Survival, treatment duration and costs of patients with prostate cancer treated with triptorelin in Italy: a study of administrative databases

Authors

  • Orazio Caffo Department of Medical Oncology, Santa Chiara Hospital, Trento - Italy https://orcid.org/0000-0001-7968-2531
  • Gaetano Facchini Medical Oncology Unit, ‘S. Maria delle Grazie’ Hospital-Pozzuoli, Napoli - Italy
  • Luca Degli Esposti CliCon S.r.l. Società Benefit, Health, Economics & Outcomes Research, Bologna - Italy
  • Valentina Acciai IPSEN, Milan - Italy
  • Giorgio Mauri IPSEN, Milan - Italy https://orcid.org/0009-0008-7689-6460
  • Paola Mazzanti IPSEN, Milan - Italy https://orcid.org/0009-0009-2605-4879
  • Giuseppe Fornarini Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genova - Italy

DOI:

https://doi.org/10.33393/grhta.2024.3055

Keywords:

Administrative databases, Prostate cancer, Real-world studies, Treatment, Triptorelin

Abstract

Background: Several data support the efficacy/effectiveness, safety and favorable impact on quality of life of triptorelin treatment in patients with prostate cancer. However, little evidence is available concerning triptorelin use in the long term.

Methods: We analyzed data on triptorelin treatment in patients with prostate cancer in an integrated Italian administrative database, covering around 6 million health-assisted subjects throughout the country. Patients with at least one prescription for triptorelin in the period 2010-2020 and with no evidence of metastasis were included and followed up until 2021. Overall survival (OS) and duration of treatment were analyzed using Kaplan-Meier curves, starting from the date of first prescription.

Results: The cohort included a total of 3,411 patients (mean age: 76.8 ± 8.7 years), of whom 1,326 (38.9%) were treated with triptorelin only and 2,085 (61.1%) with triptorelin combined with an anti-androgen. Overall, 847 (24.8%) patients with prostate cancer died and 1,037 (30.4%) had a treatment switch during the follow-up period, and both the median OS and median duration of treatment were not reached in both groups. The mean annual total cost per patient was estimated as 5,574 €, with almost half of the costs related to medication expenses (2,737 €).

Conclusions: We found a long survival and duration of triptorelin treatment in this population of Italian patients with prostate cancer. This study with a long follow-up period further highlights the usefulness of healthcare utilization databases to integrate results obtained from clinical studies with those from everyday clinical practice.

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References

Ferlay J, Ervik M, Lam F, et al. Global Cancer Observatory: Cancer Today. Lyon, France. 2020. https://gco.iarc.fr/today. (Accessed February 2024).

ISTAT. 2022. https://demo.istat.it/. (Accessed February 2024).

AIOM-AIRTUM. I numeri del cancro in Italia. Intermedia Editore; 2021. https://www.aiom.it/wp-content/uploads/2021/10/2021_NumeriCancro_web.pdf (Accessed February 2024)4. AIRTUM. Italian cancer figures, report 2016: survival of cancer patients in Italy. Epidemiol Prev. 2017;41(2):1-248. https://www.registri-tumori.it/PDF/AIRTUM2017/AIRTUM2017_full.pdf (Accessed February 2024)

Siegel DA, O’Neil ME, Richards TB, Dowling NF, Weir HK. Prostate cancer incidence and survival, by stage and race/ethnicity – United States, 2001-2017. MMWR Morb Mortal Wkly Rep. 2020;69(41):1473-1480. https://doi.org/10.15585/mmwr.mm6941a1 PMID:33056955

Rebello RJ, Oing C, Knudsen KE, et al. Prostate cancer. Nat Rev Dis Primers. 2021;7(1):9. https://doi.org/10.1038/s41572-020-00243-0 PMID:33542230

Sandhu S, Moore CM, Chiong E, Beltran H, Bristow RG, Williams SG. Prostate cancer. Lancet. 2021;398(10305):1075-1090. https://doi.org/10.1016/S0140-6736(21)00950-8 PMID:34370973

