The burden of symptomatic skeletal events in castrate-resistant prostate cancer patients with bone metastases at three Canadian uro-oncology centres

Saad, Fred; Fleshner, Neil; So, Alan; Lorier, Jacques Le; Perrault, Louise; Poulin‐Costello, Melanie; Rogoza, Raina M.; Robson, Ewan J.D.

doi:10.5489/cuaj.5053

Cited by 5 publications

(8 citation statements)

References 23 publications

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“…To our knowledge, no observational studies have estimated incidence rates of SREs in men with CRPC starting at the time of castration resistance. An observational study of men who died from or were treated palliatively for metastatic CRPC at three medical centers in Canada reported an incidence rate of symptomatic skeletal events of 85.4 per 100 patient-years (7.1 per 100 person-months), which is higher than the incidence rate of SREs observed in the present analysis [3]. Notable differences from our study include that their study used medical records to assess multiple symptomatic skeletal events from the time of diagnosis of bone metastases until death.…”

Section: Discussioncontrasting

confidence: 62%

“…Skeletal-related events (SREs) are common in men with bone metastases and have negative consequences for patients with castration-resistant prostate cancer (CRPC), including pain, reduced quality of life, and increased risk of death [1, 2]. Studies have examined the incidence of SREs in cohorts of men with metastatic prostate cancer [1, 3–5], but no population-based studies have been conducted in men with prostate cancer starting at the time of castration resistance. The objective of this study was to estimate incidence rates of SREs in a cohort of men with CRPC in the Surveillance, Epidemiology, and End Results (SEER)-Medicare-linked database.…”

Section: Introductionmentioning

confidence: 99%

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Incidence of Skeletal-Related Events in Patients with Castration-Resistant Prostate Cancer: An Observational Retrospective Cohort Study in the US

Kawai

Martínez²,

Saltus

et al. 2019

Prostate Cancer

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Background and Objective. Skeletal-related events (SREs) are common in men with bone metastases and have negative consequences for patients with castration-resistant prostate cancer (CRPC), including pain, reduced quality of life, and increased mortality. We estimated incidence rates of first SREs in a cohort of men with CRPC in the Surveillance, Epidemiology, and End Results-Medicare database. Methods. We included men aged ≥ 65 years with a prostate cancer diagnosis in 2000-2011 if they had no prior malignancy (other than nonmelanoma skin cancer) and had surgical or medical castration with subsequent second-line systemic therapy, which was used to infer castration resistance. The first occurrence of an SRE (fracture, bone surgery, radiation therapy, or spinal cord compression) in Medicare claims was identified. Incidence rates of SREs were estimated in all eligible person-time and, in secondary analyses, stratified by any use of bone-targeted agents (BTAs) and history of SRE. Results. Of 2,234 men with CRPC (84% white, mean age = 76.6 years), 896 (40%) had an SRE during follow-up, with 74% occurring within a year after cohort entry. Overall, the incidence rate of SREs was 3.78 (95% CI, 3.53-4.03) per 100 person-months. The incidence rate of SREs before any BTA use was 4.16 (95% CI, 3.71-4.65) per 100 person-months, and after any BTA use was 3.60 (95% CI, 3.32-3.91) per 100 person-months. The incidence rate in patients with no history of SRE was 3.33 (95% CI 3.01-3.68) per 100 person-months, and in patients who had such a history, it was 4.20 (95% CI 3.84-4.58) per 100 person-months. Conclusions. In this large cohort of elderly men with CRPC in the US, SREs were common. A decrease in incidence of SREs after starting BTA is suggested, but the magnitude of the effect may be confounded by indication and other factors such as age and prior SRE.

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Section: Discussioncontrasting

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Incidence of Skeletal-Related Events in Patients with Castration-Resistant Prostate Cancer: An Observational Retrospective Cohort Study in the US

Kawai

Martínez²,

Saltus

et al. 2019

Prostate Cancer

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“…Beyond survival, health-related quality of life (HRQoL) and pain are highly relevant to patients with mCRPC ( 11 ). Up to 90% of patients have bone metastases, which are a clinically significant cause of morbidity that often result in severe bone pain, either directly due to metastatic disease or indirectly as a result of symptomatic skeletal events (SSEs) such as fracture and spinal-cord compression ( 2 , 8 ).…”

Section: Introductionmentioning

confidence: 99%

Treatment landscape and burden of disease in metastatic castration-resistant prostate cancer: systematic and structured literature reviews

Leaning,

Kaur,

Morgans

et al. 2023

Front. Oncol.

