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Open Access Highly Accessed Research article

Treatment patterns and characteristics of European patients with castration-resistant prostate cancer

Cora N Sternberg15*, Edwina S Baskin-Bey2, Mark Watson2, Andrew Worsfold3, Alex Rider3 and Bertrand Tombal4

Author Affiliations

1 San Camillo and Forlanini Hospitals, Rome, Italy

2 Astellas Pharma Europe, Leiden, Netherlands

3 Adelphi Real World, Macclesfield, UK

4 Cliniques universitaires Saint-Luc UCL, Institut de Recherche Clinique, Université catholique de Louvain, Brussels, Belgium

5 Department of Medical Oncology, San Camillo Forlanini Hospital, Padiglione Flajani, 1st floor, Circonvallazione Gianicolense 87, Rome 00152, Italy

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BMC Urology 2013, 13:58  doi:10.1186/1471-2490-13-58

Published: 9 November 2013

Abstract

Background

European treatment guidelines recommend the use of hormonal therapy for the treatment of advanced prostate cancer, including castration-resistant prostate cancer (CRPC), but there is little understanding of how common practices in prostate cancer treatment compare across Europe. The aim of this analysis was to evaluate the management of CRPC patients across five European countries (France, Germany, Italy, Spain and the UK).

Methods

Data were drawn from the Adelphi Real World Prostate Cancer Disease Specific Programme (DSP), a cross-sectional survey of patients undertaken between December 2009 and May 2010. The study is based on physician interviews, physician-completed detailed patient record forms, and a patient-completed questionnaire.

Results

A total of 348 physicians (191 urologists and 157 oncologists) reported on 3477 patients with prostate cancer. Of the 3477 patients, 1405 (40%) were categorised as having CRPC, and 1119 of these had metastatic CRPC. Bone metastases were the most common (78%), followed by liver (37%) and lung (30%). The mean age of CRPC patients was 71 years, 35% were current or ex-smokers and 10% had a family history of prostate cancer. CRPC patients had a mean of 1.8 comorbidities; 66% had hypertension and 32% had diabetes. Most physicians estimated their patients would stop responding to initial hormone therapy after 19–24 months. Overall, addition of an anti-androgen to a luteinising-hormone-releasing hormone (LHRH) agonist was the most commonly prescribed therapy when patients failed initial LHRH agonist therapy, although there were considerable variations between countries. While 72% of physicians in Europe would choose chemotherapy as the next treatment option after diagnosis of CRPC, 31% of this group would initially prescribe this without an LHRH agonist.

Conclusions

Results from this analysis highlight inconsistencies in common hormonal therapy treatment patterns for CRPC and hormonal therapy across the EU.

Keywords:
Castrate-resistant prostate cancer; CRPC; treatment; hormonal therapy; Anti-androgen; LHRH; Chemotherapy; Survey