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英国转移性激素敏感型前列腺癌患者三联疗法临床应用的德尔菲共识改良版。

A modified Delphi consensus regarding the clinical utility of triplet therapy in patients with metastatic hormone-sensitive prostate cancer patients in the UK.

机构信息

Beatson West of Scotland Cancer Centre, Glasgow, UK

University Hospitals Bristol NHS Foundation Trust, Bristol, UK.

出版信息

BMJ Open. 2024 Nov 27;14(11):e090013. doi: 10.1136/bmjopen-2024-090013.

Abstract

OBJECTIVES

This study aimed to determine the clinical utility of the androgen deprivation therapy (ADT)+docetaxel (DOCE)+androgen receptor-targeted agent (ARTA) triplet therapy in patients with metastatic hormone-sensitive prostate cancer (mHSPC) in the UK.

DESIGN

A modified Delphi method. A steering group of eight UK healthcare professionals experienced in prostate cancer care discussed treatment challenges, developing 39 consensus statements across four topics. Agreement with the statements was tested with a broader panel of professionals within this therapeutic area in the UK through an anonymous survey, using a four-point Likert scale. This was distributed by the steering group members and an independent third party. Following the survey, the steering group convened to discuss the results and formulate recommendations.

SETTING

The steering group convened online for discussions. The survey was distributed via email by the clinicians and the independent third party.

PARTICIPANTS

Healthcare professionals involved in the provision of prostate cancer care, working in relevant professional roles (oncology, urology or geriatric consultant, oncology nurse specialist, and hospital pharmacist) within the UK. No patients or members of the public were involved within the study.

INTERVENTIONS

None.

PRIMARY AND SECONDARY OUTCOME MEASURES

Consensus was defined as high (≥75% agreement) and very high (≥90% agreement).

RESULTS

Responses were received from 120 healthcare professionals, including oncologists (n=73), urologists (n=16), geriatricians (n=15), nurse specialists (n=11) and hospital pharmacists (n=5). Consensus was reached for 37 out of 39 (95%) statements, and 27/39 (69%) statements achieved very high agreement ≥90%. Consensus was not reached for 2/39 (5%) statements.

CONCLUSIONS

Based on the consensus observed, the steering group developed a set of recommendations for the clinical utility of ADT+DOCE+ARTA in treating patients with mHSPC in the UK. Following these recommendations enables clinicians to identify appropriate patients with mHSPC for triplet treatment, thereby improving patients' outcomes.

摘要

目的

本研究旨在确定雄激素剥夺疗法(ADT)+多西他赛(DOCE)+雄激素受体靶向药物(ARTA)三联疗法在英国转移性激素敏感前列腺癌(mHSPC)患者中的临床应用价值。

设计

改良 Delphi 法。一个由 8 名具有前列腺癌治疗经验的英国医疗保健专业人员组成的指导小组讨论了治疗挑战,围绕四个主题制定了 39 项共识声明。通过对英国该治疗领域更广泛的专业人员进行匿名调查,使用 4 分李克特量表来测试他们对这些声明的认同度。该调查由指导小组成员和独立第三方分发。调查结束后,指导小组召开会议讨论结果并制定建议。

设置

指导小组在线讨论。调查由临床医生和独立第三方通过电子邮件分发。

参与者

参与前列腺癌治疗的医疗保健专业人员,在英国从事相关专业角色(肿瘤学、泌尿科或老年病学顾问、肿瘤学护士专家和医院药剂师)。研究中没有涉及患者或公众成员。

干预措施

无。

主要和次要结果

共识定义为高(≥75%的一致性)和非常高(≥90%的一致性)。

结果

共收到 120 名医疗保健专业人员的回复,其中肿瘤学家(n=73)、泌尿科医生(n=16)、老年病学家(n=15)、护士专家(n=11)和医院药剂师(n=5)。39 项声明中的 37 项(95%)达成了共识,27/39 项(69%)声明达到了非常高的共识≥90%。有 2/39 项(5%)声明未达成共识。

结论

基于观察到的共识,指导小组为 ADT+DOCE+ARTA 在英国治疗 mHSPC 患者的临床应用制定了一套建议。遵循这些建议可以使临床医生识别出适合接受三联治疗的 mHSPC 患者,从而改善患者的治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/903c/11603693/3759f30bcd4f/bmjopen-14-11-g001.jpg

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