Adelphi Real World, Bollington, UK.
Merck & Co., Inc., Kenilworth, NJ, USA.
Adv Ther. 2022 May;39(5):2236-2255. doi: 10.1007/s12325-022-02073-w. Epub 2022 Mar 22.
Prostate cancer (PC) is the second most common cancer, and the fifth most common cause of cancer-related mortality among male patients, worldwide. In Europe and Japan, the incidence of PC in men in 2020 exceeded that of lung cancer. Although national and regional clinical guidelines for the treatment of metastatic castration-resistant prostate cancer (mCRPC) are available in Europe and Japan, a literature review did not identify a published comparison of differing guidelines, but identified a lack of studies reporting treatment patterns of approved mCRPC treatments in Europe and Japan in normal clinical practice. The objective of this real-world study was to compare national treatment guidelines and real-world treatment for mCRPC in Europe and Japan.
Physician-reported demographics, clinical characteristics, and treatment data of patients with mCRPC were drawn from the Adelphi Prostate Cancer Disease Specific Programme™, conducted in five European countries and Japan (2020) and analysed descriptively.
All current treatment guidelines recommended the use of novel hormonal agents (NHA-abiraterone/enzalutamide) and chemotherapy (mainly docetaxel), with some intercountry differences, with NHA rechallenge accepted in Germany, Italy and Japan, but not in France, Spain or the United Kingdom. Overall, 271 physicians provided data for 1753 patients. At 1st-line (1L), the most common treatment was NHAs followed by (→) chemotherapy, in all countries. Chemotherapy was the most common 2nd-line (2L) treatment, except in Japan, where 2L NHA use was preferred, and Spain, where both were used equally. NHA → chemotherapy and chemotherapy → NHA were the first and second usual 1L → 2L sequence in most countries, except for France, where the second most common sequence was NHA → NHA, and Japan, with androgen deprivation therapy alone → NHA.
Real-world mCRPC treatment patterns largely reflected national guidelines. It is expected that guidelines and treatment patterns will change with the development of new treatment options.
前列腺癌（PC）是全球范围内第二大常见癌症，也是男性癌症相关死亡的第五大常见原因。在欧洲和日本，2020 年男性 PC 的发病率超过了肺癌。尽管欧洲和日本都有治疗转移性去势抵抗性前列腺癌（mCRPC）的国家和地区临床指南，但文献回顾并未发现已发表的不同指南比较，仅发现缺乏报告欧洲和日本真实临床实践中批准的 mCRPC 治疗方法治疗模式的研究。本真实世界研究旨在比较欧洲和日本的国家 mCRPC 治疗指南和真实世界治疗方法。
从 Adelphi 前列腺癌疾病专项计划中获取了 mCRPC 患者的医生报告人口统计学、临床特征和治疗数据，该计划于 2020 年在五个欧洲国家和日本进行，并进行了描述性分析。
所有现行治疗指南都建议使用新型激素药物（NHA-阿比特龙/恩扎鲁胺）和化疗（主要是多西他赛），各国之间存在一些差异，德国、意大利和日本接受 NHA 再挑战，但法国、西班牙和英国不接受。总体而言，271 名医生为 1753 名患者提供了数据。在一线（1L）治疗中，所有国家最常见的治疗方法是 NHA，其次是化疗。化疗是最常见的二线（2L）治疗方法，但在日本，二线 NHA 治疗更受欢迎，而在西班牙，两者的使用率相当。在大多数国家，NHA→化疗和化疗→NHA 是最常见的一线→二线治疗顺序，除了法国，二线最常见的治疗顺序是 NHA→NHA，以及日本，单独使用雄激素剥夺疗法→NHA。
真实世界 mCRPC 的治疗模式在很大程度上反映了国家指南。预计随着新治疗方案的发展，指南和治疗模式将发生变化。
