Helissey Carole, Maillet Denis, Narciso Bérengère, Berdah Jean-François, Ouzaid Idir, Hilgers Werner, Fiard Gaëlle, Dubergé Thomas, Jovenin Nicolas, Topart Delphine, Beauval Jean-Baptiste, Bergeron Mathias, Roubaud Guilhem
Clinical Research Unit, Military Hospital Begin, Saint-Mandé, France.
Department of Medical Oncology, Civil Hospitals of Lyon-Lyon South Hospital, Lyon, France.
Fr J Urol. 2024 Jul;34(7-8):102661. doi: 10.1016/j.fjurol.2024.102661. Epub 2024 May 31.
While androgen deprivation therapy (ADT) has been the standard of care for patients with metastatic castration-sensitive prostate cancer (mCSPC), recent strategies like intensification of systemic treatment (Rozet et al., 2020) (i.e. adding another treatment to ADT) and radiotherapy have improved overall survival. PROFILE, a national retrospective multicentric real-world study, involved patients with mCSPC recruited by medical oncologists, urologists, and radiation oncologists, and who started treatment between November 2020 and May 2021. Patients by sites were included consecutively. Data were collected from medical records. Primary objectives were to: (1) describe retrospectively the characteristics of whole population of patients with mCSPC as well as subgroups defined by prognostic factors in France at diagnosis; (2) identify current practices for managing mCSPC in a real-life clinical setting. Among the 416 patients with mCSPC included in the PROFILE study, 315 (76%) were synchronous (metastasis at the initial diagnosis) and 101 (24%) were metachronous patients (metastasis diagnosed post-progression). A majority (83% of synchronous and 73% of metachronous patients) received an intensified systemic treatment (ADT plus ARSI [androgen-receptor signaling inhibitors]±chemotherapy±primary tumour radiotherapy±metastasis-directed therapy [MDT]), while only 40% of low-volume patients received prostate radiotherapy. This study depicts the standardization of new therapeutic strategies for patients with mCSPC in France with most of them receiving an intensified treatment, mainly with ADT+ARSI (64% of synchronous intensified patients and 76% of metachronous intensified patients). Most of patients were assessed using conventional imaging (CT scan and/or bone scan). Overall, PROFILE results are in line with French and European guidelines for diagnosis, management, and follow-up of such patients (Rozet et al., 2020; Cornford et al., 2021).
虽然雄激素剥夺疗法（ADT）一直是转移性去势敏感性前列腺癌（mCSPC）患者的标准治疗方法，但近期的策略，如强化全身治疗（Rozet等人，2020年）（即在ADT基础上加用另一种治疗方法）和放疗，已改善了总生存期。PROFILE是一项全国性回顾性多中心真实世界研究，纳入了由医学肿瘤学家、泌尿科医生和放射肿瘤学家招募的mCSPC患者，这些患者于2020年11月至2021年5月开始接受治疗。按部位连续纳入患者。数据从病历中收集。主要目标是：（1）回顾性描述法国mCSPC患者总体以及诊断时由预后因素定义的亚组的特征；（2）确定现实临床环境中mCSPC的当前管理实践。在PROFILE研究纳入的416例mCSPC患者中，315例（76%）为同时性转移（初始诊断时即有转移），101例（24%）为异时性转移患者（进展后诊断为转移）。大多数患者（同时性转移患者的83%和异时性转移患者的73%）接受了强化全身治疗（ADT加雄激素受体信号抑制剂[ARSI]±化疗±原发性肿瘤放疗±转移灶定向治疗[MDT]），而只有40%的低瘤负荷患者接受了前列腺放疗。这项研究描述了法国mCSPC患者新治疗策略的标准化情况，大多数患者接受了强化治疗，主要是ADT+ARSI（同时性转移强化治疗患者的64%和异时性转移强化治疗患者的76%）。大多数患者使用传统成像方法（CT扫描和/或骨扫描）进行评估。总体而言，PROFILE研究结果与法国和欧洲针对此类患者的诊断、管理和随访指南一致（Rozet等人，2020年；Cornford等人，2021年）。
