A population‐based study of factors associated with systemic treatment in advanced prostate cancer decedents
Abstract Introduction Life‐prolonging therapies (LPTs) are rapidly evolving for the treatment of advanced prostate cancer, although factors associated with real‐world uptake are not well characterized. Methods In this cohort of prostate‐cancer decedents, we analyzed factors associated with LPT acces...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-03-01
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| Series: | Cancer Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/cam4.5401 |
| _version_ | 1827986489221316608 |
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| author | Jennifer Leigh Danial Qureshi Ewa Sucha Roshanak Mahdavi Igal Kushnir Luke T. Lavallée Dominick Bosse Colleen Webber Peter Tanuseputro Michael Ong |
| author_facet | Jennifer Leigh Danial Qureshi Ewa Sucha Roshanak Mahdavi Igal Kushnir Luke T. Lavallée Dominick Bosse Colleen Webber Peter Tanuseputro Michael Ong |
| author_sort | Jennifer Leigh |
| collection | DOAJ |
| description | Abstract Introduction Life‐prolonging therapies (LPTs) are rapidly evolving for the treatment of advanced prostate cancer, although factors associated with real‐world uptake are not well characterized. Methods In this cohort of prostate‐cancer decedents, we analyzed factors associated with LPT access. Population‐level databases from Ontario, Canada identified patients 65 years or older with prostate cancer receiving androgen deprivation therapy and who died of prostate cancer between 2013 and 2017. Univariate and multivariable analyses assessed the association between baseline characteristics and receipt of LPT in the 2 years prior to death. Results Of 3575 patients who died of prostate cancer, 40.4% (n = 1443) received LPT, which comprised abiraterone (66.3%), docetaxel (50.3%), enzalutamide (17.2%), radium‐223 (10.0%), and/or cabazitaxel (3.5%). Use of LPT increased by year of death (2013: 22.7%, 2014: 31.8%, 2015: 41.8%, 2016: 49.1%, and 2017: 57.9%, p < 0.0001), driven by uptake of all agents except docetaxel. Adjusted odds of use were higher for patients seen at Regional Cancer Centers (OR: 1.8, 95% CI: 1.5–2.1) and who received prior prostate‐directed therapy (OR: 1.3, 95% CI: 1.0–1.5), but lower with advanced age (≥85: OR: 0.54, 95% CI:0.39–0.75), increased chronic conditions (≥6: OR: 0.62, 95% CI: 0.43–0.92), and long‐term care residency (OR: 0.38, 95% CI: 0.17–0.89). Income, stage at presentation, and distance to the cancer center were not associated with LPT uptake. Conclusion In this cohort of prostate cancer‐decedents, real‐world uptake of novel prostate cancer therapies occurred at substantially higher rates for patients receiving care at Regional Cancer Centers, reinforcing the potential benefits for treatment access for patients referred to specialist centers. |
| first_indexed | 2024-04-09T23:32:11Z |
| format | Article |
| id | doaj.art-bc6ea2bab9004d078643679d45ffd48b |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-04-09T23:32:11Z |
| publishDate | 2023-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-bc6ea2bab9004d078643679d45ffd48b2023-03-21T05:20:40ZengWileyCancer Medicine2045-76342023-03-011255569557910.1002/cam4.5401A population‐based study of factors associated with systemic treatment in advanced prostate cancer decedentsJennifer Leigh0Danial Qureshi1Ewa Sucha2Roshanak Mahdavi3Igal Kushnir4Luke T. Lavallée5Dominick Bosse6Colleen Webber7Peter Tanuseputro8Michael Ong9Department of Medicine University of Ottawa Ottawa Ontario CanadaOttawa Hospital Research Institute Ottawa Ontario CanadaOttawa Hospital Research Institute Ottawa Ontario CanadaICES University of Ottawa, Ottawa Hospital Research Institute Ottawa Ontario CanadaSackler Faculty of Medicine Tel Aviv University Tel Aviv IsraelOttawa Hospital Research Institute Ottawa Ontario CanadaDepartment of Medicine University of Ottawa Ottawa Ontario CanadaOttawa Hospital Research Institute Ottawa Ontario CanadaDepartment of Medicine University of Ottawa Ottawa Ontario CanadaDepartment of Medicine University of Ottawa Ottawa Ontario CanadaAbstract Introduction Life‐prolonging therapies (LPTs) are rapidly evolving for the treatment of advanced prostate cancer, although factors associated with real‐world uptake are not well characterized. Methods In this cohort of prostate‐cancer decedents, we analyzed factors associated with LPT access. Population‐level databases from Ontario, Canada identified patients 65 years or older with prostate cancer receiving androgen deprivation therapy and who died of prostate cancer between 2013 and 2017. Univariate and multivariable analyses assessed the association between baseline characteristics and receipt of LPT in the 2 years prior to death. Results Of 3575 patients who died of prostate cancer, 40.4% (n = 1443) received LPT, which comprised abiraterone (66.3%), docetaxel (50.3%), enzalutamide (17.2%), radium‐223 (10.0%), and/or cabazitaxel (3.5%). Use of LPT increased by year of death (2013: 22.7%, 2014: 31.8%, 2015: 41.8%, 2016: 49.1%, and 2017: 57.9%, p < 0.0001), driven by uptake of all agents except docetaxel. Adjusted odds of use were higher for patients seen at Regional Cancer Centers (OR: 1.8, 95% CI: 1.5–2.1) and who received prior prostate‐directed therapy (OR: 1.3, 95% CI: 1.0–1.5), but lower with advanced age (≥85: OR: 0.54, 95% CI:0.39–0.75), increased chronic conditions (≥6: OR: 0.62, 95% CI: 0.43–0.92), and long‐term care residency (OR: 0.38, 95% CI: 0.17–0.89). Income, stage at presentation, and distance to the cancer center were not associated with LPT uptake. Conclusion In this cohort of prostate cancer‐decedents, real‐world uptake of novel prostate cancer therapies occurred at substantially higher rates for patients receiving care at Regional Cancer Centers, reinforcing the potential benefits for treatment access for patients referred to specialist centers.https://doi.org/10.1002/cam4.5401decedentlife‐prolonging therapyprostate cancerregional cancer center |
| spellingShingle | Jennifer Leigh Danial Qureshi Ewa Sucha Roshanak Mahdavi Igal Kushnir Luke T. Lavallée Dominick Bosse Colleen Webber Peter Tanuseputro Michael Ong A population‐based study of factors associated with systemic treatment in advanced prostate cancer decedents Cancer Medicine decedent life‐prolonging therapy prostate cancer regional cancer center |
| title | A population‐based study of factors associated with systemic treatment in advanced prostate cancer decedents |
| title_full | A population‐based study of factors associated with systemic treatment in advanced prostate cancer decedents |
| title_fullStr | A population‐based study of factors associated with systemic treatment in advanced prostate cancer decedents |
| title_full_unstemmed | A population‐based study of factors associated with systemic treatment in advanced prostate cancer decedents |
| title_short | A population‐based study of factors associated with systemic treatment in advanced prostate cancer decedents |
| title_sort | population based study of factors associated with systemic treatment in advanced prostate cancer decedents |
| topic | decedent life‐prolonging therapy prostate cancer regional cancer center |
| url | https://doi.org/10.1002/cam4.5401 |
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