Patterns of Care and Outcomes for NonMetastatic Prostate Cancer in the United States: Results of the CancerMPact® Survey 2018

Abstract

Purpose: We describe patterns of care and treatment outcomes for non-metastatic PCa (nmPCA), either hormone-sensitive or castration-resistant, in the United States of America (USA) in 2018. Methods: A survey (CancerMPact®) recruited physicians nationwide to answer an online questionnaire about how they treated patients with nmPCA. Questions covered aspects of treatment at all disease stages. Board-certified urologists and oncologists with at least five years of clinical practice and who treated at least 30 PCa patients monthly were included. Results: The survey included responses from ninety-four physicians with an average of 17.5 years of clinical practice, who had treated a combined average of 4415 patients with nmPCA per month in 2018. Approximately 40% of patients in stage I were managed with either active surveillance or observation/no therapy, decreasing to 20%, 8% and 6% in stages II, III and IV(M0), respectively. Intensity-modulated radiotherapy was favored over other radiotherapy modalities, with rates of use ranging between 60% and 69% depending on disease stage. Leuprolide as monotherapy or in combination with enzalutamide, abiraterone or bicalutamide were the most common systemic treatment options for non-metastatic hormonesensitive PCa (nmHSPC) patients with the first or second recurrence. Only 16.5% of nonmetastatic castration-resistant PCa (nmCRPC) patients did not relapse within five years of initial therapy for nmCRPC. Conclusion: While PCa treatment recommendations are rapidly changing due to advances in treatment, we observed great concordance between their most current versions and realworld data treatment patterns reported by US physicians.