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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

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Paper Summary

Paperzilla title
Who Gets the Best Prostate Cancer Treatment? It Depends on Your Doctor (and Your Age)

In a study of older men with advanced prostate cancer in Ontario, Canada, researchers found that the type of doctor initially prescribing hormone therapy significantly influenced whether patients received additional, life-extending treatments. Older patients were also less likely to receive these intensified treatments, even when medically appropriate.

Explain Like I'm Five

The study found that men with prostate cancer are more likely to get stronger treatments if their first hormone therapy is prescribed by a cancer specialist, and if they are younger. This matters because these extra treatments help people live longer.

Possible Conflicts of Interest

Several authors disclosed receiving personal fees, research funding, grants, and/or holding advisory board positions for various pharmaceutical companies, including those manufacturing treatments for prostate cancer (e.g., Janssen, Bayer, Astellas, Merck, Pfizer). These potential conflicts should be considered when interpreting the findings.

Identified Limitations

Limited Clinical Data
The study relied on administrative data, lacking details like disease volume and specific metastatic sites, which could influence treatment decisions. This makes it difficult to fully analyze treatment patterns based on individual patient and disease characteristics.
Age Restriction
The study focused on patients 66 and older due to data availability on prescription drug coverage. This limits the generalizability of findings to younger patients.
Proxy for Abiraterone Acetate
The study used a proxy to identify patients receiving abiraterone acetate due to its limited public reimbursement, introducing potential misclassification bias.

Rating Explanation

This is a well-conducted population-based study that identifies important variations and potential disparities in prostate cancer care. The large sample size and use of real-world data are strengths, but limitations regarding data granularity and generalizability to younger patients prevent a higher rating.

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Topic Hierarchy

Domain: Health Sciences
Field: Medicine
Subfield: Oncology

File Information

Original Title: 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
Uploaded: September 10, 2025 at 02:29 PM
Privacy: Public