Predictors of real-world utilisation of docetaxel combined with androgen deprivation therapy in metastatic hormone-sensitive prostate cancer

Arun A. Azad, Ben Tran, Ian D. Davis, Phillip Parente, Melanie Evans, Shirley Wong, Stephen Brown, Sue Evans, Jeremy Millar, Declan G. Murphy, Nathan Papa

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6 Citations (Scopus)

Abstract

Background: Docetaxel has emerged as a standard-of-care for metastatic hormone-sensitive prostate cancer (mHSPC). Uptake of docetaxel for mHSPC in Australia has not previously been reported. Aims: To investigate the real-world uptake of docetaxel in mHSPC and to identify predictors of utilisation of docetaxel in mHSPC. Methods: Men diagnosed from June 2014 to December 2018 and enrolled in the Prostate Cancer Outcomes Registry-Victoria (PCOR-Vic) were included. Data collected include demographics, diagnosis method and institution, staging investigations and treatments within 12 months of diagnosis. Wilcoxon rank-sum, Chi-squared and trend tests were used to identify predictors of docetaxel utilisation. All predictors were entered as covariates simultaneously into a multivariable logistic regression model. Statistical significance was set at 0.05 (two sided). Results: In all, 1014 men with mHSPC were analysed, 25% of whom received docetaxel with androgen deprivation therapy. Uptake of docetaxel increased from 20% in 2014 to 33% in 2018. Predictors of higher usage of docetaxel were younger age and treatment in a private hospital, with both remaining significant on multivariable analysis. Notably, the proportion of men aged <70 years receiving docetaxel increased from 54% in 2014–2015 to 64% in 2016–2018, while in men aged ≥70 years the comparative figures were 15% and 22% respectively. Conclusions: Although docetaxel was not used in the majority of cases, there was a clear increase in docetaxel uptake, especially in younger men following publication of the CHAARTED and STAMPEDE trials. Identifying barriers to real-world implementation of pivotal clinical trial data is critical to improving outcomes in mHSPC.

Original languageEnglish
Number of pages20
JournalInternal Medicine Journal
DOIs
Publication statusAccepted/In press - 12 Mar 2021

Keywords

  • castration
  • chemotherapy
  • docetaxel
  • hormone-sensitive
  • metastatic
  • prostate cancer

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