Impact of the COVID-19 pandemic on new starts to oral oncology medications in the US

Introduction The COVID-19 pandemic has had a significant impact on healthcare delivery. Although others have documented the impact on new cancer diagnoses, trends in new starts for oncology drugs are less clear. We examined changes in new users of oral oncology medications in the US following COVID-19 stay-at-home orders in 2020 compared to prior years. Methods We examined prescription data for members enrolled with a national pharmacy benefits manager in the US from January 1-October 31 of 2018, 2019, and/or 2020. This is a retrospective, observational study comparing new users per 100,000 members per month for all oral oncology drugs, and separately for breast, lung, and prostate cancer, leukemia, and melanoma oral drugs. We performed a difference-in-differences analysis for change in new users from pre-period (prior to pandemic-induced disruption, January-March), to post-period (following pandemic-induced disruption, April-October), between 2020 and 2019, and 2020 and 2018. Results New oral oncology drug users per 100,000 members per month declined by an additional 11.3% in the 2020 post-period compared to 2019 ( p = 0.048). New oral breast cancer drug starts declined by an additional 14.0% in the 2020 post-period compared to 2019 ( p = 0.040). Similar but non-significant trends were found between 2020 and 2018. No significant differences were found between post-period monthly new starts of leukemia, melanoma, lung or prostate cancer disease-specific oral medications. Conclusions Long-term implications of delays in cancer treatment initiation are unclear, although there is concern that patient outcomes may be negatively impacted.

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The impact of plasma zinc status on the severity of prostate cancer disease

Investigative and Clinical Urology ◽

10.4111/icu.2019.60.3.162 ◽

2019 ◽

Vol 60 (3) ◽

pp. 162 ◽

Cited By ~ 2

Author(s):

Victor C. Wakwe ◽

Ehimen. P. Odum ◽

Collins Amadi

Keyword(s):

Prostate Cancer ◽

Zinc Status ◽

Plasma Zinc ◽

Cancer Disease ◽

The Impact

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Impact of skeletal related events (SREs) on health-related quality of life (HRQoL) and healthcare resource utilization (HRU) in prostate cancer patients with bone metastases (BM).

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e16046 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e16046-e16046

Author(s):

Jorge Arellano ◽

Kristina S Chen ◽

Carolyn Atchison ◽

Alex Rider ◽

Andrew Worsfold ◽

...

Keyword(s):

Prostate Cancer ◽

Cancer Patients ◽

Negative Impact ◽

Underlying Disease ◽

Cord Compression ◽

Healthcare Resource Utilization ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Cancer Disease ◽

The Impact

e16046 Background: Advanced prostate cancer often leads to the development of BM and as a result SREs. Treatment and management of SREs, as well as the underlying disease, influences the patient’s HRQoL and HRU. We evaluated the impact of SREs on HRQoL (FACT-P) and HRU in patients with BM. Methods: Data were extracted from the Adelphi Prostate Cancer Disease-Specific Programme (DSP), a cross-sectional survey of 150 urologists and oncologists and their prostate cancer patients conducted from March to June 2012 in the US. Each specialist completed comprehensive record forms on 12 of their patients being treated for prostate cancer. Patients were invited to complete a questionnaire, which included the FACT-P HRQoL instrument. Patients were stratified by SRE experience to assess the impact of SRE on patients with BM. SRE was defined as an event of bone radiation, bone surgery, fracture, or spinal cord compression. Results: Data were collected from 1,749 prostate cancer patients, of which 941 were identified with BM; SRE status was recorded in 499 BM patients (Table). HRQoL was significantly lower in patients experiencing SREs, while the rate of consultations and likelihood of being hospitalized was significantly higher. Conclusions: SREs result in a significant economic burden on the healthcare system and negative impact on HRQoL in prostate cancer patients with BM. [Table: see text]

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Genomic/genetic testing patterns for patients with metastatic castrate-resistant prostate cancer: Results from a real-world study in the United States.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.6_suppl.49 ◽

2021 ◽

Vol 39 (6_suppl) ◽

pp. 49-49

Author(s):

Andrea Leith ◽

Amanda Ribbands ◽

Matthew Last ◽

Alicia Gayle ◽

Sarah Payne ◽

...

