title: Patient experience in the treatment of metastatic castration-resistant prostate cancer: state of the science.
abstract: Contemporary therapies for metastatic castration-resistant prostate cancer (mCRPC) have shown survival improvements, which do not account for patient experience and health-related quality of life (HRQoL).
  
  
  
  This literature review included a search of MEDLINE for randomized clinical trials enrolling ⩾50 patients with mCRPC and reporting on patient-reported outcomes (PROs) since 2010.
  
  
  
  Nineteen of 25 publications describing seven treatment regimens (10 clinical trials and nine associated secondary analyses) met the inclusion criteria and were critically appraised. The most commonly used measures were the Functional Assessment of Cancer Therapy-Prostate (n=5 trials) and Brief Pain Inventory Short Form (n=4 trials) questionnaires. The published data indicated that HRQoL and pain status augmented the clinical efficacy data by providing a better understanding of treatment impact in mCRPC. Abiraterone acetate and prednisone, enzalutamide, radium-223 dichloride and sipuleucel-T offered varying levels of HRQoL benefit and/or pain mitigation versus their respective comparators, whereas three treatments (mitoxantrone, estramustine phosphate and docetaxel, and cabazitaxel) had no meaningful impact on HRQoL or pain. The main limitation of the data were that the PROs utilized were not developed for use in mCRPC patients and hence may not have comprehensively captured symptoms important to this population.
  
  
  
  Recently published randomized clinical trials of new agents for mCRPC have captured elements of the patient experience while on treatment. Further research is required to standardize methods for measuring, quantifying and reporting on HRQoL and pain in patients with mCRPC in the clinical practice setting.
authors.affiliation: Department of Genitourinary Cancers, Duke Cancer Institute, Durham, NC, USA.|Flatiron Health, Inc., New York, NY, USA.
authors.forename: N
authors.initials: N
authors.lastname: Nussbaum
authors.affiliation: Department of Genitourinary Cancers, Duke Cancer Institute, Durham, NC, USA.
authors.forename: D J
authors.initials: DJ
authors.lastname: George
authors.affiliation: Flatiron Health, Inc., New York, NY, USA.
authors.forename: A P
authors.initials: AP
authors.lastname: Abernethy
authors.affiliation: CMD Consulting, Inc., Sandy, UT, USA.
authors.forename: C M
authors.initials: CM
authors.lastname: Dolan
authors.affiliation: Department of Clinical Pharmacy, University of California San Francisco, San Francisco, CA, USA.
authors.forename: N
authors.initials: N
authors.lastname: Oestreicher
authors.affiliation: Health Economics and Clinical Outcomes Research, Astellas Pharma Global Development, Inc., Northbrook, IL, USA.
authors.forename: S
authors.initials: S
authors.lastname: Flanders
authors.affiliation: USC Norris Cancer Hospital, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
authors.forename: T B
authors.initials: TB
authors.lastname: Dorff
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D006801:Humans; D007167:Immunotherapy / Q000009:adverse effects / Q000379:methods; D008297:Male; D009362:Neoplasm Metastasis; D064129:Prostatic Neoplasms, Castration-Resistant / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D011788:Quality of Life; D016896:Treatment Outcome
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