BackgroundContinuous androgen deprivation therapy (CADT) is commonly used for patients with non-metastatic prostate cancer as primary therapy for high-risk disease, adjuvant therapy together with radiation or for recurrence after initial local therapy. Intermittent ADT (IADT), a recently developed alternative strategy for providing ADT, is thought to potentially reduce adverse effects, but little is known about practice patterns relating to it. We aimed to describe factors related to physicians’ ADT use and modality for patients with non-metastatic prostate cancer.MethodsA 45 min online survey was completed by urologists and oncologists responsible for treatment decisions for non-metastatic prostate cancer from 19 countries with high or increasing prevalence of non-metastatic prostate cancer.ResultsThere were 441 treating physicians who completed the survey which represented 99 177 patients with prostate cancer under their care, of which 76 386 (77%) had non-metastatic prostate cancer. Of patients with non-metastatic prostate cancer, 38% received ADT (37% gonadotropin-releasing hormone (GnRH), 2% orchiectomy); among patients on GnRH, 54% received CADT (≥6 without >3 months interruption), 23% IADT and 23% <6 months. Highest rates of ADT were reported among oncologists (62%) and in Eastern Europe (Czech Republic, Hungary and Poland). Prostate-specific antigen (PSA) levels (65%), Gleason score (52%) and treatment guidelines (48%) were the most common reasons for CADT whereas PSA levels (54%), patient request (48%), desire to maintain sexual function (40%), patient age and comorbidities (38%) were cited most frequently as reasons for IADT.ConclusionsThis international survey with 441 treating physicians from 19 countries showed that ADT is commonly used in treating patients with non-metastatic prostate cancer, and type of ADT is influenced by high-risk criteria (PSA and Gleason), treatment guidelines and patient preferences. IADT use was primarily driven by PSA levels, patient request and patient age/comorbidities, likely reflecting an attempt to minimise adverse effects of ADT in patients with lower risk tumours.

Background: Continuous androgen deprivation therapy (CADT) is commonly used for patients with non-metastatic prostate cancer as primary therapy for high-risk disease, adjuvant therapy together with radiation or for recurrence after initial local therapy. Intermittent ADT (IADT), a recently developed alternative strategy for providing ADT, is thought to potentially reduce adverse effects, but little is known about practice patterns relating to it. We aimed to describe factors related to physicians' ADT use and modality for patients with non-metastatic prostate cancer.Methods: A 45 min online survey was completed by urologists and oncologists responsible for treatment decisions for non-metastatic prostate cancer from 19 countries with high or increasing prevalence of nonmetastatic prostate cancer.Results: There were 441 treating physicians who completed the survey which represented 99 177 patients with prostate cancer under their care, of which 76 386 (77%) had non-metastatic prostate cancer. Of patients with non-metastatic prostate cancer, 38% received ADT (37% gonadotropin-releasing hormone (GnRH), 2% orchiectomy); among patients on GnRH, 54% received CADT (≥6 without >3 months interruption), 23% IADT and 23% <6 months. Highest rates of ADT were reported among oncologists (62%) and in Eastern Europe (Czech Republic, Hungary and Poland). Prostate-specific antigen (PSA) levels (65%), Gleason score (52%) and treatment guidelines (48%) were the most common reasons for CADT whereas PSA levels (54%), patient request (48%), desire to maintain sexual function (40%), patient age and comorbidities (38%) were cited most frequently as reasons for IADT.

e16040 Background: ADT represents standard of care for PC patients (pts) with signs of recurrence after primary therapy (tx). Nature and extent of ADT among M0 pts is not well-characterized, and nearly all ADT-treated pts relapse to develop castration-resistant PC (CRPC) after a median 18-24 months (mos) (Felici 2012). This physician survey quantifies ADT in populations with high or increasing incidence of M0 PC (Ferlay 2010). Methods: A 45-minute online survey was completed by urology and oncology practitioners (MDs) from 19 countries. Eligibility ensured MDs were responsible for tx decisions in the care of M0 PC, and had ≥10 pts on ADT. MDs were asked about tx at different points in the PC pathway, focusing on ADT (gonadotropin-releasing hormone [GnRH] or bilateral orchiectomy [bil orch]), type and duration of GnRH (intermittent vs. continuous), concurrent tx, and pts with CRPC (high risk CRPC definitions explored). Results: In total, 441 MDs completed the survey; predominantly urologists (88%). MDs had 98,689 PC pts under their care, 76,386 (77%) M0 PC. Of M0 PC, 38% received ADT: 37% (28104) GnRH (mainly leuprorelin [47%] or goserelin [21%]) and 1.6% (1251) bil orch (Table). The 34% tx rate reported by US MDs is consistent with decreasing ADT use (Shahinian 2010), whereas rates remain higher in Europe, particularly for Eastern European pts. Across regions, 74% (20,729) of GnRH pts received ≥6 mos, 48% (13,594) continuously; of these, 71% were expected to develop CRPC, 57% of CRPC were considered high risk for bone metastasis (BM). PSA doubling time ≤6 mos was most commonly cited high risk definition. Conclusions: These findings further our understanding of ADT use among M0 PC, which differs by country, by region, with highest rates reported in Europe. ADT rates have public health implications on the number of men expected to develop CRPC and be at high risk of BM in the future. [Table: see text]

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