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  • Bjartell, AndersLund University,Lunds universitet,Avdelningen för translationell cancerforskning,Institutionen för laboratoriemedicin,Medicinska fakulteten,Urologisk cancerforskning, Malmö,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Division of Translational Cancer Research,Department of Laboratory Medicine,Faculty of Medicine,Urological cancer, Malmö,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Skåne University Hospital (author)

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

  • Article/chapterEnglish2022

Publisher, publication year, extent ...

  • Elsevier,2022
  • electronicrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:umu-199833
  • https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-199833URI
  • https://doi.org/10.1016/j.euros.2022.08.018DOI
  • https://lup.lub.lu.se/record/584e9dd4-9a9d-4af2-8c37-2674f5fe9d16URI

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  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • 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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  • Costa, LuisOncology Division, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal; Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal; Instituto de Medicina Molecular João Lobo Antunes, Lisbon, Portugal,University of Lisbon (author)
  • Kramer, GeroDepartment of Urology, Medical University of Vienna, Vienna, Austria (author)
  • Zurawski, BogdanCentrum Onkologii im. Prof. F. Lukaszczyka w Bydgoszczy, Dzial Onkologii Klinicznej, Ambulatorium Chemioterapii, Bydgoszcz, Poland (author)
  • Galli, LucaPisana University Hospital, Pisa, Italy,University Hospital of Pisa (author)
  • Werbrouck, PatrickAZ Groeninge, Kortrijk, Belgium,Algemeen Ziekenhuis Groeninge (author)
  • Ecke, ThorstenHelios Klinikum Bad Saarow, Bad Saarow, Germany (author)
  • Parikh, OmiRoyal Blackburn Hospital, Blackburn, United Kingdom (author)
  • Bennamoun, MostefaInstitut Mutualiste Montsouris, Paris, France (author)
  • Garcia Freire, CamiloHospital Clínico Universitario de Santiago, Servicio de Urología, Santiago de Compostela, Spain,Complejo Hospitalario Universitario de Santiago (author)
  • Peer, AvivitRambam Medical Center, Haifa, Israel (author)
  • Ljungberg, Börje,Professor,1949-Umeå University,Umeå universitet,Urologi och andrologi(Swepub:umu)bolj0001 (author)
  • Cicin, IrfanTrakya University Hospital, Medical Oncology Department, Edirne, Turkey (author)
  • Smith, EmmaJanssen-Cilag, High Wycombe, United Kingdom (author)
  • Lukac, MartinParexel International Czech Republic sro, on behalf of Janssen Pharmaceutica NV, Beerse, Belgium (author)
  • Wapenaar, RobertJanssen-Cilag BV, Breda, Netherlands (author)
  • Chowdhury, SimonGuy's and St Thomas’ NHS Foundation Trust and Sarah Cannon Research Institute, London, United Kingdom (author)
  • Avdelningen för translationell cancerforskningInstitutionen för laboratoriemedicin (creator_code:org_t)

Related titles

  • In:European Urology Open Science: Elsevier45, s. 12-222666-16912666-1683

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