The authors obtained MRU data from the LATITUDE trial which consisted consisted of medical utilization other than that mandated by protocol while patients were on treatment. Examples of MRU types included overnight hospitalizations, length of stay (LOS), emergency room (ER) visits, radiotherapy, surgery, imaging, and specialist and general practitioner (GP) visits. Rates by treatment (per 100 person-years) and rate ratios were estimated using zero-inflated Poisson regression. Difference in average LOS between treatment arms was assessed using repeated measures regression.
A total of 1199 patients were evaluated. Statistically significantly lower rates (24% reduction) of hospitalizations were observed with AAP + ADT compared with ADT alone. The most common reasons for hospitalization were bladder/urethral symptoms and infections, lung infections, and musculoskeletal/connective tissue pain. Average LOS per hospitalization episode was similar. Statistically significantly lower rates of imaging (40% reduction) and radiotherapy were also observed for AAP + ADT vs ADT alone. No significant difference could be demonstrated for rates of specialist visits, surgery, ER visits, and GP visits.
Adding AAP to ADT does not increase MRU but actually lowers rates of hospitalization, imaging, and radiotherapy. This likely reflects the more favorable clinical outcomes with AAP + ADT therapy. Clinical trial information: NCT01715285
Presented by: Tracy Li, PhD
Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre @GoldbergHanan at the 2018 American Society of Clinical Oncology Genitourinary (ASCO GU) Cancers Symposium, February 8-10, 2018 - San Francisco, CA