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

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dc.contributor.authorBjartell, Anders
dc.contributor.authorCosta, Luis
dc.contributor.authorKramer, Gero
dc.contributor.authorZurawski, Bogdan
dc.contributor.authorGalli, Luca
dc.contributor.authorWerbrouck, Patrick
dc.contributor.authorEcke, Thorsten
dc.date.accessioned2024-06-12T10:50:14Z
dc.date.available2024-06-12T10:50:14Z
dc.date.issued2022
dc.departmentTrakya Üniversitesien_US
dc.description.abstractBackground: Prostate cancer has a multifaceted treatment pattern. Evidence is lacking for optimal treatment sequences for metastatic castration-resistant pros-tate 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 analy-sis 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, qual-ity 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 treat-ment 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 perfor-mance status. The benefit to patients from these observations remains unknown.(c) 2022 The Authors. Published by Elsevier B.V. on behalf of European Association of Urology. This is an open access article under the CC BY license (http://creativecommons. org/licenses/by/4.0/).en_US
dc.description.sponsorshipJanssen EMEAen_US
dc.description.sponsorshipThis study was funded by Janssen EMEA. Janssen EMEA contributed to the study design; collection, analysis, and interpretation of data; writing of the report; and decision to submit the paper for publication.en_US
dc.identifier.doi10.1016/j.euros.2022.08.018
dc.identifier.endpage22en_US
dc.identifier.issn2666-1691
dc.identifier.issn2666-1683
dc.identifier.pmid36353661en_US
dc.identifier.scopus2-s2.0-85138029038en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpage12en_US
dc.identifier.urihttps://doi.org/10.1016/j.euros.2022.08.018
dc.identifier.urihttps://hdl.handle.net/20.500.14551/17933
dc.identifier.volume45en_US
dc.identifier.wosWOS:000861488500003en_US
dc.identifier.wosqualityQ3en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherElsevieren_US
dc.relation.ispartofEuropean Urology Open Scienceen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectAbiraterone Acetateen_US
dc.subjectAndrogen Deprivation Therapyen_US
dc.subjectAntiandrogenen_US
dc.subjectEnzalutamideen_US
dc.subjectCabazitaxelen_US
dc.subjectCastration-Resistant Prostateen_US
dc.subjectCanceren_US
dc.subjectDocetaxelen_US
dc.subjectRa-223en_US
dc.subjectReal-World Evidenceen_US
dc.subjectMenen_US
dc.titleReal-world Treatment Sequencing in Patients with Metastatic Castration-resistant Prostate Cancer: Results from the Prospective, International, Observational Prostate Cancer Registryen_US
dc.typeArticleen_US

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