Chiong Edmund, Saad Marniza, Hamid Agus Rizal A H, Ong-Cornel Annielyn Beryl, Lojanapiwat Bannakij, Pripatnanont Choosak, Serrano Dennis, Songco Jaime, Sin Loh Chit, Hakim Lukman, Chua Melvin Lee Kiang, Nguyen Nguyen Phuc, Phuong Pham Cam, Patnaik Ravi Sekhar, Umbas Rainy, Kanesvaran Ravindran
Department of Urology, National University Hospital, Department of Surgery, National University of Singapore, 5 Lower Kent Ridge Road, Singapore 119074, Singapore.
Clinical Oncology Unit, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
Ther Adv Med Oncol. 2024 Jan 18;16:17588359231216582. doi: 10.1177/17588359231216582. eCollection 2024.
Prostate cancer (PC) has a serious public health impact, and its incidence is rising due to the aging population. There is limited evidence and consensus to guide the management of PC in Southeast Asia (SEA). We present real-world data on clinical practice patterns in SEA for advanced PC care.
A paper-based survey was used to identify clinical practice patterns and obtain consensus among the panelists. The survey included the demographics of the panelists, the use of clinical guidelines, and clinical practice patterns in the management of advanced PC in SEA.
Most panelists (81%) voted prostate-specific antigen (PSA) as the most effective test for early PC diagnosis and risk stratification. Nearly 44% of panelists agreed that prostate-specific membrane antigen positron emission tomography-computed tomography imaging for PC diagnostic and staging information aids local and systemic therapy decisions. The majority of the panel preferred abiraterone acetate (67%) or docetaxel (44%) as first-line therapy for symptomatic mCRPC patients. Abiraterone acetate (50%) is preferred over docetaxel as a first-line treatment in metastatic castration-sensitive prostate cancer patients with high-volume disease. However, the panel did not support the use of abiraterone acetate in non-metastatic castration-resistant prostate cancer (nmCRPC) patients. Apalutamide (75%) is the preferred treatment option for patients with nmCRPC. The cost and availability of modern treatments and technologies are important factors influencing therapeutic decisions. All panelists supported the use of generic versions of approved therapies.
The survey results reflect real-world management of advanced PC in a SEA country. These findings could be used to guide local clinical practices and highlight the financial challenges of modern healthcare.
前列腺癌（PC）对公众健康有严重影响，且由于人口老龄化其发病率正在上升。在东南亚（SEA），指导PC管理的证据和共识有限。我们展示了SEA地区晚期PC护理临床实践模式的真实世界数据。
采用纸质调查问卷来确定临床实践模式并在小组成员中达成共识。该调查包括小组成员的人口统计学信息、临床指南的使用情况以及SEA地区晚期PC管理中的临床实践模式。
大多数小组成员（81%）投票认为前列腺特异性抗原（PSA）是早期PC诊断和风险分层最有效的检测方法。近44%的小组成员一致认为，前列腺特异性膜抗原正电子发射断层扫描 - 计算机断层扫描成像用于PC诊断和分期信息有助于局部和全身治疗决策。大多数小组成员倾向于将醋酸阿比特龙（67%）或多西他赛（44%）作为有症状的mCRPC患者的一线治疗。在高负荷疾病的转移性去势敏感前列腺癌患者中，醋酸阿比特龙（50%）比多西他赛更适合作为一线治疗。然而，该小组不支持在非转移性去势抵抗前列腺癌（nmCRPC）患者中使用醋酸阿比特龙。阿帕鲁胺（75%）是nmCRPC患者的首选治疗方案。现代治疗和技术的成本及可及性是影响治疗决策的重要因素。所有小组成员都支持使用已批准疗法的仿制药。
调查结果反映了SEA一个国家晚期PC的真实世界管理情况。这些发现可用于指导当地临床实践，并突出现代医疗保健的财务挑战。
