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Area of Science:

  • Oncology
  • Prostate Cancer Research
  • Clinical Outcomes

Background:

  • Androgen receptor targeted therapies (ARTs) are preferred for metastatic castration-resistant prostate cancer (mCRPC) over chemotherapy due to similar efficacy and better tolerability.
  • Limited data exist on ART outcomes and end-of-life (EOL) care for mCRPC patients with reduced performance status (PS), defined as ECOG ≥2.

Purpose of the Study:

  • To evaluate overall survival (OS) in mCRPC patients receiving ARTs based on performance status (PS).
  • To describe and compare end-of-life (EOL) outcomes in mCRPC patients treated with ARTs, stratified by PS (ECOG ≥2 vs. 0-1).

Main Methods:

  • Retrospective analysis of 142 mCRPC patients treated with ARTs from 2010-2021.
  • Comparison of baseline characteristics, ART treatment course, OS, and EOL outcomes between patients with ECOG ≥2 and ECOG 0-1.
  • Statistical analysis included Fisher exact tests, Wilcoxon signed-rank tests, and Cox regression for OS.

Main Results:

  • Patients with mCRPC and ECOG ≥2 demonstrated significantly shorter OS when treated with ARTs compared to those with ECOG 0-1.
  • A higher proportion of patients with ECOG ≥2 died in the hospital, indicating potential differences in EOL care settings.

Conclusions:

  • Reduced performance status (PS) is associated with poorer OS in mCRPC patients undergoing ART.
  • Findings underscore the importance of continuous PS assessment and shared decision-making in ART treatment selection.
  • Further research is needed to understand the link between PS and EOL outcomes in this patient population.