Abstract 602P
Background
Despite the importance of accurate diagnosis of prostate cancer (PC) patients for their appropriate management, the real prevalence of PC statuses is poorly documented. This observational, cross-sectional study aimed to assess the prevalence of castration-resistant PC (CRPC) of unknown metastatic status (CRPC-MX) and describe its clinical management.
Methods
This was a retrospective, multicenter, real-world study including adult patients with CRPC who had received continuous androgen deprivation therapy (ADT) for at least ≥6 months before their inclusion in the study in 46 Spanish hospitals. In the first phase of this study, PC patients were classified according to hormonal (hormone-sensitive [HSPC] and castration-resistant [CRPC]) and metastatic (metastatic [M1], non-metastatic [M0], and unknown [MX]) statuses, using an algorithm designed ad hoc based on clinical guidelines.
Results
Of the 6,169 patients included, metastatic status was unknown in 2,922 (47.4%) due to lack of recommended imaging exams during the study period. Castration status was unknown in 757 (12.3%) patients due to invalid or absence of testosterone values. A total of 323 (5.24%) patients were CRPC-MX, and 2,043 (33.1%) were HSPC-MX. Castration and metastatic statuses were unknown in 559 (9.0%) patients (Table). Table: 602P
Classification of patients with prostate cancer receiving androgen deprivation therapy according to castration and metastatic statuses, n (%) N=6,169
| n | % | |
| Valid testosterone a | 5,412 | 87.7 |
| HSPC-M0 | 821 | 13.3 |
| HSPC-M1 | 77 | 12.5 |
| HSPC-MX | 2,043 | 33.1 |
| CRPC-M0 | 214 | 3.5 |
| CRPC-M1 | 1,241 | 20.1 |
| CRPC-MX | 323 | 5.2 |
| Invalid testosterone b | 757 | 12.3 |
| M0 | 88 | 1.4 |
| M1 | 113 | 1.8 |
| MX | 556 | 9.0 |
HSPC, hormone-sensitive prostate cancer; CRPC, castration-resistant prostate cancer; M0, non-metastatic; M1, metastatic; MX; unknown metastatic status a below castration levels (i.e., <50 ng/mL) b above castration levels (i.e., >50 ng/mL) and/or unavailable
Conclusions
In the real-world setting, successful castration is not appropriately monitored in a subset of PC patients on ADT, and the metastatic status is unknown in almost half of ADT-treated PC patients, despite guidelines recommending imaging exams to assess metastatic status, particularly in CRPC patients. The suboptimal characterization of PC patients leads to inappropriate diagnosis and may preclude patients’ access to appropriate treatments based on their status.
Clinical trial identification
Editorial acknowledgement
We thank Sara Cervantes (i2e3 Biomedical Research Institute, Spain) for providing medical writing assitance.
Legal entity responsible for the study
Janssen-Cilag, S.A.
Funding
Janssen-Cilag, S.A.
Disclosure
M. Rodrigo-Aliaga: Financial Interests, Personal, Other, Honoraria: Astellas; Financial Interests, Personal, Other, Honoraria: Janssen; Financial Interests, Personal, Other, Honoraria: Ipsen; Financial Interests, Personal, Advisory Role: Bayer; Financial Interests, Personal, Advisory Role: Janssen; Financial Interests, Personal, Advisory Role: Astellas; Financial Interests, Personal, Advisory Role: Pfizer; Financial Interests, Personal, Other, Travel expenses: Janssen; Financial Interests, Personal, Other, Travel expenses: Astellas. J.L. Álvarez-Ossorio: Financial Interests, Personal, Advisory Role: Janssen; Financial Interests, Personal, Advisory Role: Ipsen; Financial Interests, Personal, Advisory Role: Bayer; Financial Interests, Personal, Advisory Role: Astellas; Financial Interests, Personal, Advisory Role: Pfizer; Financial Interests, Personal, Invited Speaker: Janssen; Financial Interests, Personal, Invited Speaker: Astellas; Financial Interests, Personal, Invited Speaker: Bayer; Financial Interests, Personal, Invited Speaker: Pfizer; Financial Interests, Personal, Invited Speaker: Ipsen; Financial Interests, Personal, Research Grant: Janssen; Financial Interests, Personal, Research Grant: Bayer. A. Rodríguez-Alonso: Financial Interests, Personal, Advisory Board: Janssen; Financial Interests, Personal, Invited Speaker: Janssen; Financial Interests, Personal, Principal Investigator: Janssen. Á. García García-Porrero: Financial Interests, Personal, Full or part-time Employment: Janssen. A. Quesada-García: Financial Interests, Personal, Full or part-time Employment: Janssen. J. Muñoz del Toro: Financial Interests, Personal, Full or part-time Employment: Janssen. A. Rodríguez-Antolín: Financial Interests, Personal, Invited Speaker: Janssen; Financial Interests, Personal, Invited Speaker: Astellas; Financial Interests, Personal, Invited Speaker: Bayer.