Predictors of real-world utilisation of docetaxel combined with androgen deprivation therapy in metastatic hormone-sensitive prostate cancer

Azad, AA; Tran, B; Davis, ID; Parente, P; Evans, M; Wong, S; Brown, S; Evans, S; Millar, J; Murphy, DG; Papa, N

Author(s): Azad, AA; Tran, B; Davis, ID; Parente, P; Evans, M; Wong, S; Brown, S; Evans, S; Millar, J; Murphy, DG; Papa, N;
Details: Publication Year 2022-08,Volume 52,Issue #8,Page 1339-1346
Journal Title: Internal Medicine Journal
Publication Type: Research article
Abstract: BACKGROUND: Docetaxel has emerged as a standard-of-care for metastatic hormone-sensitive prostate cancer (mHSPC). Uptake of docetaxel for mHSPC in Australia has not previously been reported. AIMS: To investigate the real-world uptake of docetaxel in mHSPC and to identify predictors of utilisation of docetaxel in mHSPC. METHODS: Men diagnosed from June 2014 to December 2018 and enrolled in the Prostate Cancer Outcomes Registry-Victoria (PCOR-Vic) were included. Data collected include demographics, diagnosis method and institution, staging investigations and treatments within 12 months of diagnosis. Wilcoxon rank-sum, Chi-squared and trend tests were used to identify predictors of docetaxel utilisation. All predictors were entered as covariates simultaneously into a multivariable logistic regression model. Statistical significance was set at 0.05 (two sided). RESULTS: In all, 1014 men with mHSPC were analysed, 25% of whom received docetaxel with androgen deprivation therapy. Uptake of docetaxel increased from 20% in 2014 to 33% in 2018. Predictors of higher usage of docetaxel were younger age and treatment in a private hospital, with both remaining significant on multivariable analysis. Notably, the proportion of men aged <70 years receiving docetaxel increased from 54% in 2014-2015 to 64% in 2016-2018, while in men aged >/=70 years the comparative figures were 15% and 22% respectively. CONCLUSIONS: Although docetaxel was not used in the majority of cases, there was a clear increase in docetaxel uptake, especially in younger men following publication of the CHAARTED and STAMPEDE trials. Identifying barriers to real-world implementation of pivotal clinical trial data is critical to improving outcomes in mHSPC.
Keywords: *Androgen Antagonists/therapeutic use; Androgens; Antineoplastic Combined Chemotherapy Protocols/therapeutic use; Docetaxel/therapeutic use; Humans; Male; *Prostatic Neoplasms/drug therapy/epidemiology; Treatment Outcome; Victoria; castration; chemotherapy; docetaxel; hormone-sensitive; metastatic; prostate cancer
Department(s): Medical Oncology; Surgical Oncology
PubMed ID: 33710759
Publisher's Version: https://doi.org/10.1111/imj.15288
Terms of Use/Rights Notice: Refer to copyright notice on published article.

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