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Purpose: Renal cell carcinoma is an aggressive disease with a high mortality rate. Management has drastically changed with the new era of immunotherapy, and novel strategies are being developed; however, identifying systemic treatments is still challenging. This paper presents an update of the expert panel consensus from the Latin American Cooperative Oncology Group and the Latin American Renal Cancer Group on advanced renal cell carcinoma management in Brazil., Methods: A panel of 34 oncologists and experts in renal cell carcinoma discussed and voted on the best options for managing advanced disease in Brazil, including systemic treatment of early and metastatic renal cell carcinoma as well as nonclear cell tumours. The results were compared with the literature and graded according to the level of evidence., Results: Adjuvant treatments benefit patients with a high risk of recurrence after surgery, and the agents used are pembrolizumab and sunitinib, with a preference for pembrolizumab. Neoadjuvant treatment is exceptional, even in initially unresectable cases. First-line treatment is mainly based on tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs); the choice of treatment is based on the International Metastatic Database Consortium (IMCD) risk score. Patients at favourable risk receive ICIs in combination with TKIs. Patients classified as intermediate or poor risk receive ICIs, without preference for ICI + ICIs or ICI + TKIs. Data on nonclear cell renal cancer treatment are limited. Active surveillance has a place in treating favourable-risk patients. Either denosumab or zoledronic acid can be used for treating metastatic bone disease., Conclusion: Immunotherapy and targeted therapy are the standards of care for advanced disease. The utilization and sequencing of these therapeutic agents hinge upon individual risk scores and responses to previous treatments. This consensus reflects a commitment to informed decision-making, drawn from professional expertise and evidence in the medical literature., (© 2024. The Author(s).)

Purpose: This study aimed to describe the demographic and clinical characteristics of cancer patients with COVID-19, exploring factors associated with adverse outcomes., Patients and Methods: This retrospective cohort study methodically extracted and curated data from electronic medical records (EMRs) of numerous healthcare institutions on cancer patients diagnosed with a confirmed SARS-CoV-2 infection between May 2020 and August 2021, to identify risk factors linked to extended hospitalization and mortality. The retrieved information encompassed the patients' demographic and clinical characteristics, including the incidence of prolonged hospitalization, acute complications, and COVID-19-related mortality., Results: A total of 1446 cancer patients with COVID-19 were identified (mean [Standard deviation] age, 59.2 [14.3] years). Most patients were female (913 [63.1%]), non-white (646 [44.7%]), with non-metastatic (818 [56.6%]) solid tumors (1318 [91.1%]), and undergoing chemotherapy (647 [44.7%]). The rate of extended hospitalization due to COVID-19 was 46% (n = 665), which was significantly impacted by age (p = 0.012), sex (p = 0.003), race and ethnicity (p = 0.049), the presence of two or more comorbidities (p = 0.006), hematologic malignancies (p = 0.013), metastatic disease (p = 0.002), and a performance status ≥ 2 (p = 0.001). The COVID-19-related mortality rate was 18.9% (n = 273), and metastatic disease (<0.001), performance status ≥2 (<0.001), extended hospitalization (p = 0.028), renal failure (p = 0.029), respiratory failure (p < 0.001), sepsis (p = 0.004), and shock (p = 0.040) significantly and negatively influenced survival., Conclusion: The rate of extended hospitalization and COVID-19-specific death in cancer patients was notably high and could be influenced by comorbidities, cancer treatment status, and clinical fragility. These observations may aid in developing risk counseling strategies regarding COVID-19 in individuals diagnosed with cancer., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 da Silva et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Identifying