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Chiong E, Saad M, Hamid ARA, Ong-Cornel AB, Lojanapiwat B, Pripatnanont C, Serrano D, Songco J, Sin LC, Hakim L, Chua MLK, Nguyen NP, Phuong PC, Patnaik RS, Umbas R, Kanesvaran R. Prostate cancer management in Southeast Asian countries: a survey of clinical practice patterns. Ther Adv Med Oncol 2024; 16:17588359231216582. [PMID: 38249332 PMCID: PMC10798109 DOI: 10.1177/17588359231216582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 07/19/2023] [Indexed: 01/23/2024] Open
Abstract
Background Prostate cancer (PC) has a serious public health impact, and its incidence is rising due to the aging population. There is limited evidence and consensus to guide the management of PC in Southeast Asia (SEA). We present real-world data on clinical practice patterns in SEA for advanced PC care. Method A paper-based survey was used to identify clinical practice patterns and obtain consensus among the panelists. The survey included the demographics of the panelists, the use of clinical guidelines, and clinical practice patterns in the management of advanced PC in SEA. Results Most panelists (81%) voted prostate-specific antigen (PSA) as the most effective test for early PC diagnosis and risk stratification. Nearly 44% of panelists agreed that prostate-specific membrane antigen positron emission tomography-computed tomography imaging for PC diagnostic and staging information aids local and systemic therapy decisions. The majority of the panel preferred abiraterone acetate (67%) or docetaxel (44%) as first-line therapy for symptomatic mCRPC patients. Abiraterone acetate (50%) is preferred over docetaxel as a first-line treatment in metastatic castration-sensitive prostate cancer patients with high-volume disease. However, the panel did not support the use of abiraterone acetate in non-metastatic castration-resistant prostate cancer (nmCRPC) patients. Apalutamide (75%) is the preferred treatment option for patients with nmCRPC. The cost and availability of modern treatments and technologies are important factors influencing therapeutic decisions. All panelists supported the use of generic versions of approved therapies. Conclusion The survey results reflect real-world management of advanced PC in a SEA country. These findings could be used to guide local clinical practices and highlight the financial challenges of modern healthcare.
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Affiliation(s)
- Edmund Chiong
- Department of Urology, National University Hospital, Department of Surgery, National University of Singapore, 5 Lower Kent Ridge Road, Singapore 119074, Singapore
| | - Marniza Saad
- Clinical Oncology Unit, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Agus Rizal A.H. Hamid
- Department of Urology, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital, Indonesia
| | | | - Bannakij Lojanapiwat
- Division of Urology, Department of Surgery, Faculty of Medicine, Chiang Mai University, Muang, Chiang Mai, Thailand
| | | | - Dennis Serrano
- Division of Urology, Department of Surgery, University of the Philippines College of Medicine – Philippines General Hospital, Manila, Philippines
| | - Jaime Songco
- Department of Urology, Cancer Center, Makati Medical Center, Manila, Philippines
| | - Loh Chit Sin
- Department of Urology, Department of Surgery, Gleneagles Hospital, Kuala Lumpur, Malaysia
| | - Lukman Hakim
- Department of Urology, Faculty of Medicine, Airlangga University/Airlangga University Teaching Hospital, Surabaya, East Java, Indonesia
| | - Melvin Lee Kiang Chua
- Division of Radiation Oncology, National Cancer Centre Singapore, Duke-NUS Medical School, Singapore, Singapore
| | | | - Pham Cam Phuong
- The Nuclear Medicine and Oncology Center, Bach Mai Hospital, Hanoi, Vietnam
| | - Ravi Sekhar Patnaik
- Department of Oncology, The Brunei Cancer Centre (TBCC), Pantai Jerudong Specialist Centre, Jerudong, Brunei
| | - Rainy Umbas
- Department of Urology, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital, Indonesia
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Tuffaha H, Edmunds K, Fairbairn D, Roberts MJ, Chambers S, Smith DP, Horvath L, Arora S, Scuffham P. Guidelines for genetic testing in prostate cancer: a scoping review. Prostate Cancer Prostatic Dis 2023:10.1038/s41391-023-00676-0. [PMID: 37202470 DOI: 10.1038/s41391-023-00676-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/11/2023] [Accepted: 04/27/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND Genetic testing, to identify pathogenic or likely pathogenic variants in prostate cancer, is valuable in guiding treatment decisions for men with prostate cancer and to inform cancer prevention and early detection options for their immediate blood relatives. There are various guidelines and consensus statements for genetic testing in prostate cancer. Our aim is to review genetic testing recommendations across current guidelines and consensus statements and the level of evidence supporting those recommendations. METHODS A scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping review (PRISMA-ScR) guidelines. Electronic database searches and manual searches of grey literature, including websites of key organisations were conducted. Using the Population, Concept, Context (PCC) framework, this scoping review included: men with prostate cancer or men at high risk of prostate cancer and their biological families; existing guidelines and consensus statements with supporting evidence for genetic testing of men with prostate cancer from any geographical location worldwide. RESULTS Of the 660 citations identified, 23 guidelines and consensus statements met the inclusion criteria for the scoping review. Based on different levels of evidence about who should be tested and how, a diverse range of recommendations were identified. There was general consensus among the guidelines and consensus statements that men with metastatic disease be offered genetic testing; however, there was less consensus in relation to genetic testing in localised prostate cancer. While there was some consensus in relation to which genes to test, recommendations varied regarding who to test, testing methods and implementation. CONCLUSION While genetic testing in prostate cancer is routinely recommended and numerous guidelines exist, there is still considerable lack of consensus regarding who should be tested and how they should be tested. Further evidence is needed to inform value-based genetic testing strategies for implementation in practice.
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Affiliation(s)
- Haitham Tuffaha
- Centre for the Business and Economics of Health, University of Queensland, Brisbane, QLD, Australia.
| | - Kim Edmunds
- Centre for the Business and Economics of Health, University of Queensland, Brisbane, QLD, Australia
| | - David Fairbairn
- Pathology Queensland, The Royal Brisbane Women's Hospital, Brisbane, QLD, Australia
| | - Matthew J Roberts
- UQ Centre for Clinical Research, University of Queensland, Brisbane, QLD, Australia
- Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Suzanne Chambers
- The Faculty of Health Sciences, Australian Catholic University, Brisbane, NSW, Australia
| | - David P Smith
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, NSW, Australia
| | - Lisa Horvath
- Medical Oncology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
- Clinical Prostate Cancer Group, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Shiksha Arora
- Centre for the Business and Economics of Health, University of Queensland, Brisbane, QLD, Australia
| | - Paul Scuffham
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
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