Treatment Intensification in Metastatic Hormone-Sensitive Prostate Cancer: An Analysis of Real-World Practice Patterns from the CancerLinQ Database.

Autor: Eule CJ; University of Colorado Cancer Center, Division of Medical Oncology, Department of Medicine., Kuna EM; University of Colorado Cancer Center, Population Health Shared Resource., Robin TP; University of Colorado Cancer Center, Department of Radiation Oncology., Gershman B; Beth Israel Deaconess Medical Center, Division of Urologic Surgery., Flaig TW; University of Colorado Cancer Center, Division of Medical Oncology, Department of Medicine., Kim SP; University of Colorado Cancer Center, Department of Surgery, Division of Urology. Electronic address: simon.kim@cuanschutz.edu.
Jazyk: angličtina
Zdroj: Urologic oncology [Urol Oncol] 2024 Dec; Vol. 42 (12), pp. 447.e17-447.e24. Date of Electronic Publication: 2024 Aug 26.
DOI: 10.1016/j.urolonc.2024.07.002
Abstrakt: Background: In metastatic hormone-sensitive prostate cancer (mHSPC), androgen deprivation therapy and standard of care treatment intensification with docetaxel and/or an androgen receptor signaling inhibitor (ARSI) are associated with improved survival outcomes for appropriate patients.
Methods: This retrospective study selected patients with de novo mHSPC diagnosed between 2014 and 2023 from CancerLinQ Discovery®, a United States (US)-based, de-identified clinical database. Patient-level data, including clinical characteristics, treatments, and demographics, were collected from CancerLinQ. Treatment intensification was defined as the use of docetaxel, abiraterone, apalutamide, enzalutamide, or docetaxel plus abiraterone or darolutamide. Patient characteristics and treatment intensification data were analyzed descriptively and using multivariable logistic regression.
Results: Of the 3,684 patients with mHSPC, the overall rate of treatment intensification was 58.4% but increased from 32.5% in 2014 to 67.5% in 2023. A relative decline in docetaxel use was accompanied by an increase in ARSI use. Black patients with mHSPC were less likely to receive treatment identification (OR 0.78, 95% CI 0.64-0.95, P = 0.013). Treatment intensification was also less likely for patients of older age and increased ECOG performance status. Despite increasing treatment intensification for Black patients with mHSPC over time, rates of docetaxel use are disproportionately declining relative to White patients.
Conclusions: Treatment intensification rates are increasing to include the majority of patients with mHSPC. However, treatment disparities exist for Black patients, who are less likely to receive intensification. These findings illustrate the importance of promoting treatment intensification in appropriate patients and addressing racial treatment disparities.
Competing Interests: Declaration of competing interest CJE, EMK, TPR, and SPK have no relevant conflicts of interest to disclose. TWF reports leadership, stock, and other ownership interests in Aurora Oncology; consulting for Seagen and Janssen Oncology; research funding from Novartis, Bavarian Nordic, Dendreon, GTx Janssen Oncology, Medication, Sanofi, Pfizer, Bristol-Myers Squibb, Roche/Genentech, Exelixis, Aragon Pharmaceuticals, Sotio, Tokai Pharmaceuticals, Atrazeneca/MedImmune, Lilly, Astellas Pharma, Agensys, Seagen, La Rocher-Posay, Merck, Seagen, Myovant Sciences, and Criterium; and patents, royalties, and other intellectual property related to 2 patents filed by the University of Colorado related to early-stage bladder cancer treatment and detection (not currently commercialized or in active clinical development).
(Copyright © 2024. Published by Elsevier Inc.)
Databáze: MEDLINE
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