Jenster G. The role of the androgen receptor in the development and progression of prostate cancer. Semin Oncol. 1999;26(4):407-421. PMID:10482183

Merseburger AS, Hupe MC. An update on triptorelin: current thinking on androgen deprivation therapy for prostate cancer. Adv Ther. 2016;33(7):1072-1093. https://doi.org/10.1007/s12325-016-0351-4 PMID:27246172

Heyns CF, Simonin MP, Grosgurin P, Schall R, Porchet HC; South African Triptorelin Study Group. Comparative efficacy of triptorelin pamoate and leuprolide acetate in men with advanced prostate cancer. BJU Int. 2003;92(3):226-231. https://doi.org/10.1046/j.1464-410X.2003.04308.x PMID:12887472

Martínez-Piñeiro L, Schalken JA, Cabri P, Maisonobe P, de la Taille A; Triptocare Study Group. Evaluation of urinary prostate cancer antigen-3 (PCA3) and TMPRSS2-ERG score changes when starting androgen-deprivation therapy with triptorelin 6-month formulation in patients with locally advanced and metastatic prostate cancer. BJU Int. 2014;114(4):608-616. https://doi.org/10.1111/bju.12542 PMID:24806330

Gil T, Aoun F, Cabri P, Maisonobe P, van Velthoven R. A prospective, observational grouped analysis to evaluate the effect of triptorelin on lower urinary tract symptoms in patients with advanced prostate cancer. Ther Adv Urol. 2015;7(3):116-124. https://doi.org/10.1177/1756287215574480 PMID:26161142

Lebret T, Culine S, Davin JL, et al. Quality of life of 1276 elderly patients with prostate cancer, starting treatment with a gonadotropin-releasing hormone agonist: results of a French observational study. Aging Male. 2014;17(2):87-93. https://doi.org/10.3109/13685538.2014.891013 PMID:24576298

Thiery-Vuillemin A, Rigaud J, Crehange G, Pello Leprince Ringuet N, Grandoulier AS, Lebret T. Baseline parameters of patients with prostate cancer (PCa) initiating a triptorelin treatment for at least 12 months in real life, TALISMAN study interim analysis. Am Soc Clin Oncol. 2022;40(6):Abstract. https://doi.org/10.1200/JCO.2022.40.6_suppl.061

Corrao G, Cantarutti A. Building reliable evidence from real-world data: needs, methods, cautiousness and recommendations. Pulm Pharmacol Ther. 2018;53:61-67. https://doi.org/10.1016/j.pupt.2018.09.009 PMID:30253238

Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373-383. https://doi.org/10.1016/0021-9681(87)90171-8 PMID:3558716

Hupe MC, Hammerer P, Ketz M, Kossack N, Colling C, Merseburger AS. Retrospective analysis of patients with prostate cancer initiating GnRH agonists/antagonists therapy using a German claims database: epidemiological and patient outcomes. Front Oncol. 2018;8:543. https://doi.org/10.3389/fonc.2018.00543 PMID:30538951

Cornford P, van den Bergh RCN, Briers E, et al. EAU-EANM-ESTRO-ESUR-SIOG guidelines on prostate cancer. Part II-2020 update: treatment of relapsing and metastatic prostate cancer. Eur Urol. 2021;79(2):263-282. https://doi.org/10.1016/j.eururo.2020.09.046 PMID:33039206

Heidenreich A, Bastian PJ, Bellmunt J, et al; European Association of Urology. EAU guidelines on prostate cancer. Part II: treatment of advanced, relapsing, and castration-resistant prostate cancer. Eur Urol. 2014;65(2):467-479. https://doi.org/10.1016/j.eururo.2013.11.002 PMID:24321502

Heidenreich A, Bastian PJ, Bellmunt J, et al; European Association of Urology. EAU guidelines on prostate cancer. part 1: screening, diagnosis, and local treatment with curative intent – update 2013. Eur Urol. 2014;65(1):124-137. https://doi.org/10.1016/j.eururo.2013.09.046 PMID:24207135

