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4.2.2.5. Immunotherapy. New therapies for mCRPC include
immunotherapy . None is currently available outside
the USA.
4.2.2.6. Palliative care. Life expectancy of <1 yr defines a
patient who might benefit from a palliative care approach
. Temel et al deserve credit for demonstrating that
it is possible to include early specialized palliative care in
the management of advanced cancer and that patients are
best served by management that combines cancer and
palliative care specialists. The major benefits were lower
anxiety and depression, better quality (and quantity) of life,
and less time spent in hospital. These studies were in lung
cancer, and similar research should be conducted in
prostate cancer, for which the burden of symptoms,
especially in the elderly, can be very high.
Task force recommendations for the management of
advanced prostate cancer in elderly patients are sum-
marised in .
5. Conclusions
A SIOG prostate cancer task force has updated recommen-
dations for the management of elderly men with prostate
cancer. Overall, the urologic approach in the fit elderly
should be the same as in younger patients and based on
existing international recommendations. Individual elderly
patients should be managed according to their health status
and not according to age.
Evaluation of health status should include a validated
screening tool (the G8) and the assessment of comorbid
conditions (CISR-G scale), degree of dependence (ADL), and
nutritional status (weight loss estimation). When patients
are frail or disabled or have severe comorbidities, a CGA is
needed. This may indicate the need for additional geriatric
interventions. Screening for cognitive impairment is man-
datory when making treatment decisions and should be
part of the initial patient assessment.
Author contributions: Jean-Pierre Droz had full access to all the data in the
study and takes responsibility for the integrity of the data and the accuracy
of the data analysis.
Study concept and design: Droz, Aapro.
Acquisition of data: Droz, Albrand, Hughes, Mottet, Oudard, Payne, Puts,
Zulian.
Analysis and interpretation of data: Droz, Albrand, Gillessen, Hughes,
Mottet, Oudard, Payne, Puts, Zulian.
Drafting of the manuscript: Droz, Albrand, Gillessen, Hughes, Mottet,
Oudard, Payne, Puts, Zulian, Balducci.
Critical revision of the manuscript for important intellectual content: Droz,
Albrand, Gillessen, Hughes, Mottet, Oudard, Payne, Puts, Zulian, Balducci,
Aapro.
Statistical analysis: None.
Obtaining funding: Aapro.
Administrative, technical, or material support: None.
Supervision: Droz, Balducci, Aapro.
Other: None.
Financial disclosures: Jean-Pierre Droz certifies that all conflicts of
interest, including specific financial interests and relationships and
affiliations relevant to the subject matter or materials discussed in the
manuscript (eg, employment/affiliation, grants or funding, consultan-
cies, honoraria, stock ownership or options, expert testimony, royalties,
or patents filed, received, or pending), are the following: Jean-Pierre Droz
has received consultancy fees from Sanofi. Silke Gillessen has received
advisory board compensation from AAA International, Active Biotech,
Astellas, Bristol-Myers Squibb, Curevac, Dendreon, Ferring, Janssen Cilag,
MaxiVAX, Millennium Pharmaceuticals, Orion, Roche, and Sanofi
Aventis; has participated in advisory boards without compensation
for Astellas, Bayer, ESSA, Nectar, ProteoMediX, and Sanofi; has received
speaker fees from Janssen and Novartis; has participated in a speaker
bureau without compensation for Astellas, Janssen, and Sanofi Aventis;
and has a pending patent application for a method for a biomarker (WO
2009138392 A1). Simon Hughes has received honoraria from Sanofi and
Bayer and consultancy fees from Astellas and Janssen. Nicolas Mottet has
received grant funding from Takeda Pharmaceutical/Millenium, Astellas,
Pierre Fabre, Sanofi, and Pasteur; and consultancy fees from Takeda
Pharmaceutical/Millenium, Janssen, Astellas, BMS, Bayer, IPSEN, Ferring,
Novartis, Nucle´tron, Pierre Fabre, Sanofi, and AstraZeneca. Ste´phane
Oudard has received consultancy fees from Sanofi, Bayer, Astellas, and
Janssen. Heather Payne has received grant funding from Astellas;
consultancy fees fromAstellas, Janssen, Sanofi, Ferring, and AstraZeneca;
and honoraria from Ipsen, Bayer, and Novartis. Lodovico Balducci has
received honoraria from Astellas, Johnson & Johnson, Teva, and Amgen.
Matti Aapro has received honoraria from Astellas, and consultancy fees
from Sanofi, Janssen, Novartis, and Amgen. Gilles Albrand, Martine Puts,
and Gilbert Zulian have nothing to disclose.
Funding/Support and role of the sponsor: This work was supported by
funding from the International Society of Geriatric Oncology. The
sponsor played a role in manuscript preparation via editorial support
provided by Adelphi Communications and Rob Stepney (medical writer,
Charlbury, UK).
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