Treatment Patterns and Trends in Patients Dying of Prostate Cancer in Quebec: A Population-Based Study

Dragomir, Alice; Rocha, Joice; Vanhuyse, Marie; Cury, Fabio; Kassouf, Wassim; Hu, Jason; Aprikian, Armen

doi:10.3747/co.24.3598

Cited by 7 publications

(3 citation statements)

References 41 publications

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“…In their study of navigation, dela Rama and Pratz 33 stated that many centres with navigators designated for specific cancers did not have a navigator for prostate cancer even though navigation could benefit patients. That observation could be especially true in the future, given the increasing options for androgen depletion therapy 34 .…”

Section: Cancer Diagnosesmentioning

confidence: 99%

Comparing Enrolees with Non-Enrolees of Cancer-Patient Navigation at End of Life

Park¹,

Johnston

Urquhart³

et al. 2018

Current Oncology

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Section: Cancer Diagnosesmentioning

confidence: 99%

Comparing Enrolees with Non-Enrolees of Cancer-Patient Navigation at End of Life

Park¹,

Johnston

Urquhart³

et al. 2018

Current Oncology

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“…These findings suggest that overall, more mCRPC patients are receiving life-prolonging treatment. Prior to the advent of NHAs, docetaxel chemotherapy was the only recourse but its uptake was always limited due to the high proportion of mCRPC patients being either too frail for treatment or due to patient preference [ 22 , 23 ]. As the baseline characteristics of our chemotherapy-naïve group show, they are on average nearly 5 years older than the post-chemotherapy patients when initiating an NHA.…”

Section: Discussionmentioning

confidence: 99%

Utilization Trends of Novel Hormonal Agents in Metastatic Castration-Resistant Prostate Cancer in Quebec

Aprikian

Saleh

et al. 2022

Current Oncology

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Background: The introduction of novel hormonal agents (NHAs) such as abiraterone acetate (ABI) and enzalutamide (ENZ) for metastatic castration-resistant prostate cancer (mCRPC) was an important milestone given their survival benefits, tolerability, and ease of administration relative to taxane chemotherapies. This descriptive study sought to describe the utilization trends of ABI and ENZ in patients with mCRPC in the early years after their approval in the province of Quebec in Canada. Methods: A retrospective population-based cohort was extracted from Quebec public healthcare administrative databases. The cohort included first-time users of NHAs (ABI or ENZ) from 2011 to 2016. The primary analyses aimed to describe the overall temporal trends (2011–2016) of NHA initiators by chemotherapy status (chemotherapy-naïve versus post-chemotherapy), and prescribing specialty (medical oncology versus urology versus others). Results: The cohort comprised 2183 patients, with 1562 (72%) in the chemotherapy-naïve group and 621 (28%) in the post-chemotherapy group. While the majority of patients were post-chemotherapy NHA initiators in 2012, this proportion decreased over time and accounted for only 13% of NHA initiators by the end of 2016. Medical oncologists were the most frequent prescribers of NHAs (upwards of 60%) throughout 2012 but fell to 45% by the end of 2016. Conversely, the proportion of prescriptions by urologists increased from 22% in 2012 to 42% in 2016. Conclusion: Over time, there was an increasing proportion of (1) patients who initiated NHAs without prior chemotherapy treatment, (2) NHA prescribing by urologists, and (3) ENZ users. Taken together, this implies that the introduction of NHAs has altered the management of mCRPC and urologists quickly adopted NHAs into their practice.

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“…Consequently, the study did not include other novel CRPC drugs (cabazitaxel, enzalutamide, and radium-223) because they were not publicly reimbursed or available in Quebec over the study period. 20…”

Section: Study Cohortmentioning

confidence: 99%

Cancer Drug Use in the Last Month of Life in Men With Castration-Resistant Prostate Cancer

Aprikian

Vanhuyse

et al. 2019

JOP

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PURPOSE: Several new drug therapies have been approved in CRPC in the past decade. However, little is known about their potential overuse at the end of life. Cancer therapy use at the end of life has been considered an indicator of overtreatment. The study objective was to describe CRPC drug use in the last month of life of CRPC patients in Quebec. PATIENTS AND METHODS: Using administrative databases from the province of Quebec in Canada, we identified patients who received medical or surgical castration treatment, received one or more CRPC drugs (chemotherapy, abiraterone, or bone-targeted therapy), and died between 2001 and 2013. CRPC drug use in the last month of life was the primary outcome. RESULTS: The cohort consisted of 1,148 patients with CRPC. A total of 316 men (27.5%) received a CRPC drug in the last month of life. For those who received chemotherapy, abiraterone, and bone-targeted therapy, 10.2%, 27.8%, and 31.8% received them in the last month of life, respectively. In multivariable analyses, age older than 75 years (odds ratio [OR], 0.75; 95% CI, 0.57 to 0.99), and prostate cancer diagnosis received less than 24 months earlier (OR, 0.43; 95% CI, 0.26 to 0.72) were associated with less CRPC drug use. Relative to dying between 2005 and 2011, dying between 2012 and 2013 (OR 1.60; 95% CI, 1.18 to 2.18) was associated with greater CRPC drug use. CONCLUSION: More than one quarter of patients received CRPC drug therapies in the last month of life. Persistent chemotherapy, abiraterone, bone-targeted therapies, and medical castration drugs in the last month of life may be an indicator of inappropriate and expensive end-of-life care.

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Treatment Patterns and Trends in Patients Dying of Prostate Cancer in Quebec: A Population-Based Study

Abstract: Introduction Since just after the year 2000 in Quebec, the management of metastatic castration-resistant prostate

Cited by 7 publications

References 41 publications

Comparing Enrolees with Non-Enrolees of Cancer-Patient Navigation at End of Life

Comparing Enrolees with Non-Enrolees of Cancer-Patient Navigation at End of Life

Utilization Trends of Novel Hormonal Agents in Metastatic Castration-Resistant Prostate Cancer in Quebec

Cancer Drug Use in the Last Month of Life in Men With Castration-Resistant Prostate Cancer

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