There is a major clinical need to devise an optimal treatment sequence for the multiple therapy options available for patients with metastatic castration-resistant prostate cancer (mCRPC). In the absence of prospective clinical trials, sequencing information can be derived from large, real-world registry studies.
PROXIMA (Treatment Patterns in Patients With Metastatic Castration-Resistant Prostate Cancer Previously Treated With Docetaxel-Based Chemotherapy) is a large, global, prospective registry study evaluating real-world treatment patterns of patients with mCRPC who experience disease progression during or after docetaxel therapy. Patients were enrolled worldwide between 2011 and 2014. Treatments were determined by the treating physicians and recorded in categories of chemotherapy, hormonal therapy, targeted therapy, immunotherapy, and palliative therapy. Treatment sequencing patterns, response to treatment, and types of progression were recorded and analyzed. Progression-free survival and overall survival with different treatment modalities were analyzed using Kaplan-Meier method.
Treatment patterns were evaluated in 903 patients. Therapy selection was influenced by region. Hormonal therapy (57.5%) and taxane chemotherapy (26.4%) were the most frequently administered first subsequent treatments after docetaxel. Tumor responses to first subsequent treatment were observed in 22.6% of evaluable patients. Overall survival and progression-free survival did not differ significantly across different treatment modalities.
Identifying an optimal treatment sequence is vital for improving the care of patients with mCRPC. The PROXIMA registry provided a representative sample of global data on real-world treatment patterns for patients with mCRPC previously treated with docetaxel. These data can be used to devise optimal therapy sequences and inform treatment decisions.
Journal of global oncology. 2018 Sep [Epub]
Hideyuki Akaza, Giuseppe Procopio, Choosak Pripatnanont, Gaetano Facchini, Sergio Fava, Duncan Wheatley, Kwong Chuen Leung, Mohammad Butt, Alberto Silva, Liliana Castillo, Vasilios Karavasilis, Ayse Ӧzatılgan, Simon Hitier, Evelyne B Ecstein-Fraisse, Mustafa Ӧzgüroḡlu
Hideyuki Akaza, The University of Tokyo, Tokyo, Japan; Giuseppe Procopio, Istituto Nazionale Tumori; Sergio Fava, Ospedale Civile di Legnano, Milan; Gaetano Facchini, Istituto Nazionale Tumori Istituto di Ricerca e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy; Choosak Pripatnanont, Prince of Songkla University, Songkla, Thailand; Duncan Wheatley, Royal Cornwall Hospital, Truro; Mohammad Butt, Castle Hill Hospital, Hull, United Kingdom; Kwong Chuen Leung, Queen Elizabeth Hospital, Hong Kong, Special Administrative Region, People's Republic of China; Alberto Silva, Instituto de Cancer do Ceará, Fortaleza, Brazil; Liliana Castillo, Hospital Oncológico Miguel Pérez Carreño, Valencia, Venezuela; Vasilios Karavasilis, Papageorgiou Hospital and Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece; Ayse Ӧzatılgan, Sanofi, Cambridge, MA; Simon Hitier, Sanofi, Chilly-Mazarin; Evelyne B. Ecstein-Fraisse, Sanofi, Paris, France; and Mustafa Ӧzgüroḡlu, Istanbul University, Istanbul, Turkey.