Abstract 656P
Background
The 2019 APCCC consensus statements reflect opinions of global clinical experts who treat a high volume of prostate cancer patients, engage in research and education. We hypothesized that NonPanelist’s (NP) consensus will differ from expert panelist clinician (P) consensus across a variety of domains. The current study compares P to NP consensus from 225 clinicians globally who were presented a choice of APCCC questions.
Methods
20 representative questions posed at APCCC2019 were posted on Urotoday.com, a global urologic oncology education site from 9/8/2019 until 18/1/20 (prior to dissemination of APCCC results) with email solicitations going out to several national societies and groups. NP was defined as clinicians treating >10 but <100 unique prostate cancer annually. The questionnaire was reviewed by the Investigational Review Board at the University of Minnesota. The primary endpoint is concordance of the most frequently chosen answers (either A-E, or Y/N) among P vs NP.
Results
Region for P/NP was Europe, North America or Other for 35/21, 42/33 and 23/46% (p=0.003). NP respondents were Urologists (35%), Medical Oncologists (46%), Clinical Oncologists (3%), Radiation Oncologists (7%) and 9% other (including nurses and trainees). For 12/20 analyzed APCCC guideline questions, there was little disagreement. In 8/20, disparate responses between NP and P (adjusted p<0.05) were observed. Questions with the greatest divergence between P and NP dealt with recommendation for germline testing in M1 castration sensitive disease ( 84% vs 34% of P and NP do so in a majority of pts, respectively, p=0.0007); Use of anti-PD1 therapy in MSI high disease ( 96% of P use outside of clinical trial vs 69% of NP, p=0.0007) and treatment of the primary tumor in patients with metastatic disease (98% of P recommend in low volume only vs 77% of NP, p<0.0008).
Conclusions
While agreement was noted on a majority of questions, the survey identified knowledge and practice gaps that may be useful for further educational and training efforts. Most gaps reflected relatively recent and sometimes controversial data (e.g. use of immune checkpoint inhibitors).
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.