individuals at a higher risk of developing cancer is a major concern for healthcare providers. Cancer predisposition syndromes are the underlying cause of cancer aggregation and young-onset tumors in many families. Germline genetic testing is underused due to lack of access, but Brazilian germline data associated with cancer predisposition syndromes are needed., Methods: Medical records of patients referred for genetic counseling at the Oncogenetics Department at the Hospital Sírio-Libanês (Brasília, DF, Brazil) from July 2017 to January 2021 were reviewed. The clinical features and germline findings were described. Detection rates of germline pathogenic/likely pathogenic variant (P/LPV) carriers were compared between international and Brazilian guidelines for genetic testing., Results: A total of 1,091 individuals from 985 families were included in this study. Most patients (93.5%) had a family history of cancer, including 64% with a family member under 50 with cancer. Sixty-six percent of patients (720/1091) had a personal history of cancer. Young-onset cancers (<50 years old) represented 62% of the patients affected by cancer and 17% had multiple primary cancers. The cohort included patients with 30 different cancer types. Breast cancer was the most prevalent type of cancer (52.6%). Germline testing included multigene panel (89.3%) and family variant testing (8.9%). Approximately 27% (236/879) of the tested patients harbored germline P/LPVs in cancer susceptibility genes. BRCA2 , BRCA1 , and TP53 were the most frequently reported genes, corresponding to 18.6%, 14.4%, and 13.5% of the positive results, respectively. Genetic testing criteria from international guidelines were more effective in identifying carriers than the Brazilian National Agency of Supplementary Health (ANS) criteria (92% vs. 72%, p<0.001). Forty-six percent of the cancer-unaffected patients who harbored a germline P/LPV (45/98) would not be eligible for genetic testing according to ANS because they did not have a family variant previously identified in a cancer-affected relative., Conclusion: The high detection rate of P/LPVs in the present study is possibly related to the genetic testing approach with multigene panels and cohort's characteristics, represented mainly by individuals with a personal or family history of young-onset cancer. Testing asymptomatic individuals with suspicious family history may also have contributed to a higher detection rate. A significant number of carriers would not have been identified using ANS criteria for genetic testing., Competing Interests: Author DAS participates in clinical studies sponsored by the company Lilly, and as a speaker at events for AstraZeneca, MSD, Novartis, Roche, Pfizer, Advisory, GSK, Roche. Author AALP reported research involvement with MSD; received honoraria from Servier, MERK, MSD, Novartis, Lilly, AstraZeneca; reported logistic support for educational meetings from AmGen/MSD/Roche; and had advisory role from Servier, Bayer, MERK. Author RB-S reported receiving speaker bureau fees from Agilant, AstraZeneca, Daichi-Sankyo, Eli Lilly, Pfizer, Novartis, Merck, and Roche; he has also served as a consultant/advisor for AstraZeneca, Daichi-Sankyo, Eli Lilly, Libbs, Roche, Merck and has received support for attending medical conferences from AstraZeneca, Eli Lilly, Daichi-Sankyo, and Merck. Author TSC participates in clinical studies sponsored by the company Lilly, Pfizer, Novartis, BMS; and reported receiving speaker bureau fees from AstraZeneca, Novartis, Pfizer, Novartis, Libs. Author IAPM is employed as an advisory board by BMS, Bayer, Astellas, Janssen, MSD, ROCHE, AstraZeneca, participates in clinical studies sponsored by the company BMS, Astellas, Janssen; and reported receiving speaker bureau fees from Novartis, Janssen, ROCHE, Astellas, MSD, BMS, IPSEN, AMGEM, AstraZeneca. Author GdSF is employed as an advisory board by BMS, MSD, ROCHE, Astellas, Boeringher, Bayer, and reported receiving speaker bureau fees from BMS, MSD, ROCHE. DAS participates in clinical studies. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Leite, Suzuki, Pereira, Machado, Barroso-Sousa, Correa, Moura, Morbeck, Gumz, Faria, Fernandes and Sandoval.)

