1
|
Fan Y, Guo X, Campobasso D, He Z. Physician preferences for nonmetastatic castration-resistant prostate cancer treatment in China. Front Oncol 2024; 14:1382678. [PMID: 38835395 PMCID: PMC11148332 DOI: 10.3389/fonc.2024.1382678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 04/30/2024] [Indexed: 06/06/2024] Open
Abstract
Introduction The treatment preferences of Chinese physicians who treat nonmetastatic castration-resistant prostate cancer (nmCRPC) and how they weigh the benefits and risks of nmCRPC treatment are still unknown. This study aimed to evaluate Chinese physicians' benefit-risk treatment preferences for nmCRPC and assist in setting nmCRPC treatment goals. Methods A paper-based discrete choice experiment (DCE) survey was administered to 80 nmCRPC-treating physicians. DCE responses were analyzed to produce the preference weight and the relative importance score for each attribute level. The marginal rate of substitution (MRS) was used to quantify the amount of overall survival (OS) physicians were willing to trade for a reduction in treatment-related adverse events (AEs). We further conducted the exploratory analysis, stratifying physicians from 5 perspectives into different subgroups and examining the treatment preferences and OS trade-off in each subgroup. Results In terms of efficacy attributes, physicians placed greater emphasis on OS than time to pain progression. With regard to safety attributes, serious fracture was perceived as the most important AE by physicians, followed by serious fall, cognitive problems, skin rash, and fatigue. In the exploratory analysis, we found generally that physicians with less clinical practice experience and those from more economically developed regions placed more emphasis on AEs and were willing to give up more of their patients' OS to reduce the risk of AEs. Conclusion Physicians from mainland China value the importance of minimizing treatment-related AEs when considering different treatment options for patients with nmCRPC, and they are willing to trade a substantial amount of OS to avoid AEs.
Collapse
Affiliation(s)
- Yu Fan
- Department of Urology, Peking University First Hospital, Beijing, China
- Institute of Urology, Peking University, Beijing, China
- National Urological Cancer Center, Beijing, China
| | - Xuanjun Guo
- Department of Urology, Peking University First Hospital, Beijing, China
- Institute of Urology, Peking University, Beijing, China
- National Urological Cancer Center, Beijing, China
| | - Davide Campobasso
- Division of Urology, Azienda Ospedaliero-Universitaria of Parma, Parma, Italy
- Prostate Cancer Unit, Azienda Ospedaliero-Universitaria of Parma, Parma, Italy
| | - Zhisong He
- Department of Urology, Peking University First Hospital, Beijing, China
- Institute of Urology, Peking University, Beijing, China
- National Urological Cancer Center, Beijing, China
| |
Collapse
|
3
|
Jardim DL, Gonçalves E Silva A, Pompeo ASFL, Sarkis AS, Cardoso APG, Sasse AD, Fay AP, Soares A, Pompeo ACL, Carneiro A, Kann AG, Fogassa C, De Freitas CH, Chade DC, Herchenhorn D, De Almeida DVP, Da Rosa DAR, Wiermann EG, Schutz FAB, Kater FR, De Moura F, Korkes F, Meyer F, De Oliveira FNG, Sabino F, Almeida GL, Avanço G, Guimaraes GC, Lemos GC, Carvalhal GF, Kim H, Morbeck IP, Campagnari JC, Rinck JA, Da Ponte JRT, Da Trindade KM, Atem L, Borges L, Nogueira LM, Batista LTEA, Maia MC, Sadi MV, Rocha MAA, Luz MDA, Smaletz O, Lages PSM, Matuda RMK, Reis RBD, Indio RF, Fernandes RDC, Cavallero SR, Souza VC, Busato W, Alfer W, Maluf F. "Non-metastatic, Castration-resistant Prostate Cancer: Diagnostic and Treatment Recommendations by an Expert Panel from Brazil". Clin Genitourin Cancer 2023; 21:e58-e69. [PMID: 36266221 DOI: 10.1016/j.clgc.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 08/30/2022] [Accepted: 09/06/2022] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Non-metastatic, castration-resistant prostate cancer (nmCRPC) is an important clinical stage of prostate cancer, prior to morbidity and mortality from clinical metastases. In particular, the introduction of novel androgen-receptor signaling inhibitors (ARSi) has changed the therapeutic landscape in nmCRPC. Given recent developments in this field, we update our recommendations for the management of nmCRPC. METHODS A panel of 51 invited medical oncologists and urologists convened in May of 2021 with the aim of discussing and providing recommendations regarding the most relevant issues concerning staging methods, antineoplastic therapy, osteoclast-targeted therapy, and patient follow-up in nmCRPC. Panel members considered the available evidence and their practical experience to address the 73 multiple-choice questions presented. RESULTS Key recommendations and findings include the reliance on prostate-specific antigen doubling time for treatment decisions, the absence of a clear preference between conventional and novel (i.e., positron-emission tomography-based) imaging techniques, the increasing role of ARSis in various settings, the general view that ARSis have similar efficacy. Panelists highlighted the slight preference for darolutamide, when safety is of greater concern, and a continued need to develop high-level evidence to guide the intensity of follow-up in this subset of prostate cancer. DISCUSSION Despite the limitations associated with a consensus panel, the topics addressed are relevant in current practice, and the recommendations can help practicing clinicians to provide state-of-the-art treatment to patients with nmCRPC in Brazil and other countries with similar healthcare settings.
