Prescribing androgen deprivation therapy for prostate cancer: results of a French questionnaire survey.

Abstract

Objective: This study aimed to assess the management of adverse effects at the initiation and during follow-up of androgen deprivation therapy (ADT) for prostate cancer (PCa), by French urologists, oncologists, and radiotherapists, including treatments with luteinizing hormone-releasing hormone (LHRH) agonists or antagonists and androgen receptor pathway inhibitors (ARPIs).

Methods: A 23-question questionnaire was sent to French oncologists, radiotherapists and urologists via various regional and national networks. Responses were collected between February and July 2024 using a Google Form. A descriptive analysis was performed.

Results: Among the 133 respondents, 27.1% were urologists, 36.1% oncologists, and 36.8% radiotherapists, with a mean age of 38.6 years. A Likert scale was used to assess the importance of different examinations before initiating ADT, ranging from 1 (not important) to 5 (very important). Lipid profile had the highest mean score (4.12), while height measurement had the lowest (2.18). Cardiologist referral for metastatic PCa patients undergoing ADT was not systematic, with 12.7% of respondents never referring these patients to a cardiologist. Darolutamide was the least prescribed ARPI (52/133), whereas abiraterone acetate (100/133) and enzalutamide (102/133) were most commonly prescribed. Key barriers to prescribing ARPIs included cardiological follow-up, drug interactions, liver and skin toxicity, and a lack of experience with the drug.

Conclusion: Pre-therapeutic assessment and follow-up of patients undergoing ADT seems to vary from one prescriber to another. These findings highlight opportunities to optimize treatment, particularly through medication reconciliation programs, which enhance the safe and appropriate use of ADT in PCa.