Despite existing clinical guidelines on bone health in patients with cancer (ESMO 2014), the use of recommended BTA is sub-optimal for many patients. It is unclear if physicians’ decisions are aligned with ESMO’s guidelines to initiate BTA as soon as bone metastasis (BM) are diagnosed, irrespective of symptomatic disease, in breast cancer (BC) or castration-resistant prostate cancer (CRPC) patients. The current study describes BTA initiation in BC or CRPC patients with BM treated within routine clinical settings.
Data reported by physicians (oncologists or urologists) in Europe via online data capture using physician-directed surveys and patients’ medical records as required were analysed. Adult BC or physician-defined CRPC patients included in the study received active anti-cancer treatment between February 2015 and April 2015. Adherence to the ESMO 2014 guidelines was defined as the proportion of patients with a BTA initiation within 3 months (<90 days) of BM diagnosis.
A total of 731 physicians reported data on 1,857 patients treated for their cancer in Europe. For BC patients (n = 1,195) and CRPC patients (n = 662) treated by oncologists, only 84% and 61%, respectively, received their first BTA within 3 months of BM diagnosis. Adherence to the ESMO 2014 guidelines was lower (55%) in the 118 urologist-treated CRPC patients. Most physicians (87%) across all specialties considered the presence or absence of bone pain as the most important factor when assessing the risk of bone complications. Bone pain was also reported by the physicians as a main reason for BTA initiation in nearly three-quarters of BTA-treated patients (71% BC, 75% CRPC). Overall, 56% of physicians considered bone pain to be either a bone complication (58% oncologists vs 48% urologists) or a skeletal-related event (53% oncologists vs 68% urologists).
Adherence to ESMO’s guidelines on bone health differed by tumour type and by physician specialty within solid tumour patients treated in routine clinical settings. Despite ESMO’s guidance on bone protection irrespective of symptomatic disease, bone pain appeared to be a trigger for BTA initiation in routine clinical practice.
Clinical trial identification
Amgen study 20150107.
Legal entity responsible for the study
Amgen (Europe) GmbH.
Amgen (Europe) GmbH.
A. Rider: Full / Part-time employment: Adelphi Group Ltd. A.M. Seesaghur: Shareholder / Stockholder / Stock options, Full / Part-time employment: Amgen; Shareholder / Stockholder / Stock options, Full / Part-time employment: Amgen. K. Lewis: Full / Part-time employment: Adelphi Group Ltd. D. Bluff: Full / Part-time employment: Adelphi Group Ltd. A. Marongiu: Full / Part-time employment, Andrea Marongiu is a contract worker at Amgen. G. Demonty: Shareholder / Stockholder / Stock options, Full / Part-time employment: Amgen.