Department of Hematology Oncology, University Hospitals Seidman Cancer Center, Cleveland, OH, USA.
Department of Internal Medicine, Adelphi Real World, Bollington, UK.
Oncologist. 2023 Sep 7;28(9):e737-e747. doi: 10.1093/oncolo/oyad046.
There is limited real-world evidence on how increasing use of treatment intensification in metastatic castration-sensitive prostate cancer (mCSPC) has influenced treatment decisions in metastatic castration-resistant prostate cancer (mCRPC). The study objective was to evaluate the impact of novel hormonal therapy (NHT) and docetaxel use in mCSPC on first-line treatment patterns among patients with mCRPC in 5 European countries and the United States (US).
Physician-reported data on patients with mCRPC from the Adelphi Prostate Cancer Disease Specific Program were descriptively analyzed.
A total of 215 physicians provided data on 722 patients with mCRPC. Across 5 European countries and the US, 65% and 75% of patients, respectively, received NHT, and 28% and 9% of patients, respectively, received taxane chemotherapy as first-line mCRPC treatment. In Europe, patients who had received NHT in mCSPC (n = 76) mostly received taxane chemotherapy in mCRPC (55%). Patients who had received taxane chemotherapy, or who did not receive taxane chemotherapy or NHT in mCSPC (n = 98 and 434, respectively) mostly received NHT in mCRPC (62% and 73%, respectively). In the US, patients who had received NHT, taxane chemotherapy, or neither in mCSPC (n = 32, 12, and 72, respectively) mostly received NHT in mCRPC (53%, 83%, and 83%, respectively). Two patients in Europe were rechallenged with the same NHT.
These findings suggest that physicians consider mCSPC treatment history when making first-line treatment decisions in mCRPC. Further studies are needed to better understand optimal treatment sequencing, especially as new treatments emerge.
转移性去势敏感前列腺癌（mCSPC）中强化治疗的应用不断增加，但其对转移性去势抵抗性前列腺癌（mCRPC）的治疗决策有何影响，目前相关的真实世界证据有限。本研究旨在评估 5 个欧洲国家和美国（US）中新型激素治疗（NHT）和多西他赛在 mCSPC 中的应用对 mCRPC 一线治疗模式的影响。
采用 Adelphi 前列腺癌疾病专项研究中的医生报告数据对 mCRPC 患者进行描述性分析。
共有 215 名医生提供了 722 例 mCRPC 患者的数据。在 5 个欧洲国家和 US，分别有 65%和 75%的 mCRPC 患者接受了 NHT，分别有 28%和 9%的 mCRPC 患者接受了紫杉烷类化疗作为一线治疗。在欧洲，mCSPC 中接受过 NHT 的患者（n=76）在 mCRPC 中大多接受了紫杉烷类化疗（55%）。在 mCSPC 中接受过紫杉烷类化疗或未接受紫杉烷类化疗或 NHT 的患者（n=98 和 434）在 mCRPC 中大多接受了 NHT（62%和 73%）。在美国，mCSPC 中接受过 NHT、紫杉烷类化疗或两者均未接受的患者（n=32、12 和 72）在 mCRPC 中大多接受了 NHT（53%、83%和 83%）。欧洲有 2 例患者接受了同种 NHT 的再次治疗。
这些发现表明，医生在制定 mCRPC 的一线治疗决策时会考虑 mCSPC 的治疗史。需要进一步的研究来更好地了解最佳治疗顺序，特别是随着新治疗方法的出现。
