title: First-line management of metastatic castrate-resistant prostate cancer patients: Audit of real-life practices.
abstract: BACKGROUND
  No reliable guidelines are available for choosing the best option between docetaxel and new hormonal therapies (NHTs) (i.e., abiraterone and enzalutamide) in first-line therapy for metastatic castration-resistant prostate cancer (mCRPC) patients. We performed an audit of real-life practices.
  
  
  METHODS
  We built an online questionnaire and distributed it with the help of French oncology networks. This questionnaire was sent to 481 physicians who treat patients with mCRPC. All of the answers were declarative, individual, and anonymized. A descriptive analysis was done. A univariate logistic regression analysis was performed for the criteria of choice between docetaxel and NHTs.
  
  
  RESULTS
  From March to July 2015, 109/481 physicians (22.6%) completed the questionnaire. The selection criteria for initially choosing docetaxel were as follows: presence of visceral metastases (79.8%), heavy tumor burden (68.8%), aggressive tumor disease (66.1%), and short-term efficacy of castration (66.1%). The selection criteria for initially choosing NHTs were as follows: long-term efficacy of castration (66.1%), higher age (67.9%), low tumor grade (56.9%), and absence of symptoms (54.1%). With docetaxel, the first tumor assessment was typically performed after three (1-6) cycles, including prostate-specific antigen (PSA) testing (96.3%), a thoraco-abdominopelvic CT scan (68.8%), and bone scintigraphy (59.6%). With NHTs, tumor assessment was mainly performed after 3 months of treatment (1-6) and included PSA testing, a thoraco-abdominopelvic CT, and bone scintigraphy in 90.8%, 61.5%, and 63.3% of cases, respectively.
  
  
  CONCLUSIONS
  This is the first study assessing real-life practices among physicians who treat patients with mCRPC. These practices were found to be homogeneous.
authors.affiliation: CHRU de Lille, medical oncology department, rue Michel-Polonovski, 59037 Lille cedex, France; Institut de biologie de Lille, CNRS-UMR8161, 1, rue du Professeur-Calmette, 59021 Lille cedex, France. Electronic address: anthony.turpin@chru-lille.fr.
authors.forename: Anthony
authors.initials: A
authors.lastname: Turpin
authors.affiliation: Centre Oscar-Lambret, department of radiotherapy, 3, rue F.-Combemale, 59020 Lille, France.
authors.forename: David
authors.initials: D
authors.lastname: Pasquier
authors.affiliation: Gustave-Roussy hospital, department of therapeutic innovation and early trials, 114, rue Edouard-Vaillant, 94800 Villejuif, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Massard
authors.affiliation: Clinique Sainte-Marguerite, medical oncology department, oncovar, avenue Alexis-Godillot, 83400 Hyères, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Berdah
authors.affiliation: AP-HP, Saint-Louis hospital, medical oncology, 75010 Paris, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Culine
authors.affiliation: Centre Oscar-Lambret, medical oncology department, 3, rue F.-Combemale, 59020 Lille, France; SIRIC ONCOLille Consortium, Clinical Research and Methodology Platform, 59000 Lille, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Penel
mesh_terms: D000367:Age Factors; D000368:Aged; D000726:Androgen Antagonists / Q000627:therapeutic use*; D000736:Androstenes / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001549:Benzamides; D001842:Bone and Bones / Q000000981:diagnostic imaging; D000077143:Docetaxel; D006801:Humans; D008297:Male; D008485:Medical Audit; D008495:Medical Oncology / Q000706:statistics & numerical data; D060787:Neoplasm Grading; D009570:Nitriles; D010669:Phenylthiohydantoin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010818:Practice Patterns, Physicians'; D017430:Prostate-Specific Antigen / Q000097:blood; D064129:Prostatic Neoplasms, Castration-Resistant / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D018787:Radiation Oncology / Q000706:statistics & numerical data; D011877:Radionuclide Imaging; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D043823:Taxoids / Q000627:therapeutic use*; D047368:Tumor Burden; D014572:Urology / Q000706:statistics & numerical data
chemical_list: D000726:Androgen Antagonists; D000736:Androstenes; D000970:Antineoplastic Agents; D001549:Benzamides; D009570:Nitriles; D043823:Taxoids; D000077143:Docetaxel; D010669:Phenylthiohydantoin; C540278:enzalutamide; D017430:Prostate-Specific Antigen; C089740:abiraterone
keywords: Abiraterone; Abiratérone; Cancer de la prostate résistant à la castration; Castrate-resistant prostate cancer; Docetaxel; Docétaxel; Enzalutamide; First-line therapy; Première ligne