Purpose: To present a summary of the recommendations for the treatment and follow-up for metastatic castration-resistant prostate cancer (mCRPC) as acquired through a questionnaire administered to 99 physicians working in the field of prostate cancer in developing countries who attended the Prostate Cancer Consensus Conference for Developing Countries., Methods: A total of 106 questions out of more than 300 questions addressed the use of imaging in staging mCRPC, treatment recommendations across availability and response to prior drug treatments, appropriate drug treatments, and follow-up, and those same scenarios when limited resources needed to be considered. Responses were compiled and the percentages were presented by clinicians to support each response. Most questions had five to seven relevant options for response including abstain and/or unqualified to answer, or in the case of yes or no questions, the option to abstain was offered., Results: Most of the recommendations from this panel were in line with prior consensus, including the preference of a new antiandrogen for first-line therapy of mCRPC. Important aspects highlighted in the scenario of limited resources included the option of docetaxel as treatment preference as first-line treatment in several scenarios, docetaxel retreatment, consideration for reduced doses of abiraterone, and alternative schedules of an osteoclast-targeted therapy., Conclusion: There was wide-ranging consensus in the treatment for men with mCRPC in both optimal and limited resource settings., Competing Interests: Fernando Cotait MalufHonoraria: Janssen Oncology, Astellas Pharma, Bayer Schering Pharma, Merck Sharp & Dohme, Roche/Genentech, BMS Brazil, Ipsen, Sanofi/Aventis, Merck Serono, AstraZenecaConsulting or Advisory Role: Janssen Oncology, Astellas Pharma, Bayer Schering Pharma, Merck Sharp & Dohme, Roche/Genentech, BMS Brazil, Ipsen, Merck Serono, AstraZenecaResearch Funding: Janssen-Cilag, Merck Sharp & DohmeTravel, Accommodations, Expenses: Merck Sharp & Dohme, Bayer Schering Pharma Felipe MoraesHonoraria: Janssen, Zodiac Pharma, MSD, Libbs, Bayer, AmgenConsulting or Advisory Role: Janssen Adriano Gonçalves SilvaHonoraria: MSD Oncology, Janssen Oncology, Astellas Pharma, Roche, Pfizer/EMD Serono, Bayer, BMS BrazilConsulting or Advisory Role: Janssen Oncology, Astellas Pharma, Pfizer/EMD Serono, MSD OncologyResearch Funding: MSD Oncology, Janssen OncologyTravel, Accommodations, Expenses: Janssen Oncology, Astellas Pharma, MSD Oncology, Roche Aldo Lourenço Abbade DettinoHonoraria: Janssen-Cilag, Bayer, Astellas Pharma, RocheConsulting or Advisory Role: NovartisResearch Funding: Janssen, RocheTravel, Accommodations, Expenses: MSD Oncology Ana Paula Garcia CardosoConsulting or Advisory Role: Janssen Oncology, Pfizer, Astellas PharmaSpeakers' Bureau: Janssen Oncology, Novartis, MSD Oncology, Astellas Pharma, AstraZeneca, BayerTravel, Accommodations, Expenses: Ipsen, Janssen Oncology, Bristol-Myers Squibb André Seeke SasseHonoraria: Roche, Astellas Pharma, Janssen-Cilag, Bristol-Myers Squibb, Merck KGaA, MSD Oncology, NovartisConsulting or Advisory Role: Astellas Pharma, Janssen-Cilag, Merck KGaA, Novartis, RocheResearch Funding: Bristol-Myers SquibbTravel, Accommodations, Expenses: MSD Oncology, Janssen-Cilag Andrey SoaresHonoraria: Janssen, Pfizer, Bayer, Novartis, AstraZeneca, Astellas Pharma, Pierre Fabre, Merck Serono, Sanofi, Roche, MSDConsulting or Advisory Role: Astellas Pharma, Janssen, Roche, Bayer, Lilly, AstraZeneca, Novartis, MSD, Bristol-Myers SquibbResearch Funding: Bristol-Myers SquibbTravel, Accommodations, Expenses: AstraZeneca, Pfizer, Astellas Pharma, Bristol-Myers Squibb, Bayer, Roche, Janssen, Merck Serono, Sanofi, Ipsen, MSD Ariel Galapo KannConsulting or Advisory Role: Janssen OncologySpeakers' Bureau: Janssen Oncology, GlaxoSmithKline, Roche Daniel HerchenhornConsulting or Advisory Role: Janssen-Cilag Denis Leonardo Fontes JardimHonoraria: Janssen-Cilag, Roche/Genentech, Astellas Pharma, MSD Oncology, BMS Brazil, Pfizer, Libbs, MerckConsulting or Advisory Role: Janssen-Cilag, Pfizer, MSDTravel, Accommodations, Expenses: MSD, BMS Brazil, Janssen-Cilag Diego