Learning From Evidence: Changes in Real-World Use of Second Androgen Receptor Targeted Treatments in Metastatic Castration-Resistant Prostate Cancer (mCRPC)

Dianne Bosch; Kim J.M. van der Velden; Tom Belleman; Welmoed K. van Deen; André M Bergman; Maarten J. van der Doelen; Alfons J M van den Eertwegh; Winald R Gerritsen; Reindert J A van Moorselaar; Diederik M. Somford; Metin Tascilar; Hans M. Westgeest; Carin A Uyl-de Groot; Peter F.A. Mulders; Malou C.P. Kuppen; Inge M. van Oort

doi:10.1016/j.clgc.2025.102317

Learning From Evidence: Changes in Real-World Use of Second Androgen Receptor Targeted Treatments in Metastatic Castration-Resistant Prostate Cancer (mCRPC)

Dianne Bosch, Kim J.M. van der Velden, Tom Belleman, Welmoed K. van Deen, André M Bergman, Maarten J. van der Doelen, Alfons J M van den Eertwegh, Winald R Gerritsen, Reindert J A van Moorselaar, Diederik M. Somford, Metin Tascilar, Hans M. Westgeest, Carin A Uyl-de Groot, Peter F.A. Mulders, Malou C.P. Kuppen, Inge M. van Oort

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Abstract

BACKGROUND: Androgen receptor targeted therapies (ART) play a major role in the treatment of metastatic castration-resistant prostate cancer (mCRPC). In recent years consensus has been reached that treatment with a second ART should be avoided due to low response rates. The aim of this study was to investigate if new scientific insights led to changes in clinical daily practice in the Netherlands.

METHODS: Patients included in the Dutch CAPRI-3 prostate cancer registry, currently encompassing 19 hospitals, and treated with at least 1 ART (ie, abiraterone or enzalutamide) were included. Patients were stratified based on start date of first ART (ART1) according to standard of care between 2016-2017, 2018-2019 and 2020-2021. Second ART (ART2) was defined as either direct (ART1>ART2) or at any given time (any ART2).

RESULTS: Between the first and last ART1 group, the prevalence of ART1>ART2 declined from 14.3% to 6.5% (P = .001) and the prevalence of any ART2 from 27.6% to 10.7% (P < .001). The decline was observed before recommendations were included in European guidelines. The use of other life-prolonging drugs (LPDs) after ART1 (ART1>LPD) increased. Patients who were selected for ART1>ART2 instead of ART1>LPD were older, less frequently treated with taxane-based chemotherapy for mHSPC and had a longer time to development of mCRPC.

CONCLUSIONS: New scientific insights were incorporated into clinical daily practice, with a significant decline in in the prevalence of sequential ART treatment, even before recommendations were included in European guidelines.

Original language	English
Article number	102317
Journal	Clinical Genitourinary Cancer
Volume	23
Issue number	3
Early online date	18 Feb 2025
DOIs	https://doi.org/10.1016/j.clgc.2025.102317
Publication status	E-pub ahead of print - 18 Feb 2025

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Bosch, D., van der Velden, K. J. M., Belleman, T., van Deen, W. K., Bergman, A. M., van der Doelen, M. J., van den Eertwegh, A. J. M., Gerritsen, W. R., van Moorselaar, R. J. A., Somford, D. M., Tascilar, M., Westgeest, H. M., Uyl-de Groot, C. A., Mulders, P. F. A., Kuppen, M. C. P., & van Oort, I. M. (2025). Learning From Evidence: Changes in Real-World Use of Second Androgen Receptor Targeted Treatments in Metastatic Castration-Resistant Prostate Cancer (mCRPC). Clinical Genitourinary Cancer, 23(3), Article 102317. Advance online publication. https://doi.org/10.1016/j.clgc.2025.102317

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title = "Learning From Evidence: Changes in Real-World Use of Second Androgen Receptor Targeted Treatments in Metastatic Castration-Resistant Prostate Cancer (mCRPC)",

abstract = "BACKGROUND: Androgen receptor targeted therapies (ART) play a major role in the treatment of metastatic castration-resistant prostate cancer (mCRPC). In recent years consensus has been reached that treatment with a second ART should be avoided due to low response rates. The aim of this study was to investigate if new scientific insights led to changes in clinical daily practice in the Netherlands.METHODS: Patients included in the Dutch CAPRI-3 prostate cancer registry, currently encompassing 19 hospitals, and treated with at least 1 ART (ie, abiraterone or enzalutamide) were included. Patients were stratified based on start date of first ART (ART1) according to standard of care between 2016-2017, 2018-2019 and 2020-2021. Second ART (ART2) was defined as either direct (ART1>ART2) or at any given time (any ART2).RESULTS: Between the first and last ART1 group, the prevalence of ART1>ART2 declined from 14.3% to 6.5% (P = .001) and the prevalence of any ART2 from 27.6% to 10.7% (P < .001). The decline was observed before recommendations were included in European guidelines. The use of other life-prolonging drugs (LPDs) after ART1 (ART1>LPD) increased. Patients who were selected for ART1>ART2 instead of ART1>LPD were older, less frequently treated with taxane-based chemotherapy for mHSPC and had a longer time to development of mCRPC.CONCLUSIONS: New scientific insights were incorporated into clinical daily practice, with a significant decline in in the prevalence of sequential ART treatment, even before recommendations were included in European guidelines.",

author = "Dianne Bosch and {van der Velden}, {Kim J.M.} and Tom Belleman and {van Deen}, {Welmoed K.} and Bergman, {Andr{\'e} M} and {van der Doelen}, {Maarten J.} and {van den Eertwegh}, {Alfons J M} and Gerritsen, {Winald R} and {van Moorselaar}, {Reindert J A} and Somford, {Diederik M.} and Metin Tascilar and Westgeest, {Hans M.} and {Uyl-de Groot}, {Carin A} and Mulders, {Peter F.A.} and Kuppen, {Malou C.P.} and {van Oort}, {Inge M.}",

