OBJECTIVES : To describe patterns of care and treatment outcomes for non-metastatic PCa, either sensitive or resistant to castration, in the United States of America in 2018

METHODS : This survey (CancerMPactÒ) recruited nationwide physicians to answer an online questionnaire about how they treated their patients with non-metastatic PCa. Questions were detailed to cover aspects of the treatment for all stages of the disease. Only board-certified urologists and oncologists with at least five years of clinical practice, and who treated at least 30 PCa patients monthly were included in the study.

RESULTS : The survey comprises responses from ninety-four physicians with an average of 17.5 years of clinical practice, who collectively had treated an average of 4,415 patients with non-metastatic PCa per month in 2018. Around 40% of the patients in stage I were managed with either active surveillance or observation/ no therapy, with that rate dropping to roughly 20%, 8% and 6% in stages II, III and IV(M0), respectively. Intensity modulated radiotherapy was largely favored over other radiotherapy modalities, with rates of used ranging from 60% to 69% depending on disease stage. Abirateron and Enzalutamide combined with Leuprolide were the most common systemic treatment options for non-metastatic hormone-sensitive PCa (nmHSPC) patients with a second recurrence; they also rated among the four top regimens among nmHSPC patients with a first recurrence for all stage subgroups. Over 60% of non-metastatic castration-resistant PCa (nmCRPC) patients received a second-generation hormone as initial therapy. Only 16.5% of nmCRPC patients did not relapse within five years of initial therapy for nmCRPC

CONCLUSIONS

: Despite a fast pace progress of PCa treatment recommendations, we observed great concordance between their most current versions and real-world data treatment patterns reported by US physicians.