Emilio Lopera CortésConsulting or Advisory Role: Bristol-Myers Squibb, Pfizer, NovartisSpeakers' Bureau: Dr Reddy's Laboratories, Bristol-Myers Squibb, Boehringer Ingelheim, PfizerTravel, Accommodations, Expenses: MSD Oncology Fábio Roberto KaterConsulting or Advisory Role: Janssen-Cilag, PfizerTravel, Accommodations, Expenses: Janssen-Cilag Igor A. Protzner MorbeckHonoraria: Janssen-Cilag, BMS Brazil, AstraZeneca, MSD Oncology, Astellas PharmaConsulting or Advisory Role: BMS Brazil, Janssen-Cilag, TakedaTravel, Accommodations, Expenses: Astellas Pharma, BMS Brazil Juan Jose ZarbáConsulting or Advisory Role: Pfizer/EMD Serono, Astellas PharmaResearch Funding: MSD Oncology, Lilly, Exelixis, Astellas PharmaExpert Testimony: LillyTravel, Accommodations, Expenses: Roche, Pfizer Karine Martins da TrindadeHonoraria: BMS Brazil, Janssen-Cilag, MSD OncologyConsulting or Advisory Role: MSD Oncology, Janssen-Cilag, Astellas PharmaResearch Funding: BMS Brazil, Roche/Genentech, MSD Oncology, Janssen-CilagTravel, Accommodations, Expenses: Janssen-Cilag, BMS Brazil, Ipsen Leonardo Atem G. A. CostaHonoraria: Janssen Oncology, Astellas Pharma, AstraZenecaConsulting or Advisory Role: Janssen Oncology, Astellas Pharma, AstraZenecaTravel, Accommodations, Expenses: Janssen Oncology, Boehringer Ingelheim, Astellas Pharma, AstraZeneca Lucas V. dos SantosStock and Other Ownership Interests: Merck Sharp & Dohme, Eisai, Fleury GroupHonoraria: BMS Brazil, United Medical, Roche/GenentechConsulting or Advisory Role: Lilly, Bristol-Myers Squibb, MSD, Roche/GenentechSpeakers' Bureau: BMS Brazil, United MedicalResearch Funding: Roche/Genentech, Janssen Oncology, Novartis, GlaxoSmithKline, Amgen, Boston Scientific, Takeda, BMS Brazil, MSD, Exelixis Manuel Caitano MaiaConsulting or Advisory Role: AstraZeneca, Janssen OncologySpeakers' Bureau: Janssen Oncology, AstraZeneca, Bayer, MSD Oncology, Pfizer, Astellas PharmaExpert Testimony: MSD OncologyTravel, Accommodations, Expenses: Astellas Pharma, Janssen Oncology Mariana Bruno SiqueiraConsulting or Advisory Role: Novartis, Janssen-CilagSpeakers' Bureau: Novartis, MSD Oncology, Bayer, Janssen-CilagTravel, Accommodations, Expenses: Roche, Pfizer, Ipsen Silke GillessenConsulting or Advisory Role: Astellas Pharma, Advanced Accelerator Applications, Roche, Janssen, Bayer, Orion Pharma GmbH, Menarini Silicon Biosystems, Tolero Pharmaceuticals, MSD Oncology, Amgen, PfizerSpeakers' Bureau: Janssen-CilagPatents, Royalties, Other Intellectual Property: Method for biomarker (WO 3752009138392 A1)Travel, Accommodations, Expenses: ProteoMedixOther Relationship: ProteoMediX, Aranda PharmaNo other potential conflicts of interest were reported.

Purpose: To present a summary of the treatment and follow-up recommendations for the biochemical recurrence in castration-sensitive prostate cancer (PCa) acquired through a questionnaire administered to 99 PCa experts from developing countries during the Prostate Cancer Consensus Conference for Developing Countries., Methods: A total of 27 questions were identified as related to this topic from more than 300 questions. The clinician's responses were tallied and presented in a percentage format. Topics included the use of imaging for staging biochemical recurrence, treatment recommendations for three different clinical scenarios, the field of radiation recommended, and follow-up. Each question had 5-7 relevant response options, including "abstain" and/or "unqualified to answer," and investigated not only recommendations but also if a limitation in resources would change the recommendation., Results: For most questions, a clear majority (> 50%) of clinicians agreed on a recommended treatment for imaging, treatment scenarios, and follow-up, although only a few topics reached a consensus > 75%. Limited resources did affect several areas of treatment, although in many cases, they reinforced more stringent criteria for treatment such as prostate-specific antigen values > 0.2 ng/mL and STAMPEDE inclusion criteria as a basis for recommending treatment., Conclusion: A majority of clinicians working in developing countries with limited resources use similar cutoff points and selection criteria to manage patients treated