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Real-world Treatment Sequencing in Patients with Metastatic Castration-resistant Prostate Cancer: Results from the Prospective, International, Observational Prostate Cancer Registry

BACKGROUND: Prostate cancer has a multifaceted treatment pattern. Evidence is lacking for optimal treatment sequences for metastatic castration-resistant prostate cancer (mCRPC). OBJECTIVE: To increase the understanding of real-world treatment pathways and outcomes in patients with mCRPC. DESIGN, SE...

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Autores principales: Bjartell, Anders, Costa, Luis, Kramer, Gero, Zurawski, Bogdan, Galli, Luca, Werbrouck, Patrick, Ecke, Thorsten, Parikh, Omi, Bennamoun, Mostefa, Garcia Freire, Camilo, Peer, Avivit, Ljungberg, Börje, Cicin, Irfan, Smith, Emma, Lukac, Martin, Wapenaar, Robert, Chowdhury, Simon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9637537/
https://www.ncbi.nlm.nih.gov/pubmed/36353661
http://dx.doi.org/10.1016/j.euros.2022.08.018
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author Bjartell, Anders
Costa, Luis
Kramer, Gero
Zurawski, Bogdan
Galli, Luca
Werbrouck, Patrick
Ecke, Thorsten
Parikh, Omi
Bennamoun, Mostefa
Garcia Freire, Camilo
Peer, Avivit
Ljungberg, Börje
Cicin, Irfan
Smith, Emma
Lukac, Martin
Wapenaar, Robert
Chowdhury, Simon
author_facet Bjartell, Anders
Costa, Luis
Kramer, Gero
Zurawski, Bogdan
Galli, Luca
Werbrouck, Patrick
Ecke, Thorsten
Parikh, Omi
Bennamoun, Mostefa
Garcia Freire, Camilo
Peer, Avivit
Ljungberg, Börje
Cicin, Irfan
Smith, Emma
Lukac, Martin
Wapenaar, Robert
Chowdhury, Simon
author_sort Bjartell, Anders
collection PubMed
description BACKGROUND: Prostate cancer has a multifaceted treatment pattern. Evidence is lacking for optimal treatment sequences for metastatic castration-resistant prostate cancer (mCRPC). OBJECTIVE: To increase the understanding of real-world treatment pathways and outcomes in patients with mCRPC. DESIGN, SETTING, AND PARTICIPANTS: A prospective, noninterventional, real-world analysis of 3003 patients with mCRPC in the Prostate Cancer Registry (PCR; NCT02236637) from June 14, 2013 to July 9, 2018 was conducted. INTERVENTION: Patients received first- and second-line hormonal treatment and chemotherapy as follows: abiraterone acetate plus prednisone (abiraterone)-docetaxel (ABI-DOCE), abiraterone-enzalutamide (ABI-ENZA), abiraterone–radium-223 (ABI-RAD), docetaxel-abiraterone (DOCE-ABI), docetaxel-cabazitaxel (DOCE-CABA), docetaxel-enzalutamide (DOCE-ENZA), and enzalutamide-docetaxel (ENZA-DOCE). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Baseline patient characteristics, quality of life, mCRPC treatments, and efficacy outcomes (progression and survival) were presented descriptively. RESULTS AND LIMITATIONS: Data from 727 patients were eligible for the analysis (ABI-DOCE n = 178, ABI-ENZA n = 99, ABI-RAD n = 27, DOCE-ABI n = 191, DOCE-CABA n = 74, DOCE-ENZA n = 116, and ENZA-DOCE n = 42). Demographics and disease characteristics among patients between different sequences varied greatly. Most patients who started on abiraterone or enzalutamide stopped therapy because of disease progression. No randomisation to allow treatment/sequence comparisons limited this observational study. CONCLUSIONS: The real-world PCR data complement clinical trial data, reflecting more highly selected patient populations than seen in routine clinical practice. Baseline characteristics play a role in mCRPC first-line treatment selection, but other factors, such as treatment availability, have an impact. Efficacy observations are limited and should be interpreted with caution. PATIENT SUMMARY: Baseline characteristics appear to have a role in the first-line treatment selection of metastatic castration-resistant prostate cancer in the real-world setting. First-line abiraterone acetate plus prednisone seems to be the preferred treatment option for older patients and those with lower Gleason scores, first-line docetaxel for younger patients and those with more advanced disease, and first-line enzalutamide for patients with fewer metastases and more favourable performance status. The benefit to patients from these observations remains unknown.
