Real-world management of advanced prostate cancer: A Canadian comparison of academic specialists and community-based prostate cancer physicians.

Authors

null

Sebastien J. Hotte

Juravinski Cancer Centre, McMaster University, Hamilton, ON, Canada

Sebastien J. Hotte , Antonio Finelli , Kim N. Chi , Christina M. Canil , Neil Fleshner , Anil Kapoor , Michael Paul Kolinsky , Shawn Malone , Chris Morash , Tamim Niazi , Krista Noonan , Michael Ong , Frederic Pouliot , Bobby Shayegan , Alan So , Delna Sorabji , Huong Hew , Laura Park-Wyllie , Fred Saad

Organizations

Juravinski Cancer Centre, McMaster University, Hamilton, ON, Canada, University of Toronto, Toronto, ON, Canada, BC Cancer and Vancouver Prostate Centre, Vancouver, BC, Canada, Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada, Division of Urology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON, Canada, Department of Medical Oncology, University of Alberta Cross Cancer Institute, Edmonton, AB, Canada, The Ottawa Hospital Cancer Center, Ottawa, ON, Canada, Ottawa Hospital, Ottawa, ON, Canada, Jewish General Hospital, McGill University, Montreal, QC, Canada, British Columbia Cancer Agency - Fraser Valley Centre, Surrey, BC, Canada, The Ottawa Hospital Cancer Centre, Ottawa, ON, Canada, Cancer Research Center, Centre Hospitalier Universitaire (CHU) de Québec-Université Laval, Quebec City, QC, Canada, Vancouver Prostate Centre, Vancouver, BC, Canada, Janssen Canada Medical Affairs, Toronto, ON, Canada, Medical Affairs, Janssen Inc., Toronto, ON, Canada, Centre Hospitalier de l’Université de Montréal (CHUM), Montréal, QC, Canada

Research Funding

Pharmaceutical/Biotech Company
Janssen Canada.

Background: The Canadian GU Research Consortium recently conducted a consensus development conference with 27 academic prostate cancer (PC) specialists leading to 31 consensus recommendations. We conducted a survey to compare community-based practice with the consensus recommendations on the management of metastatic castration sensitive prostate cancer (mCSPC), metastatic castration resistant prostate cancer (mCRPC) and non-metastatic castration resistant prostate cancer (nmCRPC). Methods: An 87-item online questionnaire was sent to 600 Canadian community urologists, medical oncologists, radiation oncologists, and general practitioner oncologists involved in the treatment of PC. Results: Seventy-two physicians responded to the questionnaire (12% response). A discordance of >25% was observed in 15 of 31 recommendations (48%). Among the areas of discordance were treatment approach for patients with nmCRPC and PSADT < 10 months who are negative for metastases on conventional imaging but metastatic on PET-based imaging. Of the academic physicians, 89% indicated treating with agents approved for nmCRPC compared to 50% of community physicians (p=0.0005). Important discrepancies were also observed across academic and community physicians for radiation to the prostate for low-volume mCSPC which was 74% vs 27%, (p<0.0001) respectively; criteria for stopping therapy in mCRPC in which 78% of academic physicians favored continuation of therapy in the event of PSA progression only, compared to 24% of community physicians. Sequencing of therapy after prior apalutamide for nmCRPC using subsequent docetaxel treatment was observed in 81% of academic physicians vs 35% of community physicians, (p<0.0001), and use of genetic testing was favored by 74% of academics vs 36% of community physicians, (p<0.0001) for newly diagnosed metastatic prostate cancer. Conclusions: The areas of discordance between a national sample of community-based PC physicians and academic consensus recommendations represent potential areas for education, practice tools and future research.

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Abstract Details

Meeting

2020 Genitourinary Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session A: Prostate Cancer

Track

Prostate Cancer - Advanced,Prostate Cancer - Localized

Sub Track

Patient-Reported Outcomes and Real-World Evidence

Citation

J Clin Oncol 38, 2020 (suppl 6; abstr 29)

Abstract #

29

Poster Bd #

A17

Abstract Disclosures