Docetaxel has emerged as a standard-of-care for metastatic hormone-sensitive prostate cancer (mHSPC). Uptake of docetaxel for mHSPC in Australia has not previously been reported.
i) To investigate the real-world uptake of docetaxel in mHSPC; and ii) To identify predictors of utilisation of Docetaxel in mHSPC.
Men diagnosed from June 2014 to December 2018 and enrolled in the Prostate Cancer Outcomes Registry-Victoria (PCOR-Vic) were included. Data collected includes demographics, diagnosis method and institution, staging investigations, and treatments within 12 months of diagnosis. Wilcoxon rank-sum, chi-square and trend tests were used to identify predictors of docetaxel utilisation. All predictors were entered as covariates simultaneously into a multivariable logistic regression model. Statistical significance was set at 0.05 (two-sided).
1014 men with mHSPC were analysed, 25% of whom received docetaxel with androgen deprivation therapy (ADT). Uptake of docetaxel increased from 20% in 2014 to 33% in 2018. Predictors of higher usage of docetaxel were younger age and treatment in a private hospital, with both remaining significant on multivariable analysis. Notably, the proportion of men under 70 receiving docetaxel increased from 54% in 2014-15 to 64% in 2016-18, while in men aged 70 and over the comparative figures were 15% and 22% respectively.
Although docetaxel was not used in a majority of cases, there was a clear increase in docetaxel uptake especially in younger men following publication of the CHAARTED and STAMPEDE trials. Identifying barriers to real-world implementation of pivotal clinical trial data is critical to improving outcomes in mHSPC. This article is protected by copyright. All rights reserved.
Internal medicine journal. 2021 Mar 12 [Epub ahead of print]
Arun A Azad, Ben Tran, Ian D Davis, Phillip Parente, Melanie Evans, Shirley Wong, Stephen Brown, Sue Evans, Jeremy Millar, Declan G Murphy, Nathan Papa
Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia., Medical Oncology Unit, Eastern Health, Melbourne, Australia., School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia., Cancer Services, Western Health, Melbourne, Australia., Medical Oncology, Ballarat Regional Integrated Cancer Centre, Ballarat, Australia., Victorian Cancer Registry, Cancer Council Victoria, Melbourne, Australia., Alfred Health Radiation Oncology, Alfred Hospital, Melbourne, Australia., Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia.