A retrospective observational study assessing bone metastases (mets) detection and management of patients (pts) with castration-resistant prostate cancer (CRPC) in Canada.

Authors

Fred Saad

Fred Saad

Centre Hospitalier de l’Université de Montréal, Université de Montréal, Montréal, QC, Canada

Fred Saad , Anil Kapoor , Armen G. Aprikian , Richard Casey , Michele Caveen , Maureen Reiner , Brad Gillesby , Antonio Finelli

Organizations

Centre Hospitalier de l’Université de Montréal, Université de Montréal, Montréal, QC, Canada, McMaster Institute of Urology, St Joseph's Healthcare, Hamilton, ON, Canada, Division of Urology, Department of Surgery, McGill University, Montreal, QC, Canada, The Fe/Male Health Centre, Oakville, ON, Canada, Amgen Canada, Inc., Mississauga, ON, Canada, Amgen Inc., Thousand Oaks, CA, Department of Surgery, Division of Urology, University Health Network, Princess Margaret Cancer Center, University of Toronto, Toronto, ON, Canada

Research Funding

Pharmaceutical/Biotech Company

Background: Canadian Urological Association guidelines outline the scheduling of imaging modalities based on prostate-specific antigen doubling time (PSADT) to screen for mets in pts with nonmetastatic (M0) CRPC and to manage pts with metastatic (M1) CRPC. Data describing guideline adoption and real-world timing of bone scans and treatment patterns in Canadian CRPC pts are limited. Methods: A retrospective chart review conducted at 13 Canadian urology practices included pts with CRPC (PSA ≥2 ng/mL despite androgen deprivation therapy) sequentially identified in reverse chronological order starting July 30, 2015. Pts had no mets at CRPC diagnosis (index date). Data were abstracted from the index date to the chart review date. Coprimary objectives were to describe CRPC management in terms of timing of the 1st and repeat bone scans in M0 and treatment patterns when pts became metastatic. Secondary objectives described nonbone imaging. Results: 232 pts enrolled. Over the observation period 109 remained nonmetastatic (M0 cohort); 123 developed mets (M1 cohort). Median index PSADT was ~1.5x greater for the M0 cohort than the M1 cohort. 68 pts (71.6%) in M0 and 117 pts (95.1%) in M1 had ≥1 bone scan. Median (95% CI) months from CRPC diagnosis to 1st bone scan was 7.5 (5.6–9.6) for pts in M1 and 15.7 (10.0–23.0) for pts in M0. Median (95% CI) months from identification of mets to start of treatment for the M1 cohort was 3.2 (2.3–5.7). The most common therapies were abiraterone (55%) and enzalutamide (42%), with respective median (95% CI) durations of 12.7 (8.7–23.3) and 15.7 months (10.4–NE). 25% of pts received a bone-targeted agent. Conclusions: In CRPC, time to first bone scan was shorter for pts who subsequently developed mets or had rapid PSADT. Abiraterone and enzalutamide were the most common therapies in pts with mets.

Cohort.
M0 (N=109)M1 (N=123)
Median age,* y8175
Year of CRPC diagnosis, %
<2010916
2010–June 20133137
July 2013–Dec 20142131
Jan 2015–Present3915
Median index PSA,* ng/mL3.34.2
Median index PSADT,* mnths5.33.5
Index PSADT category,* mnths
<84465
8–1288
>124827
No. of bone scans, %
12927
22225
31016
4412
556
6+212
*Baseline

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2019 Genitourinary Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session A: Prostate Cancer

Track

Prostate Cancer,Prostate Cancer

Sub Track

Prostate Cancer - Advanced Disease

Citation

J Clin Oncol 37, 2019 (suppl 7S; abstr 161)

DOI

10.1200/JCO.2019.37.7_suppl.161

Abstract #

161

Poster Bd #

G4

Abstract Disclosures