%) should be treated with BTAs at the doses and schedule for CTIBL prevention. All mCRPC patients with bone metastasis should be treated with BTAs to reduce skeletal-related events (94%). In all settings, the panel analyzed the type and timing of treatments and examinations to carry out for BH monitoring. The panel agreed on the higher risk of sarcopenic obesity of these patients and its correlation with bone fragility. Conclusions: This consensus highlights areas lacking major agreement, like non-metastatic hormone-sensitive prostate cancer patients undergoing short-term ADT. Evaluation of these issues in prospective clinical trials and identification of early biomarkers of bone loss are particularly urgent.
Author(s): Di Maio M, Berruti A, De Giorgi U, Altavilla A, Atzori F, Banna GL, Barni S, Basso U, Bauckneht M, Berardi R, Berruti A, Bertoldo F, Bertoldo F, Bimbatti D, Boccardo F, Buti S, Buttigliero C, Caffo O, Calabro F, Cattrini C, Cellini F, Conteduca V, Cursano MC, Cursano MC, De Feo G, Di Lorenzo G, Di Maio M, Di Napoli M, Ermacora P, Fornarini G, Fratino L, Fusco V, Gernone A, Ibrahim T, Lanzetta G, Malgeri A, Maruzzo M, Masini C, Messina C, Mosca A, Naglieri E, Nole F, Ortega C, Palermo A, Pantano F, Pantano F, Prati V, Procopio G, Procopio G, Rescigno P, Roberto M, Rossetti S, Roviello G, Santini D, Santini D, Stellato M, Tambaro R, Toma I, Tucci M, Tucci M, Valsecchi AA, Valsecchi AA, Verzoni E, Zanardi E, Zucali PA
Publication type: Article
Publication status: Published
Journal: ESMO Open
Year: 2024
Volume: 9
Issue: 7
Print publication date: 01/07/2024
Online publication date: 19/06/2024
Acceptance date: 02/04/2024
Date deposited: 07/11/2024
ISSN (electronic): 2059-7029
Publisher: Elsevier B.V.
URL: https://doi.org/10.1016/j.esmoop.2024.103484
DOI: 10.1016/j.esmoop.2024.103484
PubMed id: 38901175
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