J.P. Maroto

Hospital de la Santa Creu i Sant Pau, Barcino, Catalonia, Spain

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Publications (3)11.63 Total impact

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    ABSTRACT: ContextControversies and uncertainties among integral management of advanced castration resistant prostate cancer continue to exist despite the number of evidence based clinical practice guidelines published with high international consensus.Objective To develop a document that reviews the management of controversies in advanced castration resistant prostate cancer, with recommendations from the definition, to the management in hormonal maneuvers, first-line treatment and second-line with new treatments as cabazitaxel or abirarerone and the multidisciplinary approach of the pathology with the goal of finding the most efficient, best time to act and safety.Evidence AcquisitionTwo meetings of a multidisciplinary group of experts involved in the management of this disease (oncologist and urologist) where pooled analysis of original literature and reached consensus document of recommendations on castration resistant prostate cancer, reviewing and attempting to address the current controversies of the disease.Evidence SynthesisThis document is endorsed by the corresponding Scientific Associations and Working Groups involved in the current management of Genitourinary Tumours: the Spanish Association of Urology (AEU) with the Uro-Oncoloy Group (GUO) and the Spanish Oncology of Genitourinary Group (SOGUG).Conclusions With the adaptation and implementation of this Document of Recommendations for clinical practice are available for the first time, a real road map for quality, efficiency and safety in the management of patients with CRPC.ResumenContextoEn el manejo integral del cáncer de próstata avanzado resistente a la castración siguen existiendo incertidumbres y controversias a pesar de la existencia de numerosas guías de práctica clínica basadas en la evidencia, internacionalmente consensuadas.ObjetivoElaborar un documento en el que se revise el manejo de controversias en el cáncer de próstata avanzado resistente a la castración con recomendaciones desde su definición hasta el manejo de maniobras hormonales y el tratamiento de primera y segunda línea con nuevos fármacos como cabacitaxel y abiraterona, así como el abordaje multidisciplinar de la patología con el objetivo de buscar la alternativa más eficiente, el mejor momento de actuar y la mayor seguridad.Adquisición de la EvidenciaSe realizaron 2 reuniones de un grupo de expertos multidisciplinares implicados en el manejo de esta enfermedad (urólogos y oncólogos) donde se pusieron en común el análisis bibliográfico de artículos originales y se consensuó este documento de recomendaciones sobre el cáncer de próstata resistente a la castración, revisando e intentando dar respuesta a las actuales controversias de la enfermedad.Síntesis de la EvidenciaEste documento está avalado por las principales Sociedades Científicas y grupos de trabajo implicados en el manejo actual de los tumores genitourinarios: la Asociación Española de Urología (AEU), el Grupo de Urología Oncológica (GUO) y el Grupo Español de Oncología Genitourinaria (SOGUG).ConclusionesCon la adaptación e implementación de este Documento de Recomendaciones a la práctica clínica se dispone, por primera vez, de una verdadera hoja de ruta de calidad, eficiencia y seguridad del manejo de los pacientes con cáncer de próstata avanzado resistente a la castración.
    Actas urologicas españolas 12/2012; 36(10):569–577. · 1.14 Impact Factor
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    ABSTRACT: The approval and use of molecular targeted agents for the first-line treatment of metastatic renal cell carcinoma (mRCC) has substantially improved the clinical outcome of patients. Although eventually all patients progress, hopes have been renewed with the approval of everolimus for patients who progress on or after treatment with tyrosine kinase inhibitors. In order to improve the prognosis for these patients, it is imperative to understand the reasons why patients with mRCC fail on first-line treatment. Currently, progression is assessed on the basis of the Response Evaluation Criteria in Solid Tumors, but it is known that targeted agents tend to cause disease stabilization rather than a significant decrease in tumor mass. Therefore, it may be time to evaluate the need to incorporate additional diagnostic methods in the assessment of disease response. Equally important is the study of the factors that determine the success or failure of second-line therapy in order to increase the chances of delivering the most effective and personalized therapy possible. In this article, we review the evidence related to the evaluation of patients with mRCC who fail on first-line treatment with targeted agents, including the systems to assess response and progression, the prognostic factors, the prognostic models that have been created based on these factors, and what is known about predictive biomarkers of disease outcome.
    CANCER AND METASTASIS REVIEW 06/2012; 31 Suppl 1:S3-9. · 9.35 Impact Factor
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    ABSTRACT: ContextControversies and uncertainties among integral management of advanced castration resistant prostate cancer continue to exist despite the number of evidence based clinical practice guidelines published with high international consensus.Objective To develop a document that reviews the management of controversies in advanced castration resistant prostate cancer, with recommendations from the definition, to the management in hormonal maneuvers, first-line treatment and second-line with new treatments as cabazitaxel or abirarerone and the multidisciplinary approach of the pathology with the goal of finding the most efficient, best time to act and safety.Evidence AcquisitionTwo meetings of a multidisciplinary group of experts involved in the management of this disease (Oncologist and Urologist) where pooled analysis of original literature and reached consensus document of recommendations on castration resistant prostate cancer, reviewing and attempting to address the current controversies of the disease.Evidence SynthesisThis document is endorsed by the corresponding Scientific Associations and Working Groups involved in the current management of Genitourinary Tumours: the Spanish Association of Urology (AEU) with the Uro-Oncoloy Group (GUO) and the Spanish Oncology of Genitourinary Group (SOGUG).Conclusions With the adaptation and implementation of this Document of Recommendations for clinical practice are available for the first time, a real road map for quality, efficiency and safety in the management of patients with CRPC.
    Actas urologicas españolas 01/2012; 36(10):569–577. · 1.14 Impact Factor