Evidence map›Paper›PMID 40906580›Full record

ArticleCancer2025

Association of patient and physician characteristics with androgen-deprivation-therapy intensification in patients with de novo hormone-sensitive metastatic prostate cancer: A population-based study.

David-Dan Nguyen, Raj Satkunasivam, Khatereh Aminoltejari, Amanda Hird, Soumyajit Roy, Scott C Morgan, Shawn Malone, Michael Ong, Di Maria Jiang, Geoffrey T Gotto and 5 more

Abstract read
In one paragraph

Article in Cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
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

15 authors.

David-Dan NguyenDivision of Urology, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
Raj SatkunasivamDepartment of Urology, Houston Methodist Hospital, Houston, Texas, USA.
Khatereh AminoltejariDivision of Urology, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
Amanda HirdDivision of Urology, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
Soumyajit RoyDepartment of Radiation Oncology, Rush University Medical Center, Chicago, Illinois, USA.ORCID https://orcid.org/0000-0001-6617-5522
Scott C MorganDepartment of Radiology, Radiation Oncology and Medical Physics, The Ottawa Hospital Cancer Centre, University of Ottawa, Ottawa, Ontario, Canada.ORCID https://orcid.org/0000-0002-6568-3346
Shawn MaloneDepartment of Radiology, Radiation Oncology and Medical Physics, The Ottawa Hospital Cancer Centre, University of Ottawa, Ottawa, Ontario, Canada.ORCID https://orcid.org/0000-0001-5497-3455
Michael OngDepartment of Medical Oncology, The Ottawa Hospital Cancer Centre, University of Ottawa, Ottawa, Ontario, Canada.
Di Maria JiangDepartment of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.ORCID https://orcid.org/0000-0002-1950-2292
Geoffrey T GottoDivision of Urology, Department of Surgery, University of Calgary, Calgary, Alberta, Canada.
Bobby ShayeganDivision of Urology, Department of Surgery, St. Joseph's Healthcare Hamilton, McMaster University, Hamilton, Ontario, Canada.
Girish S KulkarniDivision of Urology, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
Rodney H BreauDivision of Urology, Department of Surgery, The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada.
Aly-Khan A LalaniDepartment of Medical Oncology, Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada.
Christopher J D WallisDivision of Urology, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.ORCID https://orcid.org/0000-0002-5990-4026

Funding

BayerCUASF Early Investigator Research ScholarshipUniversity of Toronto Urologic Oncology Research and Innovation Fund
6 · The paper itself

Abstract

introductionTreatment intensification with androgen receptor signaling inhibitors and/or chemotherapy is guideline recommended for patients with de novo metastatic hormone-sensitive prostate cancer (mHSPC). However, most patients only receive androgen deprivation therapy monotherapy. The aim was to identify physician-, patient-, and tumor-related factors associated with the receipt of treatment intensification.

methodsA population-based cohort study was conducted in Ontario, Canada, which included men ≥66 years newly diagnosed with de novo mHSPC between January 2014 and December 2022. Hierarchical regression modeling was used to examine the association of physician, patient, and tumor characteristics with the receipt of treatment intensification, defined as the initiation of an androgen receptor signaling inhibitor, docetaxel, or both within six months of diagnosis. Darlington's method was used to assess predictor importance via standardized regression coefficients (SRC).

resultsAmong 6099 eligible older men newly diagnosed with de novo mHSPC, 1475 (24.2%) received treatment intensification. In multivariable modeling, patients initiated on androgen deprivation therapy by radiation oncologists were less likely to receive treatment intensification (odds ratio [OR]. 0.48; 95% CI, 0.37-0.61; p < .01; SRC: 19.46; p < .01) whereas those by medical oncologists were more likely to receive treatment intensification (OR, 1.64; 95% CI, 1.21-2.22; p < .01; SRC: 9.56; p < .01), each compared to urologists. Older patients were significantly less likely to receive treatment intensification (OR 0.94 per year over age 66; 95% CI, 0.93-0.95; p < .01; SRC: -36.21; p < .01).

conclusionPatient and physician characteristics significantly influence variation in the use of treatment intensification for de novo mHSPC. These findings inform targeted interventions and policies to enhance the delivery of life-prolonging mHSPC care.

Indexed as

Androgen AntagonistsPractice Patterns, Physicians'Prostatic NeoplasmsAgedAged, 80 and overCohort StudiesDocetaxelHumansMaleNeoplasm MetastasisOntarioAndrogen AntagonistsDocetaxelandrogen antagonistshealth services researchmedical oncologyphysicianspractice patternsprostatic neoplasmsradiation oncologyurology

Identifiers

PMID40906580
PMCPMC12410596

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.