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PurposeMetastatic castration-resistant prostate cancer (mCRPC) is a lethal disease that imposes a major burden on patients and healthcare systems. Three structured literature reviews (treatment guidelines, treatment landscape, and human/clinical/patient burden) and one systematic literature review (economic burden) were conducted to better understand the disease burden and unmet needs for patients with late-stage mCRPC, for whom optimal treatment options are unclear.MethodsEmbase®, MEDLINE®, MEDLINE® In-Process, the CENTRAL database (structured and systematic reviews), and the Centre for Reviews and Dissemination database (systematic review only) were searched for English-language records from 2009 to 2021 to identify mCRPC treatment guidelines and studies related to the treatment landscape and the humanistic/economic burden of mCRPC in adult men (aged ≥18 years) of any ethnicity.ResultsIn total, six records were included for the treatment patterns review, 14 records for humanistic burden, nine records for economic burden, three records (two studies) for efficacy, and eight records for safety. Real-world treatment patterns were broadly aligned with treatment guidelines and provided no optimal treatment sequencing beyond second line other than palliative care. Current post-docetaxel treatments in mCRPC are associated with adverse events that cause relatively high rates of treatment discontinuation or disruption. The humanistic and economic burdens associated with mCRPC are high.ConclusionThe findings highlight a lack of treatment options with novel mechanisms of action and more tolerable safety profiles that satisfy a risk-to-benefit ratio aligned with patient needs and preferences for patients with late-stage mCRPC. Treatment approaches that improve survival and health-related quality of life are needed, ideally while simultaneously reducing costs and healthcare resource utilization.

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“…If bone metastases are left untreated, there is a substantial risk of skeletal‐related events (SREs) such as fractures, spinal cord compression and need for palliative external beam radiation 11,12 . The risk of SREs is heightened in patients with bone pain and also in those with a greater burden of bone involvement 13,14 and they are associated with a significant negative impact on the quality of life, including physical, social and emotional wellbeing, and more severe pain 15,16 .…”

Section: Introductionmentioning

confidence: 99%

Use of bisphosphonates and other bone supportive agents in the management of prostate cancer—A UK perspective

Payne

Bahl

2020

Int. J. Clin. Pract.

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Bone is the most common site of metastatic spread in men with prostate cancer, occurring in up to 90% of advanced cases. 1,2 Studies have shown that within 2 years, without preventive therapy, 33-46% of men with non-metastatic castration-resistant prostate cancer (nmCRPC) and biochemical progression on androgen deprivation therapy (ADT) developed bone metastases. 3,4 The presence of bone metastases is associated with shortened survival. In one study, 1-and 5-year overall survival rates of 47% and 3% and 87% and 56% in patients with and without bone metastases, respectively, have been reported, 5 whereas in another study cancer-specific mortality at 5 years was 58% in men with exclusively bone metastases, 45% in those with exclusively lymph node metastases and 63% in those with visceral metastases alone. 6 In an analysis of data from the control arm of the STAMPEDE trial,

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The burden of symptomatic skeletal events in castrate-resistant prostate cancer patients with bone metastases at three Canadian uro-oncology centres

Cited by 5 publications

References 23 publications

Incidence of Skeletal-Related Events in Patients with Castration-Resistant Prostate Cancer: An Observational Retrospective Cohort Study in the US

Incidence of Skeletal-Related Events in Patients with Castration-Resistant Prostate Cancer: An Observational Retrospective Cohort Study in the US

Treatment landscape and burden of disease in metastatic castration-resistant prostate cancer: systematic and structured literature reviews

Use of bisphosphonates and other bone supportive agents in the management of prostate cancer—A UK perspective

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