year = "2025",

month = feb,

day = "18",

doi = "10.1016/j.clgc.2025.102317",

language = "English",

volume = "23",

journal = "Clinical Genitourinary Cancer",

issn = "1558-7673",

publisher = "Elsevier Inc.",

number = "3",

}

Bosch, D, van der Velden, KJM, Belleman, T , van Deen, WK, Bergman, AM, van der Doelen, MJ, van den Eertwegh, AJM, Gerritsen, WR, van Moorselaar, RJA, Somford, DM, Tascilar, M, Westgeest, HM, Uyl-de Groot, CA, Mulders, PFA, Kuppen, MCP & van Oort, IM 2025, 'Learning From Evidence: Changes in Real-World Use of Second Androgen Receptor Targeted Treatments in Metastatic Castration-Resistant Prostate Cancer (mCRPC)', Clinical Genitourinary Cancer, vol. 23, no. 3, 102317. https://doi.org/10.1016/j.clgc.2025.102317

Learning From Evidence: Changes in Real-World Use of Second Androgen Receptor Targeted Treatments in Metastatic Castration-Resistant Prostate Cancer (mCRPC). / Bosch, Dianne; van der Velden, Kim J.M.; Belleman, Tom et al.
In: Clinical Genitourinary Cancer, Vol. 23, No. 3, 102317, 18.02.2025.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Learning From Evidence

T2 - Changes in Real-World Use of Second Androgen Receptor Targeted Treatments in Metastatic Castration-Resistant Prostate Cancer (mCRPC)

AU - Bosch, Dianne

AU - van der Velden, Kim J.M.

AU - Belleman, Tom

AU - van Deen, Welmoed K.

AU - Bergman, André M

AU - van der Doelen, Maarten J.

AU - van den Eertwegh, Alfons J M

AU - Gerritsen, Winald R

AU - van Moorselaar, Reindert J A

AU - Somford, Diederik M.

AU - Tascilar, Metin

AU - Westgeest, Hans M.

AU - Uyl-de Groot, Carin A

AU - Mulders, Peter F.A.

AU - Kuppen, Malou C.P.

AU - van Oort, Inge M.

PY - 2025/2/18

Y1 - 2025/2/18

N2 - BACKGROUND: Androgen receptor targeted therapies (ART) play a major role in the treatment of metastatic castration-resistant prostate cancer (mCRPC). In recent years consensus has been reached that treatment with a second ART should be avoided due to low response rates. The aim of this study was to investigate if new scientific insights led to changes in clinical daily practice in the Netherlands.METHODS: Patients included in the Dutch CAPRI-3 prostate cancer registry, currently encompassing 19 hospitals, and treated with at least 1 ART (ie, abiraterone or enzalutamide) were included. Patients were stratified based on start date of first ART (ART1) according to standard of care between 2016-2017, 2018-2019 and 2020-2021. Second ART (ART2) was defined as either direct (ART1>ART2) or at any given time (any ART2).RESULTS: Between the first and last ART1 group, the prevalence of ART1>ART2 declined from 14.3% to 6.5% (P = .001) and the prevalence of any ART2 from 27.6% to 10.7% (P < .001). The decline was observed before recommendations were included in European guidelines. The use of other life-prolonging drugs (LPDs) after ART1 (ART1>LPD) increased. Patients who were selected for ART1>ART2 instead of ART1>LPD were older, less frequently treated with taxane-based chemotherapy for mHSPC and had a longer time to development of mCRPC.CONCLUSIONS: New scientific insights were incorporated into clinical daily practice, with a significant decline in in the prevalence of sequential ART treatment, even before recommendations were included in European guidelines.

AB - BACKGROUND: Androgen receptor targeted therapies (ART) play a major role in the treatment of metastatic castration-resistant prostate cancer (mCRPC). In recent years consensus has been reached that treatment with a second ART should be avoided due to low response rates. The aim of this study was to investigate if new scientific insights led to changes in clinical daily practice in the Netherlands.METHODS: Patients included in the Dutch CAPRI-3 prostate cancer registry, currently encompassing 19 hospitals, and treated with at least 1 ART (ie, abiraterone or enzalutamide) were included. Patients were stratified based on start date of first ART (ART1) according to standard of care between 2016-2017, 2018-2019 and 2020-2021. Second ART (ART2) was defined as either direct (ART1>ART2) or at any given time (any ART2).RESULTS: Between the first and last ART1 group, the prevalence of ART1>ART2 declined from 14.3% to 6.5% (P = .001) and the prevalence of any ART2 from 27.6% to 10.7% (P < .001). The decline was observed before recommendations were included in European guidelines. The use of other life-prolonging drugs (LPDs) after ART1 (ART1>LPD) increased. Patients who were selected for ART1>ART2 instead of ART1>LPD were older, less frequently treated with taxane-based chemotherapy for mHSPC and had a longer time to development of mCRPC.CONCLUSIONS: New scientific insights were incorporated into clinical daily practice, with a significant decline in in the prevalence of sequential ART treatment, even before recommendations were included in European guidelines.

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U2 - 10.1016/j.clgc.2025.102317

DO - 10.1016/j.clgc.2025.102317

M3 - Article

C2 - 40082112

SN - 1558-7673

VL - 23

JO - Clinical Genitourinary Cancer

JF - Clinical Genitourinary Cancer

IS - 3

M1 - 102317

ER -

Learning From Evidence: Changes in Real-World Use of Second Androgen Receptor Targeted Treatments in Metastatic Castration-Resistant Prostate Cancer (mCRPC)

Abstract

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