Patterns of treatment of European patients with CRPC in 2009-10

The full text of an article by Sternberg et al. (originally published in BMC Urology in 2013) has just been published to the Medscape Oncology web site and addresses patterns of treatment of men with castration-resistant prostate cancer (CRPC) in five European nations before wide availability of abiraterone.

We should be cautious about reading too much into this article because, of the 1,214 physicians invited to participate in the survey, only 348 or 31.6 percent actually did so (191 urologists and 157 oncologists), giving information on care of 3,477 patients with prostate cancer in France, Germany, Italy, Spain, and the UK. The data were extracted from a survey actually conducted between December 2009 and May 2010, which also means that the data are somewhat dated.

Sternberg and her colleagues report that their study shows significant inconsistencies in patterns of care among the patients at the time this study was carried out. Specifically:

  • 1,405/3,477 patients (40.4 percent) had CRPC.
  • Among the 1,405 patients with CRPC
    • Average (mean) patient age was 71 years.
    • 35 percent were current or former smokers.
    • 10 percent had a family history of prostate cancer.
    • 66 percent also had hypertension.
    • 32 percent also had diabetes
    • 1,119 (84.7 percent) had metastatic CRPC.
  • The most common types of metastasis reported were to
    • Bone (78 percent)
    • Liver (37 percent)
    • Lung (30 percent).
  • Physicians generally estimated that their patients would stop responding to initial hormone therapy after 19–24 months.
  • Addition of an antiandrogen (e.g., bicalutamide) to an LHRH receptor agonist was the most commonly prescribed therapy when patients failed initial LHRH receptor agonist therapy.
  • 72 percent of these European physicians would choose chemotherapy as the next treatment option after diagnosis of CRPC.
  • About a third of 72 percent of the physicians would initially prescribe chemotherapy without an LHRH agonist.

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