Show simple item record

dc.contributor.authorLorente, D
dc.contributor.authorRavi, P
dc.contributor.authorMehra, N
dc.contributor.authorPezaro, C
dc.contributor.authorOmlin, A
dc.contributor.authorGilman, A
dc.contributor.authorMiranda, M
dc.contributor.authorRescigno, P
dc.contributor.authorKolinsky, M
dc.contributor.authorPorta, N
dc.contributor.authorBianchini, D
dc.contributor.authorTunariu, N
dc.contributor.authorPerez, R
dc.contributor.authorMateo, J
dc.contributor.authorPayne, H
dc.contributor.authorTerstappen, L
dc.contributor.authorIJzerman, M
dc.contributor.authorHall, E
dc.contributor.authorde Bono, J
dc.date.accessioned2017-08-14T15:58:13Z
dc.date.issued2018-03-01
dc.identifier.citationEuropean urology focus, 2018, 4 (2), pp. 235 - 244
dc.identifier.issn2405-4569
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/778
dc.identifier.eissn2405-4569
dc.identifier.doi10.1016/j.euf.2016.09.005
dc.description.abstractBACKGROUND: Evaluation of responses to treatment for metastatic castration-resistant prostate cancer (mCRPC) remains challenging. Consensus criteria based on prostate-specific antigen (PSA) and clinical and radiologic biomarkers are inconsistently utilized. Circulating tumor cell (CTC) counts can inform prognosis and response, but are not routinely used. OBJECTIVE: To evaluate the use of biomarkers and trends in clinical decision-making in current mCRPC treatment. DESIGN, SETTING, AND PARTICIPANTS: A 23-part online questionnaire was completed by physicians treating mCRPC. OUTCOME MEASURES AND STATISTICAL ANALYSIS: Results are presented as the proportion (%) of physicians responding to each of the options. We used χ2 and Fisher's tests to compare differences. RESULTS AND LIMITATIONS: A total of 118 physicians (22.1%) responded. Of these, 69.4% treated ≥50 mCRPC patients/year. More physicians administered four or fewer courses of cabazitaxel (27.9%) than for docetaxel (10.4%), with no significant difference in the number of courses between bone-only disease and Response Evaluation Criteria in Solid Tumours (RECIST)-evaluable disease. Some 74.5% of respondents considered current biomarkers useful for monitoring disease, but only 39.6% used the Prostate Cancer Working Group (PCWG2) criteria in clinical practice. PSA was considered an important biomarker by 55.7%, but only 41.4% discarded changes in PSA before 12 wk, and only 39.4% were able to identify bone-scan progression according to PCWG2. The vast majority of physicians (90.5%) considered clinical progression to be important for switching treatment. The proportion considering biomarkers important was 71.6% for RECIST, 47.4% for bone scans, 23.2% for CTCs, and 21.1% for PSA. Although 53.1% acknowledged that baseline CTC counts are prognostic, only 33.7% would use CTC changes alone to switch treatment in patients with bone-only disease. The main challenges in using CTC counts were access to CTC technology (84.7%), cost (74.5%), and uncertainty over utility as a response indicator (58.2%). CONCLUSIONS: A significant proportion of physicians discontinue treatment for mCRPC before 12 wk, raising concerns about inadequate response assessment. Many physicians find current biomarkers useful, but most rely on symptoms to drive treatment switch decisions, suggesting there is a need for more precise biomarkers. PATIENT SUMMARY: In this report we analyse the results of a questionnaire evaluating tools for clinical decision-making completed by 118 prostate cancer specialists. We found that most physicians favour clinical progression over prostate-specific antigen or imaging, and that criteria established by the Prostate Cancer Working Group are not widely used.
dc.formatPrint-Electronic
dc.format.extent235 - 244
dc.languageeng
dc.language.isoeng
dc.publisherELSEVIER
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.subjectHumans
dc.subjectNeoplasm Metastasis
dc.subjectDisease Progression
dc.subjectTaxoids
dc.subjectAndrostenes
dc.subjectProstate-Specific Antigen
dc.subjectPrognosis
dc.subjectTreatment Outcome
dc.subjectMale
dc.subjectTubulin Modulators
dc.subjectNeoplastic Cells, Circulating
dc.subjectProstatic Neoplasms, Castration-Resistant
dc.subjectSurveys and Questionnaires
dc.subjectBiomarkers, Tumor
dc.subjectPractice Patterns, Physicians'
dc.subjectClinical Decision-Making
dc.subjectDocetaxel
dc.titleInterrogating Metastatic Prostate Cancer Treatment Switch Decisions: A Multi-institutional Survey.
dc.typeJournal Article
dcterms.dateAccepted2016-09-17
rioxxterms.versionofrecord10.1016/j.euf.2016.09.005
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by/4.0
rioxxterms.licenseref.startdate2018-03
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfEuropean urology focus
pubs.issue2
pubs.notesNot known
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Clinical Trials & Statistics Unit
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/ICR-CTSU Urology and Head and Neck Trials Team
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Prostate Cancer Targeted Therapy Group
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Clinical Trials & Statistics Unit
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/ICR-CTSU Urology and Head and Neck Trials Team
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Prostate Cancer Targeted Therapy Group
pubs.publication-statusPublished
pubs.volume4
pubs.embargo.termsNot known
icr.researchteamClinical Trials & Statistics Unit
icr.researchteamICR-CTSU Urology and Head and Neck Trials Team
icr.researchteamProstate Cancer Targeted Therapy Group
dc.contributor.icrauthorGillman, Alexa
dc.contributor.icrauthorRescigno, Pasquale
dc.contributor.icrauthorPorta, Nuria
dc.contributor.icrauthorHall, Emma
dc.contributor.icrauthorDe Bono, Johann


Files in this item

Thumbnail

This item appears in the following collection(s)

Show simple item record

https://creativecommons.org/licenses/by/4.0
Except where otherwise noted, this item's license is described as https://creativecommons.org/licenses/by/4.0