Keyword(s):

Prostate Cancer ◽

United States ◽

Genetic Testing ◽

Real World ◽

Patient Characteristics ◽

The United States ◽

Molecular Testing ◽

Cancer Disease ◽

The Us ◽

Castrate Resistant

49 Background: In May 2020, Olaparib was approved for HRRm mCRPC post progression on abiraterone and enzalutamide, and rucaparib was approved for BRCAm mCPRC following progression on androgen receptor targeted inhibitors and prior taxane therapy for mCRPC. HRRm are associated with approximately 25% of mCRPC and may be derived from germline or somatic origin. Somatic and germline alterations can be detected by tumour testing, but to differentiate between these, independent germline testing is needed. This study examined real-world genomic/genetic testing (GT) patterns in patients (pts) diagnosed with mCRPC in the United States (US). Methods: Data were drawn from the Adelphi Prostate Cancer Disease Specific Programme; a point-in-time survey administered to oncologists (onc), urologists (uro) and surgeons (sur) between January and August 2020 in the US. Physicians (phys) completed an attitudinal survey and a patient record form for the next four to nine mCRPC pts seen. Study variables included patient demographics, clinical factors and GT patterns. HRRm testers were defined as phys who tested for HRRm. Pts were identified as positive, negative or unknown depending on the outcome of the HRRm test. Results: A total of 72 phys (69% onc/ 29% uro/ 1% sur; 40% academic vs. 60% community) reported on 346 mCRPC pts. 41% of phys were based in the Northeast, 24% Midwest, 23% South and 13% in the West region of the US. 65 phys (90%) reported having access to overall GT; of these 5% identified as having access to germline tests only, while 94% were able to test for germline and somatic mutations. Challenges to conducting GT overall were ‘cost per test’ (50%), ‘having to send out for the tests (within country)’ (25%), ‘inadequate sample available’ (25%) and ‘patient refusal’ (25%). GT was typically conducted at identification of castrate-resistance (52%), metastases (51%) and at initial diagnosis (49%). 72% of total phys were HRRm testers; for these, patient characteristics primarily driving HRRm testing included Ashkenazi Jewish heritage (63%) and ECOG of 2-4 (58%). Other common drivers were family history, young diagnosis age and hormone therapy failure (all 46%). 132 (38% of 326) mCRPC pts were tested for HRRm; 39% of tested pts were identified with a HRRm. Most common HRRm tested were BRCA1 (90%), BRCA2 (89%) and ATM (55%). Conclusions: In this study majority of US phys had access to GT, but testing was only performed in 38% of pts with mCRPC. The higher than expected % of pts identified with an HRRm suggest that molecular testing was prioritised in high risk populations, as identified by the phys. With the recent approval of olaparib and rucaparib, GT may become more routine in clinical practice to identify eligible pts. Broader testing may also depend on addressing other barriers to testing including cost and testing logistics/practicalities.

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Prescribing practices for tumour aggressiveness and castration resistance in risk-stratified prostate cancer patients

Journal of Prescribing Practice ◽

10.12968/jprp.2020.2.7.392 ◽

2020 ◽

Vol 2 (7) ◽

pp. 392-397

Author(s):

Meenakshi Meenu ◽

Dharamvir Singh Arya

Keyword(s):

Prostate Cancer ◽

Bone Metastasis ◽

Essential Medicines ◽

World Health ◽

Cancer Drug ◽

Prescription Data ◽

Castration Resistant Prostate Cancer ◽

Castration Resistance ◽

Prescribing Practices ◽

Castration Resistant

Capturing real-world prescription data is important for evaluating clinical practice in prostate cancer. The aim of this study was to evaluate prescribing practices in prostate cancer. This was a cross-sectional study in which four groups were identified based on tumour aggressiveness (bone metastasis absent and bone metastasis presnt) and castration response (castration-sensitive prostate cancer and castration-resistant prostate cancer). Drug utilisation methodology and core indicators of World Health Organization were used. A total of 150 patients were stratified into the four groups. The most common regime was complete androgen blockade in both bone metastasis groups and castration-sensitive prostate cancer. Palliative radiotherapy was part of the management in the bone metastasis (present) group. In castration-resistant prostate cancer, abiraterone, fosfestrol, docetaxel, and enzalutamide were prescribed. Approximately 78% of prescriptions contained medicines from the National List of Essential Medicines, India, 2015. Polypharmacy was not a common practice, antibiotics and antidepressant medicines were rarely prescribed. The prescribing trend for prostate cancer conformed to National Comprehensive Cancer Network guidelines.

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The Impact of HMGB1 Polymorphisms on Prostate Cancer Progression and Clinicopathological Characteristics

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17197247 ◽

2020 ◽

Vol 17 (19) ◽

pp. 7247

Author(s):

Ying-Erh Chou ◽

Po-Jen Yang ◽

Chia-Yen Lin ◽

Yen-Yu Chen ◽

Whei-Ling Chiang ◽

...

