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

Movember Foundation's Global Action Plan Prostate Cancer Active Surveillance (GAP3) consortium, Sophie M. Bruinsma*, Liying Zhang, Monique J. Roobol, Chris H. Bangma, Ewout W. Steyerberg, Daan Nieboer, Mieke Van Hemelrijck, Bruce Trock, Behfar Ehdaie, Peter Carroll, Christopher Filson, Jeri Kim, Todd Morgan, Laurence Klotz, Tom Pickles, Eric Hyndman, Caroline M. Moore, Vincent Gnanapragasam, Prokar DasguptaArnauld Villers, Antti Rannikko, Riccardo Valdagni, Antoinette Perry, Jonas Hugosson, Jose Rubio-Briones, Anders Bjartell, Lukas Hefermehl, Lee Lui Shiong, Mark Frydenberg, Yoshiyuki Kakehi, Byung Ha Chung, Theo van der Kwast, Henk Obbink, Wim van der Linden, Tim Hulsen, Cees de Jonge, Mike Kattan, Ji Xinge, Kenneth Muir, Artitaya Lophatananon, Michael Fahey, Wei Guo, Tanya Milan, Nicole Benfante, Janet Cowan, Dattatraya Patil, Rachel Sanford, Tae Kyung Kim, Alexandre Mamedov, Aida Santaolalla

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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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 (60–70) years and the median prostate-specific antigen level was 5.4 (4.0–7.3) 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 (1.0–5.0) 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.

Original languageEnglish
Pages (from-to)737-744
Number of pages8
JournalBJU International
Issue number5
Early online date15 Dec 2017
Publication statusPublished - 1 May 2018


  • #PCSM
  • #ProstateCancer
  • adenocarcinoma
  • evidence-based
  • guideline


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