Real-world Treatment Sequencing in Patients with Metastatic Castration-resistant Prostate Cancer: Results from the Prospective, International, Observational Prostate Cancer Registry
Background: Prostate cancer has a multifaceted treatment pattern. Evidence is lacking for optimal treatment sequences for metastatic castration-resistant prostate cancer (mCRPC). Objective: To increase the understanding of real-world treatment pathways and outcomes in patients with mCRPC. Design, se...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-11-01
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| Series: | European Urology Open Science |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666168322008886 |
| _version_ | 1798046458495107072 |
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| author | Anders Bjartell Luis Costa Gero Kramer Bogdan Zurawski Luca Galli Patrick Werbrouck Thorsten Ecke Omi Parikh Mostefa Bennamoun Camilo Garcia Freire Avivit Peer Börje Ljungberg Irfan Cicin Emma Smith Martin Lukac Robert Wapenaar Simon Chowdhury |
| author_facet | Anders Bjartell Luis Costa Gero Kramer Bogdan Zurawski Luca Galli Patrick Werbrouck Thorsten Ecke Omi Parikh Mostefa Bennamoun Camilo Garcia Freire Avivit Peer Börje Ljungberg Irfan Cicin Emma Smith Martin Lukac Robert Wapenaar Simon Chowdhury |
| author_sort | Anders Bjartell |
| collection | DOAJ |
| description | Background: Prostate cancer has a multifaceted treatment pattern. Evidence is lacking for optimal treatment sequences for metastatic castration-resistant prostate cancer (mCRPC). Objective: To increase the understanding of real-world treatment pathways and outcomes in patients with mCRPC. Design, setting, and participants: A prospective, noninterventional, real-world analysis of 3003 patients with mCRPC in the Prostate Cancer Registry (PCR; NCT02236637) from June 14, 2013 to July 9, 2018 was conducted. Intervention: Patients received first- and second-line hormonal treatment and chemotherapy as follows: abiraterone acetate plus prednisone (abiraterone)-docetaxel (ABI-DOCE), abiraterone-enzalutamide (ABI-ENZA), abiraterone–radium-223 (ABI-RAD), docetaxel-abiraterone (DOCE-ABI), docetaxel-cabazitaxel (DOCE-CABA), docetaxel-enzalutamide (DOCE-ENZA), and enzalutamide-docetaxel (ENZA-DOCE). Outcome measurements and statistical analysis: Baseline patient characteristics, quality of life, mCRPC treatments, and efficacy outcomes (progression and survival) were presented descriptively. Results and limitations: Data from 727 patients were eligible for the analysis (ABI-DOCE n = 178, ABI-ENZA n = 99, ABI-RAD n = 27, DOCE-ABI n = 191, DOCE-CABA n = 74, DOCE-ENZA n = 116, and ENZA-DOCE n = 42). Demographics and disease characteristics among patients between different sequences varied greatly. Most patients who started on abiraterone or enzalutamide stopped therapy because of disease progression. No randomisation to allow treatment/sequence comparisons limited this observational study. Conclusions: The real-world PCR data complement clinical trial data, reflecting more highly selected patient populations than seen in routine clinical practice. Baseline characteristics play a role in mCRPC first-line treatment selection, but other factors, such as treatment availability, have an impact. Efficacy observations are limited and should be interpreted with caution. Patient summary: Baseline characteristics appear to have a role in the first-line treatment selection of metastatic castration-resistant prostate cancer in the real-world setting. First-line abiraterone acetate plus prednisone seems to be the preferred treatment option for older patients and those with lower Gleason scores, first-line docetaxel for younger patients and those with more advanced disease, and first-line enzalutamide for patients with fewer metastases and more favourable performance status. The benefit to patients from these observations remains unknown. |
| first_indexed | 2024-04-11T23:37:57Z |
| format | Article |
| id | doaj.art-653632de34f8429eb4ec99b1a412de53 |
| institution | Directory Open Access Journal |
| issn | 2666-1683 |
| language | English |
| last_indexed | 2024-04-11T23:37:57Z |
| publishDate | 2022-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | European Urology Open Science |
| spelling | doaj.art-653632de34f8429eb4ec99b1a412de532022-12-22T03:56:53ZengElsevierEuropean Urology Open Science2666-16832022-11-01451222Real-world Treatment Sequencing in Patients with Metastatic Castration-resistant Prostate Cancer: Results from the Prospective, International, Observational Prostate Cancer RegistryAnders Bjartell0Luis Costa1Gero Kramer2Bogdan Zurawski3Luca Galli4Patrick Werbrouck5Thorsten Ecke6Omi Parikh7Mostefa Bennamoun8Camilo Garcia Freire9Avivit Peer10Börje Ljungberg11Irfan Cicin12Emma Smith13Martin Lukac14Robert Wapenaar15Simon Chowdhury16Department of Urology, Skåne University Hospital, Lund University, Malmö, Sweden; Corresponding author. Department of Urology, Skåne University Hospital, Lund University, Jan Waldenströmsgata 5, 205 02 Malmö, Sweden. Tel, +4640336398.Oncology Division, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal; Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal; Instituto de Medicina Molecular João Lobo Antunes, Lisbon, PortugalDepartment of Urology, Medical University of Vienna, Vienna, AustriaCentrum Onkologii im. Prof. F. Lukaszczyka w Bydgoszczy, Dzial Onkologii Klinicznej, Ambulatorium Chemioterapii, Bydgoszcz, PolandPisana University