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spelling pubmed-96375372022-11-08 Real-world Treatment Sequencing in Patients with Metastatic Castration-resistant Prostate Cancer: Results from the Prospective, International, Observational Prostate Cancer Registry Bjartell, Anders Costa, Luis Kramer, Gero Zurawski, Bogdan Galli, Luca Werbrouck, Patrick Ecke, Thorsten Parikh, Omi Bennamoun, Mostefa Garcia Freire, Camilo Peer, Avivit Ljungberg, Börje Cicin, Irfan Smith, Emma Lukac, Martin Wapenaar, Robert Chowdhury, Simon Eur Urol Open Sci Prostate Cancer BACKGROUND: Prostate cancer has a multifaceted treatment pattern. Evidence is lacking for optimal treatment sequences for metastatic castration-resistant prostate cancer (mCRPC). OBJECTIVE: To increase the understanding of real-world treatment pathways and outcomes in patients with mCRPC. DESIGN, SETTING, AND PARTICIPANTS: A prospective, noninterventional, real-world analysis of 3003 patients with mCRPC in the Prostate Cancer Registry (PCR; NCT02236637) from June 14, 2013 to July 9, 2018 was conducted. INTERVENTION: Patients received first- and second-line hormonal treatment and chemotherapy as follows: abiraterone acetate plus prednisone (abiraterone)-docetaxel (ABI-DOCE), abiraterone-enzalutamide (ABI-ENZA), abiraterone–radium-223 (ABI-RAD), docetaxel-abiraterone (DOCE-ABI), docetaxel-cabazitaxel (DOCE-CABA), docetaxel-enzalutamide (DOCE-ENZA), and enzalutamide-docetaxel (ENZA-DOCE). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Baseline patient characteristics, quality of life, mCRPC treatments, and efficacy outcomes (progression and survival) were presented descriptively. RESULTS AND LIMITATIONS: Data from 727 patients were eligible for the analysis (ABI-DOCE n = 178, ABI-ENZA n = 99, ABI-RAD n = 27, DOCE-ABI n = 191, DOCE-CABA n = 74, DOCE-ENZA n = 116, and ENZA-DOCE n = 42). Demographics and disease characteristics among patients between different sequences varied greatly. Most patients who started on abiraterone or enzalutamide stopped therapy because of disease progression. No randomisation to allow treatment/sequence comparisons limited this observational study. CONCLUSIONS: The real-world PCR data complement clinical trial data, reflecting more highly selected patient populations than seen in routine clinical practice. Baseline characteristics play a role in mCRPC first-line treatment selection, but other factors, such as treatment availability, have an impact. Efficacy observations are limited and should be interpreted with caution. PATIENT SUMMARY: Baseline characteristics appear to have a role in the first-line treatment selection of metastatic castration-resistant prostate cancer in the real-world setting. First-line abiraterone acetate plus prednisone seems to be the preferred treatment option for older patients and those with lower Gleason scores, first-line docetaxel for younger patients and those with more advanced disease, and first-line enzalutamide for patients with fewer metastases and more favourable performance status. The benefit to patients from these observations remains unknown. Elsevier 2022-09-17 /pmc/articles/PMC9637537/ /pubmed/36353661 http://dx.doi.org/10.1016/j.euros.2022.08.018 Text en © 2022 The Authors https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Prostate Cancer
Bjartell, Anders
Costa, Luis
Kramer, Gero
Zurawski, Bogdan
Galli, Luca
Werbrouck, Patrick
Ecke, Thorsten
Parikh, Omi
Bennamoun, Mostefa
Garcia Freire, Camilo
Peer, Avivit
Ljungberg, Börje
Cicin, Irfan
Smith, Emma
Lukac, Martin
Wapenaar, Robert
Chowdhury, Simon
Real-world Treatment Sequencing in Patients with Metastatic Castration-resistant Prostate Cancer: Results from the Prospective, International, Observational Prostate Cancer Registry
title Real-world Treatment Sequencing in Patients with Metastatic Castration-resistant Prostate Cancer: Results from the Prospective, International, Observational Prostate Cancer Registry
title_full Real-world Treatment Sequencing in Patients with Metastatic Castration-resistant Prostate Cancer: Results from the Prospective, International, Observational Prostate Cancer Registry
title_fullStr Real-world Treatment Sequencing in Patients with Metastatic Castration-resistant Prostate Cancer: Results from the Prospective, International, Observational Prostate Cancer Registry
title_full_unstemmed Real-world Treatment Sequencing in Patients with Metastatic Castration-resistant Prostate Cancer: Results from the Prospective, International, Observational Prostate Cancer Registry
title_short Real-world Treatment Sequencing in Patients with Metastatic Castration-resistant Prostate Cancer: Results from the Prospective, International, Observational Prostate Cancer Registry
title_sort real-world treatment sequencing in patients with metastatic castration-resistant prostate cancer: results from the prospective, international, observational prostate cancer registry
topic Prostate Cancer
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9637537/
https://www.ncbi.nlm.nih.gov/pubmed/36353661
http://dx.doi.org/10.1016/j.euros.2022.08.018
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