The Movember Foundation's GAP3 cohort : a profile of the largest global prostate cancer active surveillance database to date

Objectives: The Movember Foundation launched the Global Action Plan Prostate Cancer Active Surveillance (GAP3) initiative to create a global consensus on the selection and monitoring of men with low-risk prostate cancer (PCa) on active surveillance (AS). The aim of this study is to present data on inclusion and follow-up for AS in this unique global AS database. Patients and Methods: Between 2014 and 2016, the database was created by combining patient data from 25 established AS cohorts worldwide (USA, Canada, Australasia, UK and Europe). Data on a total of 15 101 patients were included. Descriptive statistics were used to report patients' clinical and demographic characteristics at the time of PCa diagnosis, clinical follow-up, discontinuation of AS and subsequent treatment. Cumulative incidence curves were used to report discontinuation rates over time. Results: At diagnosis, the median (interquartile range [IQR]) patient age was 65 (60\u201370) years and the median prostate-specific antigen level was 5.4 (4.0\u20137.3) ng/mL. Most patients had clinical stage T1 disease (71.8%), a biopsy Gleason score of 6 (88.8%) and one tumour-positive biopsy core (60.3%). Patients on AS had a median follow-up time of 2.2 (1.0\u20135.0) years. After 5, 10 and 15 years of follow-up, respectively, 58%, 39% and 23% of patients were still on AS. The current version of GAP3 has limited data on magnetic resonance imaging (MRI), quality of life and genomic testing. Conclusions: GAP3 is the largest worldwide collaboration integrating patient data from men with PCa on AS. The results will allow individual patients and clinicians to have greater confidence in the personalized decision to either delay or proceed with active treatment. Longer follow-up and the evaluation of MRI, new genomic markers and patient-related outcomes will result in even more valuable data and eventually in better patient outcomes

Active surveillance for low-risk prostate cancer

Active surveillance (AS) is an important management strategy for men diagnosed with low-risk prostate cancer (PCa). The need for AS is increasing due to the awareness that many PCa are identified that show a low growth potential and therefore are likely to remain clinically asymptomatic during the lifetime of an individual. Currently there is no good method to prevent the overdiagnosis of indolent cancers upfront. During the last decade, several studies on AS around the world have made observations that feed the discussion on how to select and monitor these patients, how to proceed with the research to develop a better and more precise clinical definition of indolent cancers and how to manage men under AS clinically. Furthermore, patients' perspectives have become clearer, and quality of life studies give direction to the practical approach and care for patients and partners. This paper reflects the consensus on the state of the art and the future direction of AS, based on the Inside Track Conference " Active Surveillance for low risk prostate cancer" (Chairmen: C.H. Bangma, NL, and L. Klotz, CA; Co-Chairmen: L.J. Denis, BE, and C. Parker, UK; Scientific Coordinators: M. J. Roobol, NL, and E.W. Steyerberg, NL), organized by the European School of Oncology in collaboration with Europa Uomo in Rotterdam, the Netherlands in January 2012. Topics for discussion were the optimisation of patient selection based on indolent disease definition, the incorporation of therapeutic agents into AS programs, the optimisation of patient care, and the application of emerging technologies and biomarkers

The mini-GWAC optical follow-up of the gravitational wave alerts: results from the O2 campaign and prospects for the upcoming O3 run

International audienceThe second observational campaign of gravitational waves organized by the LIGO/Virgo Collaborations has led to several breakthroughs such as the detection of gravitational wave signals from merger systems involving black holes or neutrons stars. During O2,14 gravitational wave alerts were sent to the astronomical community with sky regions covering mostly over hundreds of square degrees. Among them, 6 have been finally confirmed as real astrophysical events. Since 2013, a new set of ground-based robotic telescopes called GWAC and its pathfinder mini-GWAC have been developed to contribute to the various challenges of themulti-messenger and time domain astronomy. The GWAC system is built up in the framework of the ground-segment system of the SVOM mission that will be devoted to the study of the multi-wavelength transient sky in the next decade. During O2, only the mini-GWAC telescopenetwork was fully operational. Due to the wide field of view and fast automatic follow-up capabilities of the mini-GWAC telescopes, they were well adapted to efficiently cover the sky localization areas of the gravitational wave event candidates. In this paper, we present the mini-GWAC pipeline we have set up to respond to the GW alerts and we report our optical follow-up observations of 8 GW alerts detected during the O2 run. Our observations provided the largest coverage of the GW localization areas in a short latency made by any optical facility. We found tens of optical transient candidates in our images, but none of those could be securely associated with any confirmed black hole-black hole merger event. Based on this first experience and the near future technical improvements of our network system, we will be more competitive to detect the optical counterparts from some gravitational wave events that will be detected during the upcoming O3 run, especially those emerging from binary neutron star mergers