Optimizing the Management of Prostate Cancer in Senior Adults: Call to Action

Fitzpatrick, John M.

doi:10.1634/theoncologist.2012-s1-01

Cited by 4 publications

(4 citation statements)

References 19 publications

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“…A total of 1515 (71%) of men who did not receive chemotherapy in this study had little or no comorbidity, indicating undertreatment. A geriatric assessment tool including biological and clinical correlates of aging may improve decision-making in old cancer patients [32,33]. …”

Section: Discussionmentioning

confidence: 99%

Population-based study on use of chemotherapy in men with castration resistant prostate cancer

et al. 2013

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Background. Chemotherapy prolongs life and relieves symptoms in men with castration resistant prostate cancer (CRPC). There is limited information on a population level on the use of chemotherapy for CRPC.Material and methods.To assess the use of chemotherapy in men with CRPC we conducted a register-based nationwide population-based study in Prostate Cancer data Base Sweden (PCBaSe) and a nationwide in-patient drug register (SALT database) between May 2009 and December 2010. We assumed that men who died of prostate cancer (PCa) underwent a period of CRPC before they died. Results.Among the 2677 men who died from PCa during the study inclusion period, 556 (21%) had received chemotherapy (intravenous or per oral) detectable within the observation period in SALT database. Specifically, 239 (61%) of men < 70 years had received chemotherapy, 246 (30%) of men between 70 and 79 years and 71 (5%) men older than 80 years. The majority of men 465/556 (84%) had received a docetaxel-containing regimen. Among chemotherapy treated men, 283/556 (51%) received their last dose of chemotherapy during the last six months prior to death. Treatment with chemotherapy was more common among men with little comorbidity and high educational level, as well as in men who had received curatively intended primary treatment.Conclusion.A majority of men younger than 70 years with CRPC were treated with chemotherapy in contrast to men between 70 and 79 years of whom half as many received chemotherapy. Chemotherapy treatment was often administered shortly prior to death. The low uptake of chemotherapy in older men with CRPC may be caused by concerns about tolerability of treatment, as well as treatment decisions based on chronological age rather than global health status.

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Section: Discussionmentioning

confidence: 99%

Population-based study on use of chemotherapy in men with castration resistant prostate cancer

et al. 2013

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“…Between 2004 and 2010, when patients began to progress on androgen deprivation therapy (ADT) despite castrate levels of testosterone, chemotherapy with docetaxel plus prednisone was the main option for treatment of mCRPC [33][34][35] (Table 1). However, some patients may never receive docetaxel due to poor performance status, comorbidities, concerns about tolerability, and in some cases patient preference [40,41]. It has been reported that around only 37% of patients received chemotherapy and the remainder received best supportive care [42,43].…”

Section: First-line Treatmentmentioning

confidence: 99%

Perspectives on Treatment of Metastatic Castration-Resistant Prostate Cancer

Merseburger

Bellmunt

Jenkins³

et al. 2013

The Oncologist

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The arrival of several new agents-cabazitaxel, abiraterone acetate, enzalutamide, and radium-223-is changing the treatment options and management of patients with metastatic castration-resistant prostate cancer (mCRPC). Many other novel agents are also being investigated. As new drugs become approved, new treatment strategies and markers to best select which patients will best respond to which drug are needed. This review article is a summary of a European Treatment Practices Meeting, which was convened to discuss these latest data on novel agents and current treatment strategies in the mCRPC setting. The Oncologist 2013;18:558 -567 Implications for Practice: With so many novel agents available to treat patients with metastatic castration-resistant prostate cancer (mCRPC), a better understanding of factors to consider when assessing the clinical utility of treatment options for patients is needed. This review article discusses treatment strategies for mCRPC in the first-and second-line setting, and highlights the role of clinical markers, patient history, and assessing fitness for treatment when making treatment decisions. Prostate cancer is a heterogeneous disease, therefore, treatment must consider the characteristics of the disease as it manifests in an individual patient. In addition, assessments of patient response to treatment should reflect the mechanism of the drug. Further study is needed to identify predictive biomarkers to indicate patient response to novel agents.

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“…This has proven beneficial in a proportion of patients, improving OS and HRQL . When patients do not receive docetaxel therapy because of poor performance status, co‐morbidity or patient preference, best supportive care (often supplemented with steroid use or third‐line ADT with oestrogen‐based therapies) was the only treatment available .…”

Section: Conventional Second‐line Hormonal Treatmentmentioning

confidence: 99%

Implementing newer agents for the management of castrate‐resistant prostate cancer: what is known and what is needed?

et al. 2014

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Men receiving androgen-deprivation therapy will in time develop metastatic castrate-resistant prostate cancer (mCRPC). Whilst effective treatment options for mCRPC have traditionally been limited, new agents are becoming available. Since 2010, the number and class of agents available to treat mCRPC has increased dramatically. As such, there is a need for clear guidance on the optimum treatment and sequence of treatments for mCRPC before and after chemotherapy. This evidence-based statement, reflecting the views of the authors, provides suggestions on the continued relevance of conventional approaches to first-and second-line treatment in mCRPC, the potential role of novel treatments, and factors that may influence the choice of hormonal agents and/or chemotherapy.Keywords castrate-resistant prostate cancer, individualised management, new agents, evidence-based best practice

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Optimizing the Management of Prostate Cancer in Senior Adults: Call to Action

Abstract: This article briefly reviews the current state of therapy for older patients with prostate cancer and provides a call‐to‐action highlighting the need for an improved global standard of care in this patient population.

Cited by 4 publications

References 19 publications

Population-based study on use of chemotherapy in men with castration resistant prostate cancer

Population-based study on use of chemotherapy in men with castration resistant prostate cancer

Perspectives on Treatment of Metastatic Castration-Resistant Prostate Cancer

Implementing newer agents for the management of castrate‐resistant prostate cancer: what is known and what is needed?

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