Initiation of bone-targeted agents in patients with bone metastases and breast or castrate-resistant prostate cancer actively treated in routine clinical practice in Europe

Moos, Roger von; Lewis, Katie; Massey, Lucy; Marongiu, Andrea; Rider, A.; Seesaghur, Anouchka

doi:10.1016/j.bone.2021.116243

Cited by 6 publications

(13 citation statements)

References 31 publications

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“…In a study from Germany assessing the implementation of clinical guidelines (ESMO 2014 and national specialist guidelines), 70% of physicians reported that they adhered completely to the guidelines [18]. In the present study, up to 81.2% of patients received denosumab within 90 days of BM diagnosis, which is in line with studies investigating the initiation of BTAs (within 3 months of BM diagnosis, where specified) [11,12,16,[19][20][21]. Late initiation (nonadherence) occurred in at least one-fifth and potentially up to one-third of patients.…”

Section: Discussionsupporting

confidence: 86%

“…It should be noted that some patients (maximum ~ 10%) had received prior antiresorptive therapy at baseline, and less than onequarter of patients across cancer types had one or more SRE prior to enrollment. Insights from other real-world studies also indicate wide variations in the proportion of patients initiating therapy and the timing of initiation [15,16,[21][22][23][24][25]. Various factors may influence the decision to delay BTAs, including a recent BM diagnosis (no time to initiate), perceived low risk of bone complications, patient refusal, patient frailty, and risk of osteonecrosis of the jaw [16,21,24].…”

Section: Discussionmentioning

confidence: 99%

“…Insights from other real-world studies also indicate wide variations in the proportion of patients initiating therapy and the timing of initiation [15,16,[21][22][23][24][25]. Various factors may influence the decision to delay BTAs, including a recent BM diagnosis (no time to initiate), perceived low risk of bone complications, patient refusal, patient frailty, and risk of osteonecrosis of the jaw [16,21,24]. Access and reimbursement, experience of the multidisciplinary team, and variations in recommendations for different cancer types may also influence the decision to delay treatment [16,24].…”

Section: Discussionmentioning

confidence: 99%

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Medication adherence with denosumab in patients with bone metastases from solid tumors treated in routine clinical settings: a retrospective study

Diel

Greil

Janssen

et al. 2022

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Purpose To describe (non)adherence with denosumab among patients with solid tumors and bone metastases. Methods This retrospective, observational study pooled data from two completed prospective, multicenter cohort studies (X-TREME; Study 240) in adult patients with bone metastases from primary breast, prostate, lung, kidney, or other solid cancer types and administered denosumab 120 mg in routine clinical practice in Germany and Central and Eastern Europe. The studies were conducted between May 2012 and May 2017; pooled analysis was completed in August 2021. Medication adherence was described according to a three-component consensus taxonomy: initiation (first-ever administration ≤ 90 days from bone metastasis diagnosis), implementation (actual vs prescribed dosing; optimal implementation = regular/consistent dosing), and persistence (≤ 60-day gap between administrations at 3, 6, 9, and 12 months). Descriptive analyses were conducted for each cancer type. Results The analysis included 1748 patients with solid tumors and bone metastases. Adherence with denosumab was generally high across the initiation, implementation, and persistence phases. Most patients experienced timely initiation (from 64.4% [kidney cancer] to 81.2% [breast cancer]) and optimal implementation (from 62.4% [lung cancer] to 72.5% [breast cancer]). The proportion of patients who were persistent with treatment at 6 months ranged from 41.4% (lung cancer) to 77.8% (prostate cancer). Conclusions This study revealed variations by cancer type in the initiation, implementation, and persistence of denosumab in patients with solid tumors and bone metastases in routine clinical practice. Further cancer-specific studies are warranted to examine the determinants of (non)adherence with denosumab, and potential ways to improve medication adherence.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Medication adherence with denosumab in patients with bone metastases from solid tumors treated in routine clinical settings: a retrospective study

Diel

Greil

Janssen

et al. 2022

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“…Furthermore, there may be genuine differences in the use of BTAs in patients with cancer with BM between the UK and other European countries. Determinants of BTA prescribing in patients with cancer with BM were evaluated in several studies 17 19 20. Findings from von Moos et al 17 indicate that some physicians base their BTA treatment decisions not only on clinical guidelines but also consider patients’ Eastern Cooperative Oncology Group (ECOG) performance score, disease burden and the presence of other sites of metastatic disease.…”

