Latin American Consensus for the Diagnosis and Treatment of Metastatic Castration-Sensitive Prostate Cancer

The treatment of metastatic castration-sensitive prostate cancer (mCSPC) is complex, requiring strategies to prevent complications and improve survival outcomes. In resource-limited settings, it is essential to guide clinical practice to ensure patients receive the best available diagnostic and treatment options. This consensus aims to provide updated recommendations for the diagnosis and management of mCSPC in Latin America. This consensus was developed with the participation of clinical experts from multiple Latin American countries. A systematic literature review was conducted by an independent methodological team to establish the foundation for the recommendations, which were evaluated and defined through a modified Delphi process. A total of 60 consensus statements were formulated, covering clinical, biochemical, and imaging evaluations; genetic testing strategies; prognosis; treatment options (hormonal therapy, radiotherapy, and bone health management); and follow-up for mCSPC patients. The management of mCSPC requires an individualized approach that considers factors such as age, functional status, comorbidities, disease stage, prognosis, and patient preferences. Best practices should always be guided by the highest quality evidence available and adapted to the local clinical context and available resources. These recommendations serve as practical guidelines to tailor mCSPC treatment to regional realities, considering the significant differences in health care infrastructure, access to diagnostic tools, and availability of treatment options across Latin American countries. These disparities must be considered when implementing recommendations to ensure equitable patient care. Continued progress in regional research will further optimize treatment strategies and improve long-term outcomes for patients across Latin America.