Purpose: The primary aim of this pilot study was to describe the characteristics and treatment patterns of patients with castration-resistant prostate cancer (CRPC) in the VA health care system.
Background: Castration-resistant prostate cancer is an advanced form of prostate cancer (PCa) that no longer responds well to androgen deprivation therapy (ADT) or progresses while on ADT. The prevalence of metastases is high (50%-84%) among these patients. Recently approved oral anticancer agents have the potential to improve survival and quality of life for patients with advanced PCa. Oral anticancer treatments provide convenience and flexibility to patients; however administration and monitoring of adherence to oral therapy can be complex. The number of veterans living with PCa is expected to increase as is the availability of oral anticancer drugs. Yet little is known about these patients or the specific challenges of oral anticancer treatment in veterans with advanced PCa.
Methods: This observational study will use data from fiscal years 2008 to 2014 from the following sources: VA Central Cancer Registry, Medical SAS Datasets, Pharmacy Benefits Management, and the VHA Vital Status File.
Data Analysis: Descriptive statistics will be used to characterize the sample population and describe treatment patterns. Trends in the use of new oral anticancer medications will be assessed. Particular attention will be paid to the use and prescribing patterns of 2 new oral anticancer agents, abiraterone with prednisone and enzalutamide.
Results: Data receipt pending. Preliminary results will be presented in October.
Conclusions: The information obtained from this pilot study will help inform research questions regarding the use of and adherence to oral anticancer medications among VA patients with CRPC. The long-term goal is to develop in-terventions aimed at delivering patient-centered care by decreasing rates of nonadherence, toxicity, and wasted medication among cancer patients who receive oral anticancer treatment. Given the high costs of these medications (about $8,000 per 30-day supply) and the expected increase in PCa survivors, it is essential to better understand patterns of anticancer treatment use in order to allocate VA resources effectively and efficiently.