Hospital, Pisa, ItalyAZ Groeninge, Kortrijk, BelgiumHelios Klinikum Bad Saarow, Bad Saarow, GermanyRoyal Blackburn Hospital, Blackburn, UKInstitut Mutualiste Montsouris, Paris, FranceHospital Clínico Universitario de Santiago, Servicio de Urología, Santiago de Compostela, SpainRambam Medical Center, Haifa, IsraelDepartment of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, SwedenTrakya University Hospital Medical Oncology Department, Edirne, TurkeyJanssen-Cilag, High Wycombe, UKParexel International Czech Republic sro, on behalf of Janssen Pharmaceutica NV, Beerse, BelgiumJanssen-Cilag BV, Breda, The NetherlandsGuy’s and St Thomas’ NHS Foundation Trust and Sarah Cannon Research Institute, London, UKBackground: Prostate cancer has a multifaceted treatment pattern. Evidence is lacking for optimal treatment sequences for metastatic castration-resistant prostate cancer (mCRPC). Objective: To increase the understanding of real-world treatment pathways and outcomes in patients with mCRPC. Design, setting, and participants: A prospective, noninterventional, real-world analysis of 3003 patients with mCRPC in the Prostate Cancer Registry (PCR; NCT02236637) from June 14, 2013 to July 9, 2018 was conducted. Intervention: Patients received first- and second-line hormonal treatment and chemotherapy as follows: abiraterone acetate plus prednisone (abiraterone)-docetaxel (ABI-DOCE), abiraterone-enzalutamide (ABI-ENZA), abiraterone–radium-223 (ABI-RAD), docetaxel-abiraterone (DOCE-ABI), docetaxel-cabazitaxel (DOCE-CABA), docetaxel-enzalutamide (DOCE-ENZA), and enzalutamide-docetaxel (ENZA-DOCE). Outcome measurements and statistical analysis: Baseline patient characteristics, quality of life, mCRPC treatments, and efficacy outcomes (progression and survival) were presented descriptively. Results and limitations: Data from 727 patients were eligible for the analysis (ABI-DOCE n = 178, ABI-ENZA n = 99, ABI-RAD n = 27, DOCE-ABI n = 191, DOCE-CABA n = 74, DOCE-ENZA n = 116, and ENZA-DOCE n = 42). Demographics and disease characteristics among patients between different sequences varied greatly. Most patients who started on abiraterone or enzalutamide stopped therapy because of disease progression. No randomisation to allow treatment/sequence comparisons limited this observational study. Conclusions: The real-world PCR data complement clinical trial data, reflecting more highly selected patient populations than seen in routine clinical practice. Baseline characteristics play a role in mCRPC first-line treatment selection, but other factors, such as treatment availability, have an impact. Efficacy observations are limited and should be interpreted with caution. Patient summary: Baseline characteristics appear to have a role in the first-line treatment selection of metastatic castration-resistant prostate cancer in the real-world setting. First-line abiraterone acetate plus prednisone seems to be the preferred treatment option for older patients and those with lower Gleason scores, first-line docetaxel for younger patients and those with more advanced disease, and first-line enzalutamide for patients with fewer metastases and more favourable performance status. The benefit to patients from these observations remains unknown.http://www.sciencedirect.com/science/article/pii/S2666168322008886Abiraterone acetateAndrogen deprivation therapyAntiandrogenEnzalutamideCabazitaxelCastration-resistant prostate cancer |
| spellingShingle | Anders Bjartell Luis Costa Gero Kramer Bogdan Zurawski Luca Galli Patrick Werbrouck Thorsten Ecke Omi Parikh Mostefa Bennamoun Camilo Garcia Freire Avivit Peer Börje Ljungberg Irfan Cicin Emma Smith Martin Lukac Robert Wapenaar Simon Chowdhury Real-world Treatment Sequencing in Patients with Metastatic Castration-resistant Prostate Cancer: Results from the Prospective, International, Observational Prostate Cancer Registry European Urology Open Science Abiraterone acetate Androgen deprivation therapy Antiandrogen Enzalutamide Cabazitaxel Castration-resistant prostate cancer |
| title | Real-world Treatment Sequencing in Patients with Metastatic Castration-resistant Prostate Cancer: Results from the Prospective, International, Observational Prostate Cancer Registry |
| title_full | Real-world Treatment Sequencing in Patients with Metastatic Castration-resistant Prostate Cancer: Results from the Prospective, International, Observational Prostate Cancer Registry |
| title_fullStr | Real-world Treatment Sequencing in Patients with Metastatic Castration-resistant Prostate Cancer: Results from the Prospective, International, Observational Prostate Cancer Registry |
| title_full_unstemmed | Real-world Treatment Sequencing in Patients with Metastatic Castration-resistant Prostate Cancer: Results from the Prospective, International, Observational Prostate Cancer Registry |
| title_short | Real-world Treatment Sequencing in Patients with Metastatic Castration-resistant Prostate Cancer: Results from the Prospective, International, Observational Prostate Cancer Registry |
| title_sort | real world treatment sequencing in patients with metastatic castration resistant prostate cancer results from the prospective international observational prostate cancer registry |
| topic | Abiraterone acetate Androgen deprivation therapy Antiandrogen Enzalutamide Cabazitaxel Castration-resistant prostate cancer |
| url | http://www.sciencedirect.com/science/article/pii/S2666168322008886 |
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