Treatment intensification in metastatic castration-sensitive prostate cancer: a real-world study in Alberta, Canada
Notice bibliographique
Résumé
To assess the current status of and factors associated with treatment intensification (TI) (with androgen receptor pathway inhibitors [ARPIs] and/or docetaxel) for metastatic castration-sensitive prostate cancer (mCSPC) in Canada. Retrospective analysis of data for 431 patients with mCSPC from the Alberta Prostate Cancer Research Initiative database (July 2014–March 2022). The primary objective was to assess the patient proportion receiving TI, time to TI, and associated factors. The secondary and exploratory objectives were evaluating TI patterns and factors associated with choice of therapy, respectively. Overall, 42% of patients received TI; most (65%) within 3 months post-index. TI was likely to occur within 3 months post-index in de novo mCSPC, but occurred later for recurrent mCSPC. Patients with recurrent mCSPC (HR [95% CI]: 0.52 [0.38–0.72]) and those aged ≥ 75 years (0.57 [0.36–0.93]) were less likely to receive TI. Patients with multiple metastatic sites and bone metastasis had a 2–3-fold higher likelihood of receiving TI. An ARPI was predominantly used (75%) for TI (median duration: 16.0 months). TI rates for mCSPC are suboptimal in Canada especially for older patients and those with recurrent mCSPC. TI prioritization in such groups may improve patient outcomes. Prostate cancer cells use hormones called androgens to help them grow and spread. Therefore, some prostate cancer treatments work by lowering the level of androgens made by the body or by blocking androgens from working. This is called hormone therapy and includes androgen-deprivation therapy (ADT) and androgen receptor pathway inhibitor (ARPI) treatments. Using ADT with ARPIs or chemotherapy is recommended by treatment guidelines to help slow disease worsening and improve quality of life for people with metastatic castration-sensitive prostate cancer (mCSPC). mCSPC is prostate cancer that has spread to other parts of the body and can be managed by hormone therapy. mCSPC can occur either at the time of prostate cancer diagnosis or after initial treatment for prostate cancer, when it is called recurrent mCSPC. This study looked at the number of people being prescribed ADT with ARPIs or chemotherapy for mCSPC treatment in Canada, and which factors led to people receiving this treatment. For this, researchers used the data of 431 people with mCSPC from the Alberta Prostate Cancer Research Initiative during 2014–2022. They found that less than half of the people received ADT with ARPIs or chemotherapy. Older people (over 75 years) or those with recurrent mCSPC were less likely to have this treatment than other groups, and it took longer for them to receive this treatment. This shows a need to increase the use of ADT with ARPIs or chemotherapy in Canada to improve outcomes, particularly for older people and those with recurrent mCSPC.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,002 | 0,008 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,002 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».