Recommandations françaises du Comité de cancérologie de l’AFU – actualisation 2020–2022 : cancer de la prostate

Rozet, François; Mongiat-Artus, Pierre; Hennequin, C.; Beauval, J.B.; Beuzeboc, Philippe; Cormier, L.; Fromont-Hankard, G.; Mathiéu, Romain; Ploussard, Guillaume; Renard-Penna, R.; Brenot-Rossi, I.; Bruyère, F.; Cochet, Alexandre; Créhange, G.; Cussenot, Olivier; Lebrét, Thierry; Rébillard, Xavier; Soulié, M.; Brureau, Laurent; Méjean, A.

doi:10.1016/s1166-7087(20)30752-1

Cited by 71 publications

(24 citation statements)

References 454 publications

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“…NHA rechallenge may become the frontline treatment option in mCRPC in countries where this is an acceptable option (e.g., Germany [40] and Japan [41]). However, in other countries, such as the UK [42] and France [43], it remains to be seen how the treatment patterns will evolve, since rechallenging NHA is not an approved treatment option and therefore chemotherapy (docetaxel) may be the first-line treatment of choice in the mCRPC setting. Future studies are warranted to assess how the treatment patterns will evolve within the metastatic prostate cancer setting.…”

Section: Discussionmentioning

confidence: 99%

Impact of next-generation hormonal agents on treatment patterns among patients with metastatic hormone-sensitive prostate cancer: a real-world study from the United States, five European countries and Japan

et al. 2022

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Background Until five years ago, the metastatic hormone-sensitive prostate cancer (mHSPC) treatment landscape was dominated by the use of androgen deprivation therapy (ADT) alone. However, novel hormonal agents (NHAs) and chemotherapy are now approved for male patients with mHSPC. This study aimed to understand the impact NHA approvals had on mHSPC real-world treatment patterns and to identify the key factors associated with NHA or chemotherapy (± ADT) usage vs ADT alone. Methods Data were collected from the Adelphi Prostate Cancer Disease Specific Programme (DSP)™, a point-in-time survey of physicians and their consulting patients conducted in the United States (US), five European countries (France, Germany, Italy, Spain, and the United Kingdom), and Japan between January and August 2020. Data were analysed using descriptive statistics for individual countries, regions, and all countries combined. Pairwise analyses were used to further investigate differences between treatment groups at global level. Results 336 physicians provided data on 1195 mHSPC patients. Globally, at data collection, the most common mHSPC regimen initiated first was ADT alone (47%), followed by NHAs (± ADT) (31%, of which 21% was abiraterone, 8% was enzalutamide, and 2% was apalutamide) and chemotherapy (± ADT) (19%). The highest rates of ADT alone usage were observed in Japan (78%) and Italy (66%), and the lowest in Spain (34%) and in the US (36%). Our results showed that clinical decision making was driven by patient fitness, compliance, tolerance of adverse events, and balance of impact on quality of life vs overall survival. Conclusions This real-world survey offered early insights into the evolving mHSPC treatment paradigm. It showed that in 2020, ADT alone remained the most common initial mHSPC therapy, suggesting that physicians may prefer using treatments which they are familiar and have experience with, despite clinical trial evidence of improved survival with NHAs or chemotherapy (± ADT) vs ADT alone. Results also indicated that physicians prescribed specific mHSPC treatments primarily based on the following criteria: patient preference, disease burden/severity, and the performance status and comorbidities of the patient. To fully appreciate the rapidly changing mHSPC treatment landscape and monitor NHA uptake, additional real-world studies are required.

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Section: Discussionmentioning

confidence: 99%

Impact of next-generation hormonal agents on treatment patterns among patients with metastatic hormone-sensitive prostate cancer: a real-world study from the United States, five European countries and Japan

et al. 2022

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“…Over the years the most common indication for prostate MRI transitioned from merely staging prostate cancer (PCa) to detecting it [ 5 ], and MRI is now recommended in biopsy-naive patients [ 6 , 7 ]. The PI-RADS scoring system [ 8 , 9 ], designed to detect PCa, is based on the internal structure of the prostate, divided into four histological zones called the peripheral (PZ), transitional (TZ), central (CZ) zones and the anterior fibromuscular stroma (AFMS) [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Challenge of prostate MRI segmentation on T2-weighted images: inter-observer variability and impact of prostate morphology

Montagne

Hamzaoui²,

Allera

et al. 2021

Insights Imaging

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Background Accurate prostate zonal segmentation on magnetic resonance images (MRI) is a critical prerequisite for automated prostate cancer detection. We aimed to assess the variability of manual prostate zonal segmentation by radiologists on T2-weighted (T2W) images, and to study factors that may influence it. Methods Seven radiologists of varying levels of experience segmented the whole prostate gland (WG) and the transition zone (TZ) on 40 axial T2W prostate MRI images (3D T2W images for all patients, and both 3D and 2D images for a subgroup of 12 patients). Segmentation variabilities were evaluated based on: anatomical and morphological variation of the prostate (volume, retro-urethral lobe, intensity contrast between zones, presence of a PI-RADS ≥ 3 lesion), variation in image acquisition (3D vs 2D T2W images), and reader’s experience. Several metrics including Dice Score (DSC) and Hausdorff Distance were used to evaluate differences, with both a pairwise and a consensus (STAPLE reference) comparison. Results DSC was 0.92 (± 0.02) and 0.94 (± 0.03) for WG, 0.88 (± 0.05) and 0.91 (± 0.05) for TZ respectively with pairwise comparison and consensus reference. Variability was significantly (p < 0.05) lower for the mid-gland (DSC 0.95 (± 0.02)), higher for the apex (0.90 (± 0.06)) and the base (0.87 (± 0.06)), and higher for smaller prostates (p < 0.001) and when contrast between zones was low (p < 0.05). Impact of the other studied factors was non-significant. Conclusions Variability is higher in the extreme parts of the gland, is influenced by changes in prostate morphology (volume, zone intensity ratio), and is relatively unaffected by the radiologist’s level of expertise.

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“…Comme illustration, une pétition a été lancée par l'association de patients ANAMACaP (Association Nationale des Malades du Cancer de la Prostate), en 2013, pour que les individus puissent avoir accès à une information notamment sur la susceptibilité de contracter la pathologie [22]. Cette nécessité d'information est également relayée de manière plus récente par l' Association française d'urologie qui recommande aux médecins une information (sur le dépistage, le diagnostic et les traitements) et un consentement des hommes, pour s'assurer que la détection précoce du cancer de la prostate soit en accord avec leurs attentes [23]. En 2013, en Australie, un jury de douze hommes âgés entre 50 et 70 ans a été informé sur tous les aspects du dépistage du cancer de la prostate puis a formulé certaines recommandations à ce sujet [24].…”

Section: Discussionunclassified

Perceptions et connaissances concernant la décision de réaliser le dépistage du cancer de la prostate

Charvin¹,

Moutel²,

Launoy³

et al. 2022

Santé Publique

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Recommandations françaises du Comité de cancérologie de l’AFU – actualisation 2020–2022 : cancer de la prostate

Cited by 71 publications

References 454 publications

Impact of next-generation hormonal agents on treatment patterns among patients with metastatic hormone-sensitive prostate cancer: a real-world study from the United States, five European countries and Japan

Impact of next-generation hormonal agents on treatment patterns among patients with metastatic hormone-sensitive prostate cancer: a real-world study from the United States, five European countries and Japan

Challenge of prostate MRI segmentation on T2-weighted images: inter-observer variability and impact of prostate morphology

Perceptions et connaissances concernant la décision de réaliser le dépistage du cancer de la prostate

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