Evidence map›Paper›PMID 38527096›Full record

ArticleThe oncologist2024

Real-World Evaluation of Primary Versus Secondary Prevention of Skeletal-Related Events in Metastatic Castration-Resistant Prostate Cancer.

William J Phillips, Fred Saad, Jennifer Leigh, Alborz Jooya, Colleen Webber, Scott Morgan, Robert MacRae, Jean-Marc Bourque, Peter Tanuseputro, Michael Ong

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The oncologist, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.8field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

William J PhillipsDepartment of Medicine, Division of Medical Oncology, University of Ottawa, ON, Canada.ORCID 0000-0002-6097-1808
Fred SaadCentre Hospitalier de l'Université de Montréal, QC, Canada.
Jennifer LeighDepartment of Medicine, Division of Medical Oncology, University of Ottawa, ON, Canada.
Alborz JooyaDepartment of Radiology, Radiation Oncology and Medical Physics, University of Ottawa, ON, Canada.
Colleen WebberOttawa Hospital Research Institute, Clinical Epidemiology Program, ON, Canada.
Scott MorganDepartment of Radiology, Radiation Oncology and Medical Physics, University of Ottawa, ON, Canada.
Robert MacRaeDepartment of Radiology, Radiation Oncology and Medical Physics, University of Ottawa, ON, Canada.
Jean-Marc BourqueDepartment of Radiation Oncology, Centre Hospitalier de l'Universite de Montreal, QC, Canada.
Peter TanuseputroDepartment of Medicine, Division of Medical Oncology, University of Ottawa, ON, Canada.
Michael OngDepartment of Medicine, Division of Medical Oncology, University of Ottawa, ON, Canada.ORCID 0000-0002-0347-5541
University of Ottawa · CACentre Hospitalier de l’Université de Montréal · CAOttawa Hospital · CA

Funding

GUMOC Astellas Research
6 · The paper itself

Abstract

introductionAnti-osteoclast treatment with denosumab or zoledronate is known to effectively reduce the need for radiotherapy to bone and other skeletal-related events (SREs) in patients with metastatic castration-resistant prostate cancer (mCRPC). In this study, we analyze primary versus secondary initiation of bone-targeting agents (BTAs) relative to first palliative bone radiotherapy in patients dying of mCRPC.

methodsProvincial administrative databases from Ontario, Canada identified patients with prostate cancer (2007-2018, n = 98 646) who received continuous androgen deprivation therapy (n = 29 453), died of prostate cancer (2013-2018, n = 3864), and received life-prolonging therapy for mCRPC (n = 1850). Variables were collected looking back 3 years from death. Multivariable analysis explored the relationship between clinical variables and BTAs.

resultsOf the 58% (1066/1850) patients with mCRPC who received BTA, only 289 (25.4%) started BTA prior to first palliative bone radiotherapy as primary prevention. Eight hundred and forty-eight (74.6%) patients either never received BTA before death (n = 447) or started BTA only after first bone radiotherapy (n = 401). More patients received denosumab (n = 825, 77%) than zoledronic acid (n = 241, 23%). 51.2% (582/1137) of palliative bone radiotherapy was initiated in the last 12 months of life. Factors associated with the use of BTA included elevated alkaline phosphatase (OR = 1.0, P = .023), de novo metastases (OR = 1.4, P = .005), medical oncologist involvement (OR = 2.0, P = .007), diagnosis 2012-2017 versus 2007-2011 (OR = 0.75, P = .034), and academic center (OR = 0.061, P = .007).

conclusionA majority of patients with mCRPC never receive BTAs prior to first SRE, despite universal access and availability of these agents in Ontario. These results highlight an opportunity to improve outcomes by emphasizing early introduction of BTA in patients with mCRPC being started on systemic therapy.

Indexed as

Bone NeoplasmsProstatic Neoplasms, Castration-ResistantAgedAged, 80 and overBone Density Conservation AgentsDenosumabHumansMaleMiddle AgedOntarioZoledronic AcidBone Density Conservation AgentsDenosumabZoledronic Acidbone-targeted agentsdenosumabprostate cancerskeletal-related eventszoledronate

Identifiers

PMID38527096
PMCPMC11448875
OpenAlexW4393142464

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.