[A QUESTIONNAIRE SURVEYON TREATMENT SELECTION FOR PATIENTS WITH ADVANCED PROSTATE CANCER IN JAPAN]

We conducted a web-based questionnaire survey targeting urologists in Japan on the real-world treatment selection for patients with advanced prostate cancer. The results were stratified by medical institution category and compared with those reported in the Advanced Prostate Cancer Consensus Conference 2024 (APCCC24). The survey included 124 urologists working at cancer centers/university hospitals (n＝48), public hospitals (n＝32), and general hospitals (n＝44). The proportion of respondents who selected triplet therapy for the majority of patients with metastatic hormone-sensitive prostate cancer (mHSPC) was higher among doctors at cancer centers/university hospitals or public hospitals, as was reported in the APCCC24, when compared with that among doctors at general hospitals. There are differences in opinions regarding the discontinuation of systemic therapy after achieving a deep prostate-specific antigen response. For cases which had progressed to metastatic castration-resistant prostate cancer after androgen receptor signaling inhibitor (ARSI) therapy and had mutations in the BRCA2 gene, the most commonly selected first line treatment was combination therapy of a poly ADP-ribose polymerase (PARP) inhibitor and an ARSI among doctors at cancer centers/university hospitals, and PARP inhibitor monotherapy among doctors at public and general hospitals. Opinions vary within the APCCC24 on whether to choose combination therapy or monotherapy. The survey results suggest that treatment selection of Japanese doctors may differ from those of the APCCC24. More extensive surveys are needed for further discussion on the treatment selection for patients with advanced prostate cancer in Japan.