T. Vermassen PhD, T. Roumeguère MD, PhD, Y. Neybuch MD, L. Hoekx MD, I. Fele , B. Sautois MD, PhD, W. Everaerts MD, PhD, D. De Maeseneer MD, F. Lecouvet MD, PhD, N. Lumen MD, PhD, P. Ost MD, PhD, S. Rorive MD, PhD, S. Stroobants MD, PhD, P. Dirix MD, PhD, S. Rottey MD, PhD
Castrate-resistant prostate cancer (CRPC) is characterised by complex strategies for therapy and follow-up. In order to standardise CRPC cancer care on a national basis, an integrated care pathway was devised, based on clinical governance principles and acknowledged best practice, in order to reduce length of hospital stay, reduce costs of patient care, improve patient outcomes (e.g. Quality-of-Life, complications), etc. Therefore, a steering group of Belgian experts, consisting of medical oncologist, urologists, radiation oncologists, oncology nurses, pathologists and nuclear medicines, was assembled to discuss the need for an integrated care pathway for CRPC in Belgium. This was made possible through the financial support of Astellas Belgium. An extensive integrated care pathway was discussed with various stages, depending on the disease status of the patient. Belgian implementation could lead towards further standardisation of cancer care for CRPC patients although several important matters still have to be discussed or adapted. Further assessment and inter-hospital deliberation seems required to ensure a national implementation of the CRPC integrated care pathway.
P. Ost MD, PhD, D. Schrijvers MD, PhD, L. Duck MD, M. Gizzi MD, K. Goffin MD, PhD, S. Joniau MD, PhD, S. Rottey MD, PhD, T. Roumeguère MD, PhD, E. Seront MD, PhD, N. Withofs MD, PhD, B. Tombal MD, PhD
The treatment landscape for metastatic castration-resistant prostate cancer (mCRPC) has changed dramatically with the approval of a variety of therapeutic agents including abiraterone acetate, cabazitaxel, docetaxel, enzalutamide and radium-223 dichloride and the introduction of docetaxel and abiraterone acetate in combination with androgen deprivation therapy in newly diagnosed metastatic prostate cancer. Evidence on the optimal sequence of these therapies is scarce. In practice, the most appropriate treatment (sequence) depends on patient and disease characteristics. This article summarises the recommendations of a multidisciplinary group of Belgian experts in sequencing treatments for patients with mCRPC, with a focus on radium-223 dichloride.