[Factors influencing the choice of androgen deprivation therapy for patients with hormone-sensitive prostate cancer : Results of the ProComD study].

J Lehmann, C W Kluike, A Haider, K S Haider, S Baumann, M Flesch, M Gedamke, D Kägebein
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Abstract

Background: Androgen deprivation therapy (ADT) with a GnRH agonist or the GnRH antagonist degarelix is a central component in the treatment of prostate cancer (PCa). Little is currently known regarding the decision criteria. Knowledge of these could improve the success of treatment in the future.

Objectives: To identify factors influencing the treatment decision in patients with hormone-sensitive prostate cancer receiving ADT and to determine the incidence of concomitant disease in both treatment groups.

Methods: The two-arm, prospective, non-interventional study "ProComD" was conducted from September 2014 to June 2019 at 80 study centers in Germany. After the therapy decision was made, patients with hormone-sensitive prostate cancer needing ADT were included in the study. Data were collected during routine visits.

Results: Data from 413 patients were evaluated (degarelix N = 268; GnRH agonists N = 145). Key factors influencing the therapy decision for both treatment options included comorbidities (42% of all patients), compliance (64%), and age (81%). The source of information consulted most frequently regarding existing comorbidities was the patient's medical history conducted by the treating urologist themselves (65% in both groups). For patients with pre-existing cardiovascular diseases, the doctor's letter (45.8% degarelix vs. 38.9% GnRH agonists) or the medical history questionnaire (38.9% degarelix vs. 20% GnRH agonists) was additionally taken into account.

Conclusion: Comorbidities along with age and compliance are among the key factors influencing the treatment decisions made by urologists.

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[影响激素敏感性前列腺癌患者选择雄激素剥夺治疗的因素:ProComD研究的结果]。
背景:使用GnRH激动剂或GnRH拮抗剂degarelix进行雄激素剥夺治疗(ADT)是前列腺癌(PCa)治疗的核心组成部分。目前对决策标准知之甚少。了解这些可以提高未来治疗的成功率。目的:探讨影响激素敏感性前列腺癌患者接受ADT治疗决策的因素,并确定两组患者的伴随病发生率。方法:2014年9月至2019年6月,在德国80个研究中心进行了两组前瞻性非干预性研究“ProComD”。在做出治疗决定后,需要ADT治疗的激素敏感性前列腺癌患者被纳入研究。在常规访问中收集数据。结果:413例患者的数据被评估(degarelix N = 268;GnRH激动剂N = 145)。影响两种治疗方案的关键因素包括合并症(占所有患者的42%)、依从性(64%)和年龄(81%)。关于现有合并症,最常咨询的信息来源是由泌尿科医生自己提供的患者病史(两组均为65%)。对于已存在心血管疾病的患者,医生的信(45.8%的degarelix对38.9%的GnRH激动剂)或病史问卷(38.9%的degarelix对20%的GnRH激动剂)也被考虑。结论:合并症、年龄和依从性是影响泌尿科医师治疗决策的关键因素。
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