Evidence map›Paper›PMID 39470659›Full record

ArticleCanadian Urological Association journal = Journal de l'Association des urologues du Canada2025

Practice patterns and predictors of treatment intensification in patients with metastatic castration-sensitive prostate cancer.

Geoffrey T Gotto, Steven M Yip, Bobby Shayegan, Dylan E O'Sullivan, Christopher J D Wallis, Naveen S Basappa, Ilias Cagiannos, Robert J Hamilton, Cristiano Ferrario, Ricardo Fernandes and 9 more

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In one paragraph

Article in Canadian Urological Association journal = Journal de l'Association des urologues du Canada, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Patient selection for triplet therapy with darolutamide in metastatic castration-sensitive prostate cancer and patterns of administration: a Spanish multicenter study.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026
    Article
  4. Article
  5. 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

19 authors.

Geoffrey T GottoSouthern Alberta Institute of Urology, University of Calgary, Calgary, AB, Canada.
Steven M YipTom Baker Cancer Centre, University of Calgary, Calgary, AB, Canada.
Bobby ShayeganSt. Joseph's Healthcare, McMaster University, Hamilton, ON, Canada.
Dylan E O'SullivanOncology Outcomes Initiative, University of Calgary, Calgary, AB, Canada.
Christopher J D WallisMount Sinai Hospital, University of Toronto, Toronto, ON, Canada.
Naveen S BasappaCross Cancer Institute, University of Alberta, Edmonton, AB, Canada.
Ilias CagiannosThe Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.
Robert J HamiltonPrincess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.
Cristiano FerrarioJewish General Hospital, McGill University, Montreal, QC, Canada.
Ricardo FernandesLondon Health Sciences Centre, Western University, London, ON, Canada.
Brita DanielsonCross Cancer Institute, University of Alberta, Edmonton, AB, Canada.
Fred SaadCentre Hospitalier de l'Université de Montréal, Montreal, QC, Canada.
Sebastien J HotteJuravinski Cancer Centre, McMaster University, Hamilton, ON, Canada.
Winson Y CheungOncology Outcomes Initiative, University of Calgary, Calgary, AB, Canada.
Devon J BoyneOncology Outcomes Initiative, University of Calgary, Calgary, AB, Canada.
Katherine ChanMedical Affairs, Janssen Inc, Toronto, ON, Canada.
Brendan OsborneMedical Affairs, Janssen Inc, Toronto, ON, Canada.
Anousheh ZardanMedical Affairs, Janssen Inc, Toronto, ON, Canada.
Shawn MaloneThe Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionTreatment intensification beyond androgen deprivation therapy (ADT) has shown survival benefit in patients with metastatic castration-sensitive prostate cancer (mCSPC). There is a need to better understand how these novel treatments fit in real-world practice.

methodsUsing electronic medical records and administrative data, a population-based, retrospective cohort study of patients diagnosed with de novo mCSPC between 2010 and 2020 in Alberta, Canada, and initiated on ADT was conducted. Treatment intensification was defined as the receipt of apalutamide, abiraterone acetate, enzalutamide, or chemotherapy (e.g., docetaxel) within 180 days of ADT initiation.

resultsA total of 2515 de novo mCSPC were identified, with 2098 (83%) patients initiating ADT post-diagnosis. Of those, 525 (25%) received intensification beyond ADT. Three percent of patients were intensified in 2010-2013; this increased to 67% in 2020. From 2014-2017, docetaxel was the most used approach, although it was supplanted by abiraterone acetate, apalutamide, and enzalutamide from 2018 onwards. In multivariable logistic regression analyses of patients diagnosed from 2014-2020, significant predictors of intensification were younger age at diagnosis, lower Charlson comorbidity index, greater number of metastatic sites, shorter time to ADT initiation, referral to a medical oncologist, transurethral resection of the prostate or radiation prior to ADT, and more recent year of diagnosis (all p<0.05).

conclusionsThere has been a considerable increase in the use of ADT intensification therapies that correspond with the timing of clinical trial data and approvals of novel agents.

Identifiers

PMID39470659
PMCPMC11790044

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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.