for biochemically recurrent castration-sensitive PCa., Competing Interests: Fernando S. M. MonteiroConsulting or Advisory Role: Bristol Myers Squibb, Roche, MSD Oncology, JanssenSpeakers' Bureau: Janssen, MSD Oncology, IpsenResearch Funding: Janssen (Inst)Travel, Accommodations, Expenses: Janssen, Roche, Bristol Myers Squibb Fabio A. SchutzEmployment: Ipsen (I)Consulting or Advisory Role: Bayer, Janssen Oncology, Roche, Merck Sharp & Dohme, Bristol Myers Squibb, Pfizer, Astellas Pharma, AstraZenecaSpeakers' Bureau: Janssen Oncology, Astellas Pharma, Bayer, Pfizer, Bristol Myers Squibb, AstraZeneca, Merck Sharp & Dohme, RocheResearch Funding: Janssen OncologyTravel, Accommodations, Expenses: Merck Sharp & Dohme, Roche, Bristol Myers Squibb, Astellas Pharma, Janssen-Cilag Igor A. P. MorbeckHonoraria: Janssen-Cilag, BMS Brazil, AstraZeneca, MSD Oncology, Astellas PharmaConsulting or Advisory Role: BMS Brazil, Janssen-Cilag, TakedaTravel, Accommodations, Expenses: Astellas Pharma, BMS Brazil Diogo A. BastosHonoraria: MSD, Roche, Bristol Myers Squibb, Janssen-Cilag, Astellas Pharma, AstraZeneca, BayerConsulting or Advisory Role: Roche, Bayer, Janssen-Cilag, MSD OncologyResearch Funding: Janssen-Cilag (Inst), Pfizer (Inst), Astellas Pharma (Inst)Travel, Accommodations, Expenses: Janssen-Cilag, Bayer Leonardo A. G. A. CostaHonoraria: Janssen Oncology, Astellas Pharma, AstraZenecaConsulting or Advisory Role: Janssen Oncology, Astellas Pharma, AstraZenecaTravel, Accommodations, Expenses: Janssen Oncology, Boehringer Ingelheim, Astellas Pharma, AstraZeneca Manuel C. MaiaConsulting or Advisory Role: AstraZeneca, Janssen OncologySpeakers' Bureau: Janssen Oncology, AstraZeneca, Bayer, MSD Oncology, Pfizer, Astellas PharmaExpert Testimony: MSD OncologyTravel, Accommodations, Expenses: Astellas Pharma, Janssen Oncology Stenio de Cassio ZequiConsulting or Advisory Role: Pfizer, Astellas BrazilSpeakers' Bureau: Pfizer, Astellas Pharma, Bayer, Janssen, Astra Zeneca Brazil Karine M. da TrindadeHonoraria: BMS Brazil, Janssen-Cilag, MSD OncologyConsulting or Advisory Role: MSD Oncology, Janssen-Cilag, Astellas PharmaResearch Funding: BMS Brazil, Roche/Genentech, MSD Oncology, Janssen-CilagTravel, Accommodations, Expenses: Janssen-Cilag, BMS Brazil, Ipsen Lucas V. dos SantosStock and Other Ownership Interests: Merck Sharp & Dohme, Eisai, Fleury GroupHonoraria: BMS Brazil, United Medical, Roche/GenentechConsulting or Advisory Role: Lilly, Bristol Myers Squibb, MSD, Roche/GenentechSpeakers' Bureau: BMS Brazil, United MedicalResearch Funding: Roche/Genentech (Inst), Janssen Oncology (Inst), Novartis (Inst), GlaxoSmithKline (Inst), Amgen (Inst), Boston Scientific (Inst), Takeda (Inst), BMS Brazil (Inst), MSD (Inst), Exelixis (Inst) Diogo A. R. da RosaHonoraria: RocheConsulting or Advisory Role: Janssen-Cilag, Bristol Myers Squibb, AstraZeneca, Astellas PharmaSpeakers' Bureau: AstraZeneca, Dr Reddy's Laboratories, Roche, MSD Oncology, BMS BrazilTravel, Accommodations, Expenses: Janssen-Cilag, Roche, BMS Brazil, Ipsen Francisco J. OrlandiHonoraria: Roche/GenentechConsulting or Advisory Role: AstraZeneca, Roche/Genentech, Bristol Myers Squibb, MSD Oncology, Pfizer, Novartis, SanofiSpeakers' Bureau: AstraZeneca/MedImmune, RocheResearch Funding: AstraZeneca/MedImmune, Amgen, Genentech/Roche, Boehringer Ingelheim, Astellas Medivation, MSD Oncology, Bristol Myers Squibb, Celltrion, Pfizer, mAbxience, Nektar, SanofiTravel, Accommodations, Expenses: MSD Oncology, Genentech/Roche Fernando N. G. de OliveiraConsulting or Advisory Role: Janssen OncologySpeakers' Bureau: Janssen Oncology, Astellas Pharma, MSD OncologyTravel, Accommodations, Expenses: Astellas Pharma, MSD Oncology Andrey SoaresHonoraria: Janssen, Pfizer, Bayer, Novartis, AstraZeneca, Astellas Pharma, Pierre Fabre, Merck Serono, Sanofi, Roche, MSDConsulting or Advisory Role: Astellas Pharma, Janssen, Roche, Bayer, Lilly, AstraZeneca, Novartis, MSD, Bristol Myers Squibb (Inst)Research Funding: Bristol Myers Squibb (Inst)Travel, Accommodations, Expenses: AstraZeneca, Pfizer, Astellas Pharma, Bristol Myers Squibb, Bayer, Roche, Janssen, Merck Serono, Sanofi, Ipsen, MSDNo other potential conflicts of interest were reported.

