Management of Advanced Prostate Cancer in the Asia-Pacific Region: Summary of the Asia-Pacific Advanced Prostate Cancer Symposium 2025.

[AIM] The aim of the fourth Asia-Pacific Advanced Prostate Cancer Symposium (APAC APCS 2025) was to discuss the application in the Asia-Pacific (APAC) region of outcomes from the fifth Advanced Prostate Cancer Consensus Conference (APCCC 2024).

[METHODS] The one-day symposium in September 2025 brought together 28 experts from 15 APAC countries or regions. The symposium covered five topics: (1) high-risk localized/locally advanced prostate cancer; (2) prostate-specific antigen persistence and recurrence; (3) radioligand therapy; (4) genetics and genomics; (5) bone protection and other aspects of supportive care. Presymposium polling and expert presentations prefaced in-depth discussions to gather insights on current practice and challenges in the region.

[RESULTS] APAC APCS 2025 highlighted the increasing complexities in diagnosis and management of advanced prostate cancer and the impact on practice of variations in access and cost. Panelists described variations in access and reimbursement for PSMA-PET/CT, abiraterone, androgen receptor pathway inhibitors, Lu-PSMA, and bone-protecting agents. While most panelists reported access to nuclear medicine expertise, access to genetic counsellors continues to be limited in many parts of the region. Discussions highlighted creative approaches used to minimize costs while maximizing options for patients.

[CONCLUSION] APAC Advanced Prostate Cancer Symposia are important forums for discussing APAC-specific considerations in areas where clinical evidence is evolving. In an era of increasingly sophisticated technologies, discussions highlight the importance of not losing sight of patient and clinical factors in decision-making. Multidisciplinary and personalized management is critical, along with the need for locally relevant data to inform APAC-specific guidelines.