Keyword(s):

Prostate Cancer ◽

Real Time ◽

Cancer Progression ◽

Cancer Susceptibility ◽

Clinical Status ◽

Clinicopathological Characteristics ◽

Gleason Grade ◽

Cancer Disease ◽

T Stage ◽

The Impact

Prostate cancer is one of the major cancers of the genitourinary tract. High-mobility group box 1 (HMGB1) was suggested as a promising therapeutic target for prostate cancer. In this study, we aim to elucidate the associations of HMGB1 single nucleotide polymorphisms (SNPs) with prostate cancer susceptibility and clinicopathological characteristics. The HMGB1 SNPs rs1412125, rs2249825, rs1045411, and rs1360485 in 579 prostate cancer patients and 579 cancer-free controls were analyzed with real-time polymerase chain reactions (real-time PCR). All of the data were evaluated with SAS statistical software. Our results showed that the HMGB1 rs1045411 T allele genotype was significantly associated with advanced pathologic T stage (odds ratio (OR) = 1.433, 95% confidence interval (CI) = 1.021–2.012; p = 0.037) and pathologic N1 stage (OR = 2.091, 95% CI = 1.160–3.767; p = 0.012), and the rs1360485 polymorphic CT + TT genotype was associated with pathologic Gleason grade group (4 + 5) (OR = 1.583, 95% CI = 1.017–2.462; p = 0.041), pathologic T stage (3 + 4) (OR = 1.482, 95% CI = 1.061–2.070; p = 0.021), and pathologic N1 stage (OR = 2.131, 95% CI = 1.178–3.852; p = 0.011) compared with their wild-type carriers. In conclusion, our results revealed that the HMGB1 SNPs were associated with the clinical status of prostate cancer. The HMGB1 SNPs may have the potential to predict prostate cancer disease progression.

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The impact and collateral damage of COVID-19 on prostate MRI and guided biopsy operations: Society of Abdominal Radiology Prostate Cancer Disease-Focused Panel survey analysis

Abdominal Radiology ◽

10.1007/s00261-021-03087-8 ◽

2021 ◽

Author(s):

Devaki Shilpa S. Surasi ◽

Xuemei Wang ◽

Tharakeswara K. Bathala ◽

Hyunsoo Hwang ◽

Sandeep Arora ◽

...

Keyword(s):

Prostate Cancer ◽

Collateral Damage ◽

Panel Survey ◽

Survey Analysis ◽

Cancer Disease ◽

Prostate Mri ◽

Abdominal Radiology ◽

Guided Biopsy ◽

The Impact

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Delivery of urological services (telemedicine and urgent surgery) during COVID-19 lockdown: experience and lessons learnt from a university hospital in United Kingdom

Scottish Medical Journal ◽

10.1177/0036933020951932 ◽

2020 ◽

Vol 65 (4) ◽

pp. 109-111 ◽

Cited By ~ 1

Author(s):

Bhaskar K Somani ◽

Amelia Pietropaolo ◽

Primrose Coulter ◽

Julian Smith

Keyword(s):

Prostate Cancer ◽

Healthcare Delivery ◽

Diagnostic Procedures ◽

University Hospital ◽

Urgent Care ◽

Clinical Activity ◽

Face To Face ◽

Urgent Surgery ◽

Urological Procedures ◽

The Impact

Background and aims Our departmental planning for COVID-19 was actioned a week before the lockdown (13th March 2020). We look at a 7- week lockdown activity for all scheduled outpatient clinics and urgent procedures. Methods and results A total of 2361 outpatient clinic slots (52.6% oncology slots and 47.4% benign urology slots) were scheduled during this period. The oncology slots included 330 (26.5%) flexible cystoscopy, 555 (44.7%) prostate cancer and 357(28.8%) non-prostate cancer slots. The benign urology slots included 323 (28.8%) andrology, 193 (17.2%) stones and 603 (54%) lower urinary tract symptoms (LUTS) slots. Of the total oncology outpatient slots (n = 1242), 66.3% were virtual consultations, 20% were face-to-face and 13.6% were cancelled. Of the total benign outpatient slots (n = 1119), 81% were virtual consultations, 9.7% were face-to-face and 9.3% were cancelled. A total of 116 anaesthetic surgical procedures were carried out, of which 54 (46.5%) were oncological procedures, 18 (15.5%) were benign urological procedures, and 44 (38%) were diagnostic procedures. Conclusions Hospitals and urologists can benefit from the model used by our hospital to mitigate the impact and prioritise patients most in need of urgent care. Reorganisation and flexibility of healthcare delivery is paramount in these troubled times and will allow clinical activity without compromising patient safety.

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