Treatment patterns and outcomes in older adults with castration-resistant prostate cancer: Analysis of an Australian real-world cohort

• Published in: Journal of geriatric oncology 2023-11, Vol.14 (8), p.101621-101621, Article 101621
• Main Authors: Fernando, Michael, Anton, Angelyn, Weickhardt, Andrew, Azad, Arun A., Uccellini, Anthony, Brown, Stephen, Wong, Shirley, Parente, Phillip, Shapiro, Julia, Liow, Elizabeth, Torres, Javier, Goh, Jeffrey, Parnis, Francis, Steer, Christopher, Warren, Mark, Gibbs, Peter, Tran, Ben
• Format: Article
• Language: English
• Subjects: Aged; Australia - epidemiology; Clinical registry; Docetaxel - therapeutic use; Humans; Male; Metastatic prostate cancer; Older adults; Prostate-Specific Antigen; Prostatic Neoplasms, Castration-Resistant - drug therapy; Prostatic Neoplasms, Castration-Resistant - pathology; Real-world cohort; Retrospective Studies; Treatment Outcome; Treatment outcomes
• ISSN: 1879-4068; 1879-4076
• DOI: 10.1016/j.jgo.2023.101621

Prostate cancer (PC) is the second commonest malignancy and fifth leading cause of cancer death in men worldwide. Older men are more likely to develop PC but are underrepresented in pivotal clinical trials, leading to challenges in treatment selection in the real-world setting. We aimed to examine treatment patterns and outcomes in older Australians with metastatic castration-resistant prostate cancer (mCRPC). We identified 753 men with mCRPC within the electronic CRPC Australian Database (ePAD). Clinical data were analysed retrospectively to assess outcomes including time to treatment failure (TTF), overall survival (OS), PSA doubling time (PSADT), PSA50 response rate, and pre-defined adverse events of special interest (AESIs). Descriptive statistics were used to report baseline characteristics, stratified by age groups (85y). Groups were compared using Kruskal-Wallis and Chi-square analyses. Time-to-event analyses were performed using Kaplan-Meier methods and compared through log-rank tests. Cox proportional hazards univariate and multivariate analyses were performed to evaluate the influence of variables on OS. Fifty-seven percent of men were aged 85y. Patients ≥75y more frequently received only one line of systemic therapy (40% of 85y; P 3 months was an independent positive prognostic factor for patients receiving any systemic therapy. Older patients who received docetaxel were more likely to experience AESIs (18% in 85y, p = 0.038) and to stop treatment as a result (21% in