Prostate cancer (PCa) is the most frequent tumor among Latin American (LATAM) men. The incidence of de novo metastatic PCa is higher in LATAM than other parts of the world, and demographic changes in the region have increased disease burden. However, region-specific information regarding prevalence, progression, and treatment effectiveness is not currently available for nonmetastatic, castration-resistant PCa (nmCRPC). Nonmetastatic, castration-resistant PCa is a heterogeneous disease with varying potential to develop metastasis with limited treatments available, until recently. New clinical trials with promising results have allowed second-generation antiandrogen drugs to be used as first-line treatments, rendering guidelines outdated. As a result, this panel of experts reviewed the current status and challenges and developed recommendations for nmCRPC diagnosis and management in LATAM. The Americas Health Foundation (AHF) conducted a literature review and identified LATAM scientists and clinicians who have published in the field of PCa since 2012. The AHF convened a panel of 7 chosen experts urologists and medical oncologists from the region. The AHF developed specific questions relating to nmCRPC, which were answered by the experts prior to the multiday meeting. Each narrative was discussed and edited by the panel, through numerous rounds of discussion until a consensus was reached in a final manuscript. The panel proposes specific and realistic recommendations for improving access to diagnosis and management of PCa in LATAM. No treatment has yet shown improvement in overall survival; however, when including metastasis-free survival as an end point, second-generation antiandrogen drugs have emerged as effective treatment options and are currently included as first-line treatment. Although nmCRPC is a specific disease that represents a small percentage of patients with PCa, effective diagnostic and treatment strategies can contribute toward increasing quality of life and survival rates of patients with PCa in LATAM.

中文翻译：

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拉丁美洲前列腺癌：挑战和建议。

前列腺癌（PCa）是拉丁美洲（LATAM）男性中最常见的肿瘤。在拉丁美洲，从头开始转移性PCa的发生率高于世界其他地区，该地区的人口变化增加了疾病负担。但是，关于非转移性，去势抵抗性PCa（nmCRPC），目前尚无关于患病率，进展和治疗效果的区域特定信息。直到最近，非转移性，去势抵抗性PCa是一种异质性疾病，具有有限的治疗潜力，具有发展转移的潜力。新的临床试验取得了可喜的结果，已允许将第二代抗雄激素药物用作一线治疗药物，从而导致指南已过时。结果是，该专家小组回顾了当前的现状和挑战，并为LATAM中的nmCRPC诊断和管理提出了建议。美洲健康基金会（AHF）进行了文献综述，并确定了自2012年以来在PCa领域发表过论文的LATAM科学家和临床医生。AHF召集了一个由该地区7位选定的泌尿科医生和医学肿瘤专家组成的小组。AHF提出了与nmCRPC有关的特定问题，在为期多天的会议之前，专家们已经回答了这些问题。小组讨论和编辑每个叙述，直到最后的稿件达成共识。该小组提出了一些切实可行的建议，以改善拉美地区PCa的诊断和管理。尚无治疗可改善总体生存率。但是，当以无转移生存为终点时，第二代抗雄激素药物已成为有效的治疗选择，目前已作为一线治疗药物。尽管nmCRPC是一种特殊疾病，仅占PCa患者的一小部分，但有效的诊断和治疗策略可有助于提高LATAM中PCa患者的生活质量和生存率。