ART discontinuation tied to toxicity, disease progression in mCRPC patients

Several patients with metastatic castration-resistant prostate cancer (mCRPC) discontinue the use of androgen receptor‒targeted therapies (ARTs) because of disease progression, while a few stopped ARTs due to treatment toxicity, according to a study.

In addition, patient-reported weakness, falls, and rash contribute to a higher likelihood of treatment discontinuation due to toxicity.

“ARTs improve survival outcomes in patients with mCRPC; however, a significant portion of patients discontinue treatment for various reasons including treatment-related toxicity,” the authors said.

This single-institution retrospective review included 133 patients with mCRPC receiving ART between 2010 and 2021. The authors identified risk factors for treatment discontinuation due to toxicity and described the patterns of ART discontinuation among mCRPC patients.

Of the patients, 14 (10.5 percent) ceased treatment due to toxicity. Their reasons for discontinuing treatment were as follows: Prostate Specific Antigen test progression, radiographic progression, toxicity, and death.

On bivariate and multivariate analyses, the following factors significantly predicted treatment discontinuation due to toxicity: patient-reported falls (odds ratio [OR], 7.67, 95 percent confidence interval [CI], 1.31‒40.42; p=0.016), rash (OR, 13.4, 95 percent CI, 1.35‒134.81; p=0.026), and weakness (OR, 4.16, 95 percent CI, 1.15‒15.0; p=0.019).

“Early monitoring of this population can prolong the duration of treatment and prevent unnecessary treatment burden,” the authors said.

“Our work presents the first description of ART treatment discontinuation and its causes in the real-world setting, as well as patient-reported side effects,” they noted.