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. 2024 Jan 18:16:17588359231216582.
doi: 10.1177/17588359231216582. eCollection 2024.

Prostate cancer management in Southeast Asian countries: a survey of clinical practice patterns

Edmund Chiong  1 , Marniza Saad  2 , Agus Rizal A H Hamid  3 , Annielyn Beryl Ong-Cornel  4 , Bannakij Lojanapiwat  5 , Choosak Pripatnanont  6 , Dennis Serrano  7 , Jaime Songco  8 , Loh Chit Sin  9 , Lukman Hakim  10 , Melvin Lee Kiang Chua  11 , Nguyen Phuc Nguyen  12 , Pham Cam Phuong  13 , Ravi Sekhar Patnaik  14 , Rainy Umbas  3 , Ravindran Kanesvaran  15
Affiliations

Prostate cancer management in Southeast Asian countries: a survey of clinical practice patterns

Edmund Chiong et al. Ther Adv Med Oncol. .

Abstract

Background: Prostate cancer (PC) has a serious public health impact, and its incidence is rising due to the aging population. There is limited evidence and consensus to guide the management of PC in Southeast Asia (SEA). We present real-world data on clinical practice patterns in SEA for advanced PC care.

Method: A paper-based survey was used to identify clinical practice patterns and obtain consensus among the panelists. The survey included the demographics of the panelists, the use of clinical guidelines, and clinical practice patterns in the management of advanced PC in SEA.

Results: Most panelists (81%) voted prostate-specific antigen (PSA) as the most effective test for early PC diagnosis and risk stratification. Nearly 44% of panelists agreed that prostate-specific membrane antigen positron emission tomography-computed tomography imaging for PC diagnostic and staging information aids local and systemic therapy decisions. The majority of the panel preferred abiraterone acetate (67%) or docetaxel (44%) as first-line therapy for symptomatic mCRPC patients. Abiraterone acetate (50%) is preferred over docetaxel as a first-line treatment in metastatic castration-sensitive prostate cancer patients with high-volume disease. However, the panel did not support the use of abiraterone acetate in non-metastatic castration-resistant prostate cancer (nmCRPC) patients. Apalutamide (75%) is the preferred treatment option for patients with nmCRPC. The cost and availability of modern treatments and technologies are important factors influencing therapeutic decisions. All panelists supported the use of generic versions of approved therapies.

Conclusion: The survey results reflect real-world management of advanced PC in a SEA country. These findings could be used to guide local clinical practices and highlight the financial challenges of modern healthcare.

Keywords: abiraterone acetate; advanced prostate cancer; androgen deprivation; mCRPC; mCSPC; nmCRPC.

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Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
The first preferred guideline is to stratify localized PC patients into low-, intermediate-, and high-risk categories, by specialty. AUA, American Urological Association; EAU, European Association of Urology, ESMO, European Society of Medical Oncology; NCCN, National Comprehensive Cancer Network.
Figure 2.
Figure 2.
Strongly agreed preferred treatment option for patients with low-risk localized prostate cancer, by specialty. CSAP, cryo surgical ablation of prostate; HDR, high-dose rate; HIFU, high intensity focused ultrasound; LDR, low-dose rate.
Figure 3.
Figure 3.
Most preferred method of treatment for patients with advanced prostate cancer. ADT, androgen deprivation therapy; LHRH, luteinizing hormone releasing hormone.
Figure 4.
Figure 4.
Most preferred method of treatment for patients with mCSPC – results from the survey. ADT, androgen deprivation therapy; mCSPC, metastatic castration-sensitive prostate cancer; MDT, metastasis-directed therapy; PSA, prostate-specific antigen; CT, computed tomography; GCSF, granulocyte colony-stimulating factor; mCSPC, metastatic castration-sensitive prostate cancer; PSA, prostate-specific antigen.
Figure 5.
Figure 5.
Most preferred method of treatment for patients with mCSPC – results from survey. ADT, androgen deprivation therapy, CT, computed tomography, GCSF, granulocyte colony stimulating factor, mCSPC, metastatic castration-sensitive prostate cancer, MRI, magnetic resonance imaging, PSA, prostate-specific antigen; PSMA-PET, prostate-specific membrane antigen positron emission tomography.
Figure 6.
Figure 6.
Most preferred method of treatment for patients with nmCRPC – results from the survey. ADT, androgen deprivation therapy; CT, computed tomography; mCRPC, metastatic castration-resistant prostate cancer; MRI, magnetic resonance imaging; nmCRPC, non-metastatic castration-resistant prostate cancer; PSMA-PET, prostate-specific membrane antigen positron emission tomography.
Figure 7.
Figure 7.
Most preferred method of treatment for patients with mCRPC – results from the survey. CRPC, castration-resistant prostate cancer; mCRPC, metastatic castration-resistant prostate cancer; mCSPC, metastatic castration-sensitive prostate cancer; PSA, prostate-specific antigen.
Figure 8.
Figure 8.
Most preferred method of treatment for patients with mCRPC – results from the survey. GCSF, granulocyte colony-stimulating factor; mCRPC, metastatic castration-resistant prostate cancer; PARP, poly (ADP-ribose) polymerase; PSMA, prostate-specific membrane antigen.
Figure 9.
Figure 9.
Most preferred method of treatment for patients with mCRPC – results from the survey. Lu, lutetium, PARP, poly (ADP-ribose) polymerase, PSMA, prostate-specific membrane antigen, mCRPC, metastatic castration-resistant prostate cancer.
Figure 10.
Figure 10.
Most preferred method of treatment for patients with mCRPC – results from the survey. mCRPC, metastatic castration-resistant prostate cancer; MSI, microsatellite instability; NGS, next-generation sequencing; PSMA-PET, prostate-specific membrane antigen positron emission tomography.
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