Karmanos Cancer Institute and Department of Oncology, Wayne State University School of Medicine, Detroit, MI.
Karmanos Cancer Institute and Department of Oncology, Wayne State University School of Medicine, Detroit, MI.
Clin Genitourin Cancer. 2022 Dec;20(6):524-532. doi: 10.1016/j.clgc.2022.06.017. Epub 2022 Jun 28.
Patients with mCSPC experience a longer overall survival with treatment intensification by addition of novel hormonal therapy (NHT) or docetaxel to androgen deprivation vs androgen deprivation alone. Real-world data report, however, that nearly half of mCSPC patients do not receive treatment intensification. In this study, treatment patterns and utilization of treatment intensification in mCSPC patients were described using the IQVIA Anonymized Patient Longitudinal Data, a dataset of fully adjudicated pharmacy and medical claims.
Reports on first line (1L) treatment patterns were obtained for years 2015 to 2021. Medicaid, Medicare, Medicare part D, cash transactions, and commercial data were included for years 2012 to 2021.
Nationwide, of 66,844 men with newly diagnosed mCSPC since 2015, on average 25% were prescribed NHT, and another 12% were prescribed chemotherapy. No differences were noted in treatment patterns based on U.S. regions and/or rural vs. urban communities. The disparity was observed in prescribing patterns between oncology and urology providers. Oncology providers prescribed 1L NHT on average 32% of the time, while urology providers did so 12% of the time. Furthermore, oncology providers prescribed chemotherapy on average 20% of the time, resulting in 52% of men with mCSPC receiving treatment intensification as 1L therapy. Patients' age group, community or health insurance did not account for the disparity between the 2 specialties.
Both medical oncology and urology providers need to improve their treatment intensification efforts for men with mCSPC to increase their patients' overall survival.
与单独去势治疗相比，新型激素治疗（NHT）或多西他赛联合去势治疗可延长 mCSPC 患者的总生存期。然而，真实世界的数据报告显示，近一半的 mCSPC 患者未接受强化治疗。本研究使用 IQVIA 匿名患者纵向数据（一个经过充分裁决的药房和医疗索赔数据集）描述了 mCSPC 患者的治疗模式和强化治疗的使用情况。
获得了 2015 年至 2021 年一线（1L）治疗模式的报告。2012 年至 2021 年，包括医疗补助、医疗保险、医疗保险 D 部分、现金交易和商业数据。
在全国范围内，自 2015 年以来，有 66844 名新诊断为 mCSPC 的男性患者，平均有 25%的患者接受了 NHT 治疗，另有 12%的患者接受了化疗。基于美国各地区以及农村和城市社区，未观察到治疗模式的差异。在肿瘤学和泌尿科医生的处方模式中观察到了这种差异。肿瘤学医生平均 32%的时间开具 1L NHT，而泌尿科医生平均 12%的时间开具 1L NHT。此外，肿瘤学医生平均 20%的时间开具化疗药物，导致 52%的 mCSPC 患者接受了作为一线治疗的强化治疗。患者的年龄组、社区或健康保险并不能解释这两个专业之间的差异。
为了提高 mCSPC 患者的总体生存率，肿瘤学和泌尿科医生都需要加强强化治疗的力度。
