Highlights
- •We conducted this survey to understand how the COVID pandemic has impacted affected managment treatment of patients with mHSPC. Fifty medical oncologists across Canada responded to the questionnaire.
- •Not surprisingly, an increased uptake of ARATs and reduced use of docetaxel was observed.
- •How this trend will impact the uptake of triplet therapy (ADT+Docetaxel+ARAT), downstream treatment choices and overall outcomes remains to be seen.
Abstract
Background
In metastatic hormone sensitive prostate cancer (mHSPC), treatment intensification
with either docetaxel or an androgen-receptor-axis targeted therapy (ARAT), added
to androgen deprivation therapy (ADT) is the new standard of care. To better understand
patterns of treatment intensification in Canada and specifically how it has been influenced
by the COVID-19 pandemic, we conducted a national survey of genitourinary medical
oncologists from across Canada.
Methods
Using SurveyMonkey, we conducted an online survey of 119 medical oncologists in Canada
from January 15 to January 27, 2021. The survey consisted of 16 questions, including
demographics, and asked specifically about their approach to managing mHSPC before
and during the pandemic.
Results
Overall there were 50/119 (42%) respondents. Most were male (65%), from Ontario (35%),
practicing in academic centers (71%), with 45% reporting their practices focused primarily
on genitourinary malignancies and one other tumor site. The majority were in practice
1 to 5 years (34%). Overall 65% indicated their practice patterns had changed since
the pandemic, with 51% offering more ARATs and less docetaxel chemotherapy. In low
volume mHSPC, the use of ARATs increased from 73% to 79%, while the use of docetaxel
remained unaltered at 2%. In high volume disease, the use of ARATs increased from
63% to 84%, while the use of docetaxel decreased from 37% to 14%. Use of granulocyte
colony stimulating factor (G-CSF) with docetaxel chemotherapy increased by 35%. Post-pandemic,
45% reported they intend to maintain these changes. Only 18% reported they had prostate
cancer patients test positive for COVID-19, and all patients recovered.
Conclusion
Management of patients with mHSPC in Canada has changed during the pandemic, with
increased uptake of ARATs and reduced use of docetaxel, a trend expected to continue
beyond the pandemic. How this trend will impact uptake of triplet therapy (ADT + ARAT + Docetaxel),
downstream treatment choices and overall outcomes remains to be seen.
Keywords
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Article info
Publication history
Published online: November 29, 2022
Accepted:
November 25,
2022
Received in revised form:
November 21,
2022
Received:
October 10,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.
