Mp37-05 Real-World Treatment Patterns in Patients With Biochemical Recurrence After Local Therapy for Prostate Cancer

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy I (MP37)1 May 2024MP37-05 REAL-WORLD TREATMENT PATTERNS IN PATIENTS WITH BIOCHEMICAL RECURRENCE AFTER LOCAL THERAPY FOR PROSTATE CANCER Neal D. Shore, Nasreen Khan, Rana R. McKay, Niculae Constantinovici, Guifang Chen, Vlasta Hlebec, Shankar Srinivasan, Zdravko Vassilev, and Daniel E. Spratt Neal D. ShoreNeal D. Shore , Nasreen KhanNasreen Khan , Rana R. McKayRana R. McKay , Niculae ConstantinoviciNiculae Constantinovici , Guifang ChenGuifang Chen , Vlasta HlebecVlasta Hlebec , Shankar SrinivasanShankar Srinivasan , Zdravko VassilevZdravko Vassilev , and Daniel E. SprattDaniel E. Spratt View All Author Informationhttps://doi.org/10.1097/01.JU.0001008948.02935.01.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Despite the frequent success of radical prostatectomy (RP) and radiation therapy (RT), many patients (pts) with prostate cancer (PC) develop biochemical recurrence (BCR), defined as rising prostate-specific antigen (PSA) levels after primary localized therapy. In this study, real-world (RW) treatment (Tx) patterns in BCR pts are described by risk status, defined by PSA doubling time (PSADT). METHODS: This retrospective cohort study used nationally representative Optum© Electronic Medical Records from 1/2010-9/2021. Eligible pts were adults with PC who developed BCR after RP or RT and had ≥6 mo of follow-up data after BCR diagnosis (PSA ≥0.2 ng/mL after RP; PSA ≥ nadir +2 ng/mL after RT). A PSADT of <12 or ≥12 mo was used to define high- or low-risk BCR, respectively; a cutoff at 9 mo was used in a sensitivity analysis. RESULTS: 3,449 BCR pts were included. Median (range) age at BCR was 67 (37-88) y; 84%/12% were White/Black. Median (Q1-Q3) follow-up was 31 (18-51) mo. 29%/41% had high/low-risk BCR; 30% had missing PSADT or undetermined risk status. Tx use was higher in pts with high-risk BCR (RP, 66.2%; RT, 57.9%). For both high- and low-risk BCR after RP, the most common Txs were subsequent RT (high-risk, 38.4%; low-risk, 39.8%), androgen deprivation therapy (ADT) alone (high-risk, 30.2%; low-risk, 23.4%), and ADT+ androgen receptor inhibitors (ARI; high-risk, 18.4%; low-risk, 7.2%; Table 1). In the RT cohort, the most common Txs for both high- and low-risk BCR were ADT alone (high-risk, 25.1%; low-risk, 13.8%), and ADT+ ARI (high-risk, 22.7%; low-risk 10.0%; Table 1). About 1/2 of pts with high-risk BCR received ADT and/or ARI (RP, 52.8%; RT, 54.3%) versus ∼1/3 of low-risk BCR pts (RP, 33.1%; RT, 31.5%). Bicalutamide was the most common ARI in both cohorts. The sensitivity analysis showed similar results. Pts with missing PSADT had a similar profile to high-risk BCR pts. CONCLUSIONS: This RW study evaluated Tx patterns in pts with BCR in PC from a large US database. Even within the high-risk BCR population (PSADT <12 or ≤9 mo in this study), many did not receive any Tx for BCR; of those who did, subsequent RT or ADT alone were most common, followed by ADT+ ARI. The most commonly used ARI was bicalutamide. Pts and caregivers should discuss available Tx options and weigh individual risks and benefits at the first sign of BCR in PC. Source of Funding: Bayer © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e603 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Neal D. Shore More articles by this author Nasreen Khan More articles by this author Rana R. McKay More articles by this author Niculae Constantinovici More articles by this author Guifang Chen More articles by this author Vlasta Hlebec More articles by this author Shankar Srinivasan More articles by this author Zdravko Vassilev More articles by this author Daniel E. Spratt More articles by this author Expand All Advertisement PDF downloadLoading ...