The data was collected from a survey performed between Dec 2009 to May 2010 among urologists and oncologists in France (FR), Germany (DE), Italy (IT), Spain (ES), and the UK concerning the management of CaP patients. They queried the physicians regarding the castration-resistant prostate cancer (CRPC) population and their current treatment regime. Patient characteristics were derived from a patient record form completed by physicians.
A total of 191 urologists (52% from academic institutions) and 157 medical/clinical oncologists completed the survey. They found that 40% (n=1,405) of patients had CRPC and of these 35% (n=487) had metastatic CRPC. CRPC patient characteristics included; mean age of 71 years, 35% were current or ex-smokers and 10% had a family history of CaP. The majority of CRPC patients had 2 co-morbidities; primarily hypertension (64%) and diabetes (33%). Sites of metastasis were bone in 77%, liver in 35%, and lung in 26%. The majority of physicians believed that patients would stop responding to initial hormone therapy between 19-24 months. 58% and 49% of CRPC patients terminated the 1st and 2nd treatment regimen due to disease progression. 85% of physicians considered PSA the most important method to assess disease progression. After failure of initial LHRHa, defined by elevated PSA, 49% of all European physicians opted to change to LHRHa + antiandrogen (AA) or to another LHRHa (20%). A switch from one LHRHa to another LHRHa is common in DE (29%), FR (26%) and IT (24%). In all countries, CRPC patients who required chemotherapy would initially receive this without LHRHa. Data would, however, support the continued use of ADT during chemotherapy. This suggests that there is educational opportunity and need to change this practice pattern.
Presented by Cora N. Sternberg, et al. at the American Urological Association (AUA) Annual Meeting - May 14 - 19, 2011 - Walter E. Washington Convention Center, Washington, DC USA
Reported for UroToday by Christopher P. Evans, MD, FACS, Professor and Chairman, Department of Urology, University of California, Davis, School of Medicine.