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Published on: March 6, 2018
Real-World Treatment Patterns in Patients With Metastatic Castration-Resistant Prostate Cancer in Greece: The
M Liontos1, E Bournakis2, A Bournakis2
1Department of Clinical Therapeutics, Alexandra Hospital National and Kapodistrian University of Athens, Athens, Greece.
Introduction:
Real-world data on management of metastatic castration resistant prostate cancer (mCRPC) with novel therapies is sparse. The aim of this study was to capture real-world management strategies in patients with mCRPC who initiated first line (1L) systemic therapy with chemotherapy or novel hormonal agents (NHAs) in Greece and describe the therapeutic sequencing strategy among patients who advanced to 2L and 3L treatment.
Patients And Methods:
In this noninterventional, multicentre, retrospective study (PROSPECT), a medical chart review of 149 patients with mCRPC who initiated 1L systemic therapy with chemotherapy or NHAs in 7 major anticancer hospital clinics, from public, academic, and private sectors in Greece was conducted. All endpoints were descriptively analysed. Kaplan-Meier was used for time-to-event outcomes.
Results:
At 1L (N = 149), most (78.5%) patients received NHAs; enzalutamide (52.3%), and abiraterone (26.2%). At 2L (N = 68), most (72.1%) patients received chemotherapy, most frequently docetaxel (50.0% of all patients). At 3L (N = 32), 56.3% and 31.3% of patients received chemotherapy and NHAs, respectively. Regarding treatment sequencing from 1L→2L (N = 68), most patients (55.9%) advanced from NHA→chemotherapy. Regarding treatment sequencing from 1L→2L→3L (N = 32), 34.4% advanced from NHAs→chemotherapy→chemotherapy and 31.3% from NHAs→chemotherapy→NHA. Estimated median times spent on treatment at 1L, 2L, and 3L were 9.8, 4.4, and 3.7 months, respectively.
Conclusion:
Most patients were treated with 1L NHAs, in accordance to established guidelines (which suggest both NHA and chemo as preferred 1st line options). There appeared to be a longer time on treatment of NHAs at 1L than chemotherapy, suggesting an unmet need for treatment optimisation/recommendations for 2L and 3L treatment in mCRPC.
Insights
Real-world data shows most metastatic castration-resistant prostate cancer (mCRPC) patients start with novel hormonal agents (NHAs). Sequencing to later lines often involves chemotherapy, indicating a need for optimized treatment strategies in mCRPC management.
Area of Science:
- Oncology
- Pharmacology
Background:
- Limited real-world data exists for managing metastatic castration-resistant prostate cancer (mCRPC) with novel therapies.
- Understanding treatment patterns is crucial for optimizing patient care.
Purpose of the Study:
- To analyze real-world management strategies for mCRPC patients initiating first-line (1L) therapy in Greece.
- To describe therapeutic sequencing from 1L to second-line (2L) and third-line (3L) treatments.
Main Methods:
- A retrospective, noninterventional study (PROSPECT) reviewed charts of 149 mCRPC patients.
- Data was collected from 7 major Greek anticancer hospital clinics.
- Descriptive analysis and Kaplan-Meier methods were used.
Main Results:
- Most patients (78.5%) received novel hormonal agents (NHAs) in 1L, primarily enzalutamide and abiraterone.
- In 2L, chemotherapy (docetaxel) was most common (72.1%).
- Treatment sequencing from 1L to 2L predominantly involved NHA to chemotherapy (55.9%). Median treatment durations were 9.8 months (1L), 4.4 months (2L), and 3.7 months (3L).
Conclusions:
- First-line NHA use aligns with guidelines for mCRPC.
- Longer treatment duration with 1L NHAs suggests potential for improved 2L and 3L treatment optimization.
- Further research is needed to refine sequential treatment recommendations for mCRPC.
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