Background: Non-metastatic castration resistant prostate cancer (M0 CRPC) has seen important developments in drugs and diagnostic tools in the last two years. New hormonal agents have demonstrated improvement in metastasis free survival in M0 CRPC patients and have been approved by regulatory agencies in Brazil. Additionally, newer and more sensitive imaging tools are able to detect metastasis earlier than before, which will impact the percentage of patients staged as M0 CRPC. Based on the available international guidelines, a group of Brazilian urology and medical oncology experts developed and completed a survey on the diagnosis and treatment of M0 CRPC in Brazil. These results are reviewed and summarized and associated recommendations are provided., Objective: To present survey results on management of M0 CRPC in Brazil., Design, Setting, and Participants: A panel of six Brazilian prostate cancer experts determined 64 questions concerning the main areas of interest: 1) staging tools, 2) treatments, 3) side effects of systemic treatment/s, and 4) osteoclast-targeted therapy. A larger panel of 28 Brazilian prostate cancer experts answered these questions in order to create country-specific recommendations discussed in this manuscript. Outcome measurements and statistical analysis: The panel voted publicly but anonymously on the predefined questions. These answers are the panelists' opinions, not a literature review or meta-analysis. Therapies not yet approved in Brazil were excluded from answer options. Each question had five to seven relevant answers including two non-answers. Results were tabulated in real time., Conclusions: The results and recommendations presented can be used by Brazilian physicians to support the management of M0 CRPC patients. Individual clinical decision making should be supported by available data, however, for Brazil, guidelines for diagnosis and management of M0 CRPC patients have not been developed. This document will serve as a point of reference when confronting this disease stage., Competing Interests: None declared., (Copyright® by the International Brazilian Journal of Urology.)

Purpose: The outcome of RCC has improved considerably in the last few years, and the treatment options have increased. LACOG-GU and LARCG held a consensus meeting to develop guidelines to support the clinical decisions of physicians and other health professionals involved in the care of RCC patients., Methods: Eighty questions addressing relevant advanced RCC treatments were previously formulated by a panel of experts. The voting panel comprised 26 specialists from the LACOG-GU/LARCG. Consensus was determined as 75% agreement. For questions with less than 75% agreement, a new discussion was held, and consensus was determined by the majority of votes after the second voting session., Results: The recommendations were based on the highest level of scientific evidence or by the opinion of the RCC experts when no relevant research data were available., Conclusion: This manuscript provides guidance for advanced RCC treatment according to the LACOG-GU/LARCG expert recommendations.

Background: Renal cell cancer (RCC) is one of the 10 most common cancers in the world, and its incidence is increasing, whereas mortality is declining only in developed countries. Therefore, two collaborative groups, The Latin American Oncology Cooperative Group-Genitourinary Section (LACOG-GU) and the Latin American Renal Cancer Group (LARCG), held a consensus meeting to develop this guideline., Methods: Issues (134) related to the treatment of RCC were previously formulated by a panel of experts. The voting panel comprised 26 specialists (urologists and medical oncologists) from the LACOG-GU/LARCG. A consensus was reached if 75% agreement was achieved. If there was less concordance, a new discussion was undertaken, and a consensus was determined by the most votes after a second voting session., Results: The expert meeting provided recommendations that were in line with the global literature; 75.0% of the recommendations made by the panel of experts were evidence-based level A, 22.5% of the recommendations were level B, and 2.5% of the recommendations were level D., Conclusions: This review suggests recommendations for the surgical treatment of RCC according to the LACOG-GU/LARCG experts., Competing Interests: Conflict of interest statement: Adriano Gonçalves e Silva, Speaker Fee: Janssen, Pfizer, Bayer, AstraZeneca, Astellas, Pierre-Fabre, Sanofi, Roche, Merck Sharp & Dohme, Bristol-Myers Squibb. Advisory Board: Astellas, Janssen, Roche, Merck Sharp & Dohme, Bristol-Myers Squibb, Pfizer, Sanofi. André Deeke Sasse, Honoraria: Janssen, Astellas, Roche, Merck