Mottet N, van den Bergh RCN, Briers E, et al. EAU-EANM-ESTRO-ESUR-SIOG guidelines on prostate cancer – 2020 update. Part 1: screening, diagnosis, and local treatment with curative intent. Eur Urol. 2021;79(2):243-262. https://doi.org/10.1016/j.eururo.2020.09.042 PMID:33172724

Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc. 1958;53(282):457-481. https://doi.org/10.1080/01621459.1958.10501452

Swanson LJ, Seely JH, Garnick MB. Gonadotropin-releasing hormone analogs and prostatic cancer. Crit Rev Oncol Hematol. 1988;8(1):1-26. https://doi.org/10.1016/S1040-8428(88)80003-9 PMID:2964939

Ploussard G, Mongiat-Artus P. Triptorelin in the management of prostate cancer. Future Oncol. 2013;9(1):93-102. https://doi.org/10.2217/fon.12.158 PMID:23252566

van den Driessche H, Mattelaer P, van Oyen P, et al. Changes in body image in patients with prostate cancer over 2 years of treatment with a gonadotropin-releasing hormone analogue (triptorelin): results from a Belgian non-interventional study. Drugs Real World Outcomes. 2016;3(2):183-190. https://doi.org/10.1007/s40801-016-0074-5 PMID:27398297

Morgia G, Russo GI, Tubaro A, et al; Members of the LUNA Foundation, Società Italiana d’Urologia. Patterns of prescription and adherence to European Association of Urology guidelines on androgen deprivation therapy in prostate cancer: an Italian multicentre cross-sectional analysis from the Choosing Treatment for Prostate Cancer (CHOICE) study. BJU Int. 2016;117(6):867-873. https://doi.org/10.1111/bju.13307 PMID:26332130

Fourcade RO, Benedict A, Black LK, Stokes ME, Alcaraz A, Castro R. Treatment costs of prostate cancer in the first year after diagnosis: a short-term cost of illness study for France, Germany, Italy, Spain and the UK. BJU Int. 2010;105(1):49-56. https://doi.org/10.1111/j.1464-410X.2009.08716.x PMID:20132102

Lazzaro C. Gruppo Informale di Studio sugli aspetti Economico-Sanitari del Carcinoma Prostatico in I. [Managing patients with prostate cancer in Italy during the first year after diagnosis. A cost description based on a sample of 8 urological wards]. Arch Ital Urol Androl. 2003;75(3):138-149. PMID:14661392

Borsoi L, Ciani O, Fornarini G, et al. Direct healthcare costs of non-metastatic castration-resistant prostate cancer in Italy. Int J Technol Assess Health Care. 2023;39(1):e2. https://doi.org/10.1017/S0266462322003336 PMID:36606465

Restelli U, Ceresoli GL, Croce D, et al. Economic burden of the management of metastatic castrate-resistant prostate cancer in Italy: a cost of illness study. Cancer Manag Res. 2017;9:789-800. https://doi.org/10.2147/CMAR.S148323 PMID:29263702

Svensson J, Lissbrant IF, Gauffin O, et al. Time spent in hormone-sensitive and castration-resistant disease states in men with advanced prostate cancer, and its health economic impact: registry-based study in Sweden. Scand J Urol. 2021;55(1):1-8. https://doi.org/10.1080/21681805.2020.1851762 PMID:33300403

Sarrazin MS, Rosenthal GE. Finding pure and simple truths with administrative data. JAMA. 2012;307(13):1433-1435. https://doi.org/10.1001/jama.2012.404 PMID:22474208

Additional Files

Published

2024-11-11

How to Cite

Caffo, O., Facchini, G., Degli Esposti, L., Acciai, V., Mauri, G., Mazzanti, P., & Fornarini, G. (2024). Survival, treatment duration and costs of patients with prostate cancer treated with triptorelin in Italy: a study of administrative databases. Global and Regional Health Technology Assessment, 11(1), 207–213. https://doi.org/10.33393/grhta.2024.3055

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Original Research Articles

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Received 2024-02-29
Accepted 2024-10-15
Published 2024-11-11

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