Collapse
Affiliation(s)
- Denis L Jardim
- Hospital Sírio Libanês, Sociedade Beneficente de Senhoras, São Paulo, SP, Brasil
| | | | - Alexandre Saad Fere Lima Pompeo
- Hospital Beneficência Portuguesa, Departamento de Uro-Oncologia, São Paulo, SP, Brasil; Grupo de Uro-Oncologia do Hcor, São Paulo, SP, Brasil
| | - Alvaro Sadek Sarkis
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, SP, Brasil
| | | | | | | | - Andrey Soares
- Hospital Israelita Albert Einstein, Departamento de Oncologia, São Paulo, SP, Brasil; Grupo Oncoclínicas, São Paulo, SP, Brasil; Latin American Cooperative Oncology Group (LACOG), Genitourinary Group
| | | | - Arie Carneiro
- Hospital Israelita Albert Einstein, Departamento de Oncologia, São Paulo, SP, Brasil
| | | | - Camilla Fogassa
- Hospital Israelita Albert Einstein, Departamento de Oncologia, São Paulo, SP, Brasil
| | | | - Daher Cezar Chade
- Instituto do Câncer do Estado de São Paulo da Faculdade de Medicina da USP, São Paulo, SP, Brasil
| | - Daniel Herchenhorn
- Latin American Cooperative Oncology Group (LACOG), Genitourinary Group; Rede D'Or, Rio de Janeiro, RJ, Brasil
| | | | | | | | | | - Fabio Roberto Kater
- Hospital Beneficência Portuguesa, Departamento de Oncologia, São Paulo, SP, Brasil
| | - Fernando De Moura
- Hospital Beneficência Portuguesa, Departamento de Oncologia, São Paulo, SP, Brasil
| | - Fernando Korkes
- Grupo de uro-oncologia da Faculdade de Medicina do ABC, Santo André, SP, Brasil; Hospital Israelita Albert Einstein, Departamento de Urologia, São Paulo, SP, Brasil
| | - Fernando Meyer
- Sociedade Brasileira de Urologia, Curitiba, PR, Brasil; Hospital Universitário Cajuru, Curitiba, PR, Brasil; Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR, Brasil
| | - Fernando Nunes Galvao De Oliveira
- Latin American Cooperative Oncology Group (LACOG), Genitourinary Group; Clínica de Oncologia do Grupo CAM (CLION), Salvador, BA, Brasil
| | - Fernando Sabino
- Latin American Cooperative Oncology Group (LACOG), Genitourinary Group; Hospital Santa Lúcia, Brasília, DF, Brasil; Hospital Universitário de Brasília, Brasília, DF, Brasil
| | | | | | | | | | - Gustavo Franco Carvalhal
- Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brasil; Hospital Moinhos de Vento, Porto Alegre, RS, Brasil
| | - Hanna Kim
- Hospital Beneficência Portuguesa, Departamento de Oncologia, São Paulo, SP, Brasil
| | - Igor Protzner Morbeck
- Hospital Sírio Libanês, Sociedade Beneficente de Senhoras, São Paulo, SP, Brasil; Universidade Católica de Brasília, Brasília, DF, Brasil
| | - Joao Carlos Campagnari
- Hospital Beneficência Portuguesa, Departamento de Oncologia, São Paulo, SP, Brasil; Clínica de Urologia e Nefrologia, São Paulo, SP, Brasil
| | | | | | - Karine Martins Da Trindade
- Latin American Cooperative Oncology Group (LACOG), Genitourinary Group; Rede D'Or, Fortaleza, CE, Brasil
| | | | - Leonardo Borges
- Hospital Israelita Albert Einstein, Departamento de Urologia, São Paulo, SP, Brasil
| | - Lucas Mendes Nogueira
- Hospital das Clínicas da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil
| | | | - Manuel Caitano Maia
- Latin American Cooperative Oncology Group (LACOG), Genitourinary Group; Hospital Porto Dias, Department of Medical Oncology, Belém, Pará, Brasil
| | | | | | - Murilo De Almeida Luz
- Hospital Beneficência Portuguesa, Departamento de Oncologia, São Paulo, SP, Brasil; Hospital Erasto Gaertner, Curitiba, PR, Brasil
| | - Oren Smaletz
- Hospital Israelita Albert Einstein, Departamento de Oncologia, São Paulo, SP, Brasil
| | | | | | | | | | - Roni De Carvalho Fernandes
- Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brasil; Irmandade da Santa Casa de Misericórdia de São Paulo - Hospital Central, São Paulo, SP, Brasil
| | - Sandro Roberto Cavallero
- Centro de Tratamento Oncológico (CTO), Belém, PA, Brasil; Hospital Adventista de Belém (HAB), Belém, PA, Brasil
| | - Vinicius Carrera Souza
- Instituto D'Or de Ensino e Pesquisa, Salvador, BA, Brasil; Rede D'Or, Salvador, BA, Brasil
| | - Wilson Busato
- Universidade do Vale do Itajai (UNIVALI), Itajai, SC, Brasil
| | - Wladimir Alfer
- Hospital Israelita Albert Einstein, Departamento de Urologia, São Paulo, SP, Brasil
| | - Fernando Maluf
- Hospital Beneficência Portuguesa, Departamento de Oncologia, São Paulo, SP, Brasil; Hospital Israelita Albert Einstein, Departamento de Urologia, São Paulo, SP, Brasil.
| |
Collapse
|