Sharp & Dohme. Advisory Board: Janssen, Astellas, Roche, Merck Sharp & Dohme, Bristol-Myers Squibb. Events Sponsorship: Janssen, Roche. André P. Fay, Honoraria: Pfizer, Astellas, Bristol-Myers Squibb, Novartis, Roche, AstraZeneca, Merck Sharp & Dohme. Advisory Board: Janssen, Novartis, Roche, Pfizer, Ipsen. Research Funding: CAPES, CNPq, Bristol-Myers Squibb, AstraZeneca, Roche, Merck Sharp & Dohme, Pfizer. Andrey Soares, Speaker Fee: Janssen, Pfizer, Bayer, Novartis, AstraZeneca, Astellas, Pierre-Fabre, Merck-Serono, Sanofi, Roche. Events sponsorship: AstraZeneca, Pfizer, Astellas, Bristol-Myers Squibb, Bayer, Roche, Janssen, Merck Serono, Sanofi, Ipsen. Advisory Board: Astellas, Janssen, Roche, Bayer, Lilly, AstraZeneca, Novartis, Merck Sharp & Dohme, Bristol-Myers Squibb. Research Funding: Bristol-Myers Squibb. Denis Leonardo Jardim, Speaker Fee: Roche, Janssen, Astellas, Merck Sharp & Dohme, Bristol-Myers Squibb and Libbs. Advisory Board: Janssen, Bristol-Myers Squibb and Libbs. Deusdedit Cortez Vieira da Silva Neto, Speaker Fee: Janssen, Astellas, Pfizer. Advisory Board: Janssen. Diogo Assed Bastos, Research Funding: Janssen, Astellas, Pfizer, Merck Sharp & Dohme. Honoraria/Advisory Board: Janssen, Astellas, Bristol-Myers Squibb, Merck Sharp & Dohme, Roche, Pfizer, Novartis, Bayer. Diogo Augusto Rodrigues da Rosa, Research Funding: Roche, Bristol-Myers Squibb, Janssen, Lilly, AstraZeneca, Merck Sharp & Dohme. Speaker Fee: Janssen, Pfizer, AstraZeneca, Astellas, Roche, Amgen, Dr Reddy’s, Merck Sharp & Dohme. Events Sponsorship: Janssen, AstraZeneca, Astellas, Bristol-Myers Squibb, Bayer, Roche, Janssen, Ipsen. Advisory Board: Janssen, Bayer, AstraZeneca. Evanius Wierman, Honoraria: Janssen, Libbs. Advisory Board: Janssen. Fabio Kater, Speaker Fee: Janssen, Roche, Amgen, Merck Sharp & Dohme, AstraZeneca, Astellas. Events Sponsorship: Roche, Janssen. Fabio A. Schutz, Advisory Board: Bristol-Myers Squibb, Merck Sharp & Dohme, Ipsen, Pfizer. Speaker’s bureau: Roche, Novartis, Pfizer, Bristol-Myers Squibb, Merck Sharp & Dohme, Janssen, Astellas. Felipe de Almeida e Paula, None. Fernando Cotait Maluf, Research Funding: Roche, Bristol-Myers Squibb, Novartis, Janssen. Speaker Fee: Sanofi, Novartis, Bayer, Janssen, Astellas, Bristol-Myers Squibb, Pfizer. Advisory Board: Sanofi, Bayer, Janssen, Astellas, Novartis, Roche. Fernando Korkes, None. Fernando Nunes Galvão de Oliveira, Speaker Fee: Astellas, Janssen, Merck Sharp & Dohme, Bayer, Roche, AstraZeneca, Libbs. Advisory Board: Merck Sharp & Dohme, Janssen, Ferring. Fernando Sabino Marques Monteiro, Speaker and Advisory Board: Bristol-Myers Squibb. Gustavo Franco Carvalhal, None. Igor Alexandre Protzner Morbeck, Research Funding: Astellas. Honoraria/Advisory Board: Janssen, Astellas, Bristol-Myers Squibb, Merck Sharp & Dohme, Roche, Pfizer, Novartis and Bayer. José Augusto Rinck Júnior, Speaker Fee/Events sponsorship: Pfizer, Astellas, Bristol-Myers Squibb, Merck Sharp & Dohme, Bayer, Roche, Janssen, Aché. Karine Martins da Trindade, Research Funding: Roche, Bristol-Myers Squibb, Merck Sharp & Dohme. Speaker Fee: Janssen, AstraZeneca, Astellas, Bristol-Myers Squibb, Roche, Pfizer, Merck Serono. Events Sponsorship: Janssen, Astellas, Bristol-Myers Squibb, Roche, AstraZeneca, Pfizer, Astellas, Merck Serono, Sanofi, Novartis. Advisory Board: Janssen, Roche, Bristol-Myers Squibb. Lucas Nogueira, Speaker Fee: Janssen, Pfizer, Bayer, Astellas, Pierre-Fabre, Roche, Merck Sharp & Dohme. Events Sponsorship: Astellas, Bayer, Janssen. Advisory Board: Astellas, Janssen, Merck Sharp & Dohme. Manuel Caitano Maia, Speaker Fee: Pfizer. Events Sponsorship: Pfizer, Astellas, Bristol-Myers Squibb, Bayer, Roche, Janssen, Libbs. Roni de Carvalho Fernandes, Events Sponsorship: Astellas, Janssen, Handle/Cook. Speaker Fee: Janssen, Aché. Advisory Board: Janssen. Rodolfo Borges dos Reis, Speaker Fee: Janssen, AstraZeneca. Advisory Board: Janssen, Astellas. Research Funding: AstraZeneca. Events Sponsorship: Janssen, Pfizer, Astellas, Roche. Stênio de Cássio Zequi, Speaker fee: Bristol-Myers Squibb, Pfizer and AstraZeneca. Research funding: Merck Sharp & Dohme. Events sponsorship: Astellas. Vinicius Carrera Souza, Research Funding: Bristol-Myers Squibb, Janssen. Speaker Fee: Bayer, Janssen, Novartis, AstraZeneca, Merck Sharp & Dohme. Advisory Board: Roche, Janssen. Wagner Eduardo Matheus, Speaker Fee: Astellas, Janssen, Zodiac, AstraZeneca, Aché. Events Sponsorship: Astellas, Zodiac, Janssen, AstraZeneca. Walter Henriques da Costa, None. Speaker Fee: Astellas, Janssen, Bristol-Meyers Squibb, Bayer. Events sponsorship: Astellas, Janssen, Zodiac. Research Funding: Bristol-Meyers Squibb. Wilson Francisco Schreiner Busato Jr, None.