Section: Discussionmentioning

confidence: 99%

Assessment of bone-targeting agents use in patients with bone metastasis from breast, lung or prostate cancer using structured and unstructured electronic health records from a regional UK-based hospital

et al. 2023

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ObjectiveTo assess use of bone-targeting agents (BTA) in patients with confirmed bone metastases (BM) from breast cancer (BC), non-small cell lung cancer (NSCLC) or prostate cancer (PC).DesignRetrospective cohort study.SettingRegional hospital-based oncology database of approximately 2 million patients in England.ParticipantsPatients aged ≥18 years with a diagnosis of BC, NSCLC or PC as well as BM between 1 January 2007 and 31 December 2018, with follow-up to 30 June 2020 or death; BM diagnosis ascertained from recorded medical codes and unstructured data using natural language processing (NLP).Main outcomes measuresInitiation or non-initiation of BTA following BM diagnosis, time from BM diagnosis to BTA initiation, time from first to last BTA, time from last BTA to death.ResultsThis study included 559 BC, 894 NSCLC and 1013 PC with BM; median age (Q1–Q3) was 65 (52–76), 69 (62–77) and 75 (62–77) years, respectively. NLP identified BM diagnosis from unstructured data for 92% patients with BC, 92% patients with NSCLC and 95% patients with PC. Among patients with BC, NSCLC and PC with BM, 47%, 87% and 88% did not receive a BTA, and 53%, 13% and 12% received at least one BTA, starting a median 65 (27–167), 60 (28–162) and 610 (295–980) days after BM, respectively. Median (Q1–Q3) duration of BTA treatment was 481 (188–816), 89 (49–195) and 115 (53–193) days for patients with BC, NSCLC and PC. For those with a death record, median time from last BTA to death was 54 (26–109) for BC, 38 (17–98) for NSCLC and 112 (44–218) days for PC.ConclusionIn this study identifying BM diagnosis from both structured and unstructured data, a high proportion of patients did not receive a BTA. Unstructured data provide new insights on the real-world use of BTA.

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“…Treatment recommendations should be individualized according to the symptoms and impact on the quality of life of the patient, his or her functional status, the clinical status of the disease (extensive metastatic or oligometastatic disease), the estimated life expectancy, and whether there is an imminent or actual fracture in the affected bone [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

Review of imaging techniques for evaluating morphological and functional responses to the treatment of bone metastases in prostate and breast cancer

et al. 2022

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Bone metastases are very common complications associated with certain types of cancers that frequently negatively impact the quality of life and functional status of patients; thus, early detection is necessary for the implementation of immediate therapeutic measures to reduce the risk of skeletal complications and improve survival and quality of life. There is no consensus or universal standard approach for the detection of bone metastases in cancer patients based on imaging. Endorsed by the Spanish Society of Medical Oncology (SEOM), the Spanish Society of Medical Radiology (SERAM), and the Spanish Society of Nuclear Medicine and Molecular Imaging (SEMNIM) a group of experts met to discuss and provide an up-to-date review of our current understanding of the biological mechanisms through which tumors spread to the bone and describe the imaging methods available to diagnose bone metastasis and monitor their response to oncological treatment, focusing on patients with breast and prostate cancer. According to current available data, the use of next-generation imaging techniques, including whole-body diffusion-weighted MRI, PET/CT, and PET/MRI with novel radiopharmaceuticals, is recommended instead of the classical combination of CT and bone scan in detection, staging and response assessment of bone metastases from prostate and breast cancer.Clinical trial registration: Not applicable.

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Initiation of bone-targeted agents in patients with bone metastases and breast or castrate-resistant prostate cancer actively treated in routine clinical practice in Europe

Cited by 6 publications

References 31 publications

Medication adherence with denosumab in patients with bone metastases from solid tumors treated in routine clinical settings: a retrospective study

Medication adherence with denosumab in patients with bone metastases from solid tumors treated in routine clinical settings: a retrospective study

Assessment of bone-targeting agents use in patients with bone metastasis from breast, lung or prostate cancer using structured and unstructured electronic health records from a regional UK-based hospital

Review of imaging techniques for evaluating morphological and functional responses to the treatment of bone metastases in prostate and breast cancer

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