UP-90 Evaluation of trends in treatment of Metastatic Hormone Sensitive Prostate Cancer (mHSPC) across Canada during the COVID-19 pandemic
Thursday June 27, 2019 from

carlos eduardo stecca, Canada

clinical research fellow

Division of medical oncology and hematololgy

University Health Network-Princess Margaret Hospital


Evaluation of trends in treatment of metastatic hormone sensitive prostate cancer (mHSPC) across Canada during the COVID-19 pandemic

Carlos Stecca1, Di Jiang1, Zachary Veitch2, Sebastian J Hotte4, Nimira Alimohamed3, Lori Wood5, Srikala Sridhar1.

1Medical Oncology and Hematology, University Health Network-Princess Margaret Hospital, Toronto, ON, Canada; 2Medical Oncology and Hematology, Saint MichaelĀ“s Hospital, Toronto, ON, Canada; 3Medical Oncology and Hematology, Tom Baker Cancer Centre, University of Calgary, Calgary, AB, Canada; 4Medical Oncology, Oncology Juravinski Cancer Centre, Hamilton, ON, Canada; 5Medical Oncology, Nova Scotia Health, Dalhousie University, Halifax, NS, Canada

Introduction: The impact of the COVID 19 pandemic on the management of mHSPC is unknown. Recent Canadian recommendations favor the use of androgen-receptor-axis targeted therapies (ARATs) over docetaxel to minimize risk of COVID-19 infections. We aimed to characterize how the pandemic has influenced current practice patterns of medical oncologists in Canada who treat mHSPC.

Methods: Using SurveyMonkey®, we conducted an online survey among 119 practicing members of the Genitourinary Medical Oncologists of Canada (GUMOC) in January 2021. The survey consisted of 16 questions, including demographics, treatment approach before and during the pandemic, and outcomes of any COVID-19 positive patients with mHSPC.

Results: Response rate was 42% (n=50). Most respondents were male (65%), and practiced in academic centers (71%). The majority (64%) described a change in practice patterns during the pandemic. For low (LV) and high volume (HV) mHSPC, the proportion of respondents offering  ARATs increased from 73% to 79% and from 63% to 84% respectively. Increased use of granulocyte colony stimulating factor primary prophylaxis with docetaxel was reported by 35% of respondents, with 22% offering it to more than half of the patients on chemotherapy. Roughly half (45%) intend to maintain these practice changes beyond the pandemic.  Only 9 (18%) reported having mHSPC patients diagnosed with COVID-19, all of which were diagnosed prior to initiation of systemic therapy. Among these patients, 77% were treated with ARAT, none with docetaxel; 4 required hospitalizations (1 required ICU), and all recovered.

Conclusion: During  the pandemic, Canadian medical oncologists reported using more ARATs and less docetaxel for patients with mHSPC. Many plan to maintain these changes post pandemic. Further research is warranted to examine whether these practice changes impact outcomes. Encouragingly, no deaths related to COVID-19 among patients with mHSPC have been reported.

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