Prostate cancer is the second most common cancer and the fi fth leading cause of cancer deaths. In Brazil, it is likewise the second most common cancer among men, second only to non-melanoma skin cancers. The aim of this consensus is to align different opinions and interpretations of the medical literature in a practical and patient-oriented approach. The fi rst Brazilian Consensus on the Treatment of Advanced Prostate Cancer was published in 2017, with the goal of reducing the heterogeneity of therapeutic conduct in Brazilian patients with metastatic prostate cancer. We acknowledge that in Brazil the incorporation of different technologies is a big challenge, especially in the Sistema Único de Saúde (SUS), which allows for the disparity in the options available to patients treated in different institutions. In order to update the recommendations and to make them objective and easily accessible, once more a panel of specialists was formed in order to discuss and elaborate a new Brazilian Consensus on Advanced Prostate Cancer. This Consensus was written through a joint initiative of the Brazilian Society of Clinical Oncology (SBOC) and the Brazilian Society of Urology (SBU) to support the clinical decisions of physicians and other health professionals involved in the care of patients with prostate cancer., Competing Interests: None declared., (Copyright® by the International Brazilian Journal of Urology.)

Introduction: Prostate cancer still represents a major cause of morbidity, and still about 20% of men with the disease are diagnosed or will progress to the advanced stage without the possibility of curative treatment. Despite the recent advances in scientific and technological knowledge and the availability of new therapies, there is still considerable heterogeneity in the therapeutic approaches for metastatic prostate cancer., Objectives: This article presents a summary of the I Brazilian Consensus on Advanced Prostate Cancer, conducted by the Brazilian Society of Urology and Brazilian Society of Clinical Oncology., Materials and Methods: Experts were selected by the medical societies involved. Forty issues regarding controversial issues in advanced disease were previously elaborated. The panel met for consensus, with a threshold established for 2/3 of the participants., Results and Conclusions: The treatment of advanced prostate cancer is complex, due to the existence of a large number of therapies, with different response profiles and toxicities. The panel addressed recommendations on preferred choice of therapies, indicators that would justify their change, and indicated some strategies for better sequencing of treatment in order to maximize the potential for disease control with the available therapeutic arsenal. The lack of consensus on some topics clearly indicates the absence of strong evidence for some decisions., Competing Interests: Andre Deeke Sasse: Received fees from Bayer, Astellas and Janssen (Consulting); Daniel Herchenhorn: Received fees from Bayer, Astellas, Janssen and Sanofi (Consulting and Lectures); Diogo Assed Bastos: Received fees from Bayer, Astellas, Janssen and Sanofi (Consulting); Fabio Augusto Barros Schutz: Received fees from Bayer, Astellas, Janssen and Sanofi (Consulting); Fernando Cotait Maluf: Received fees from Bayer, Astellas, Janssen and Sanofi (Con-sulting); Igor Alexandre Protzner Morbeck: Received fees from Bayer, Astellas and Janssen (Consulting and Lectures); Oren Smaletz: Received fees from Bayer, Astellas, Janssenand Sanofi (Consulting); Volney Soares Lima: Received fees from Janssen (Consulting) and Bayer (Lectures); Ari Adamy Jr. received fees from Janssen (Consulting); Gustavo Franco Carvalhal received fees from Bayer, Astellas, Astra-Zeneca, Pfizer and Janssen due to Lectures in scientific events; Lucas Mendes Nogueira received fees from Bayer, Astellas and Janssen, and Sanofi Aventis (Consulting). He was researcher in clinical trial sponsored by Bayer, Astellas, Janssen and GSK; Rodolfo Borges dos Reis received fees from Bayer and Janssen (Consulting), and Astra Zeneca and Janssen (Lectures); Other authors: None declared, (Copyright® by the International Brazilian Journal of Urology.)