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e13549 Background: The treatment landscape of prostate cancer (PC) is complex, and recent approvals of new agents and regimens further challenge healthcare professionals (HCPs) to select optimal therapy for patients with PC. We sought to identify practice patterns among community HCPs for PC by comparing HCP and key opinion leader (KOL) treatment recommendations using an online decision support tool. Methods: The online decision support tool was developed with 5 KOLs who provided therapy recommendations for 96 patient case scenarios encompassing mHSPC, nmCRPC, and mCRPC based on factors including disease volume and symptoms, comorbidities, previous therapy, and biomarker status. HCPs entered specific patient and disease factors into the tool along with their intended treatment plan and were shown the 5 individual KOL recommendations for the patient case. An analysis of HCP selected therapy compared with KOL recommendations was performed. Results: Between September 2023 and January 2024, 286 patient cases were entered by 100 HCPs. KOL consensus defined as ≥3 in agreement. HCP therapy selection discordance with KOL recommendations was 69% for nmCRPC (n = 64 cases), 42% for mHSPC (n = 125 cases), and 46% for mCRPC (n = 97 cases). The level of discordance was 63% (n = 43 cases) for nmCRPC with a PSADT <10 months and 81% (n = 21 cases) with a PSADT ≥10 months (Table). Regardless of PSADT, selection of therapy for nmCRPC without listed comorbidities was highly discordant 82% (n = 34 cases). In mHSPC, the highest level of discordance was seen in cases with de novo, symptomatic, high-volume disease, and diabetes at 73% (n = 11). Discordance was 54% for de novo mHSPC with symptomatic disease (n = 52 cases). HCP selection of 1L, 2L, or 3L therapy for mCRPC was 44% to 47% discordant with KOL recommendations regardless of prior therapy. Selection of therapy for mCRPC with HRR mutations including BRCA (n = 29) was 48% discordant. Among HCPs who initially selected treatment options that diverged from expert recommendations or were uncertain about therapy selection, 48% (n/N = 75/157) intend to change their therapy selection to align with the experts. Detailed data analysis with KOL recommendations will be presented. Conclusions: This analysis suggests differences in clinical practice between HCPs and KOLs for multiple case scenarios in PC and suggests that use of the decision tool may lead to increased alignment of treatment choices with KOLs. Table: see text
Becker et al. (Wed,) studied this question.