To explore the practice and views of uro‐oncologists in the UK regarding their use of bone supportive agents in patients with prostate cancer.
An expert‐devised online questionnaire was completed by members of the British Uro‐oncology Group (BUG).
Of 160 uro‐oncologists invited, 81 completed the questionnaire. Approximately 70% of respondents never use a bone supportive agent in patients with metastatic hormone‐naïve prostate cancer on androgen deprivation therapy (ADT). However, use was more frequent in men with metastatic castration‐resistant prostate cancer, from first‐line treatment onwards. The majority of uro‐oncologists do not use a bone supportive agent to prevent skeletal‐related events in men with non‐metastatic disease unless the individual patient is at an increased risk of osteoporosis. In men with more advanced disease, respondents would use an oral or intravenous (IV) bisphosphonate in 41% and 61% of patients, respectively. Zoledronic acid is the first‐choice bone supportive treatment in 77% of cases, with the lack of clinical data cited as a barrier to use for other IV bisphosphonates. Local guidelines also have a significant influence on the use of bone supportive agents, especially with respect to denosumab. Bone mineral density measurement is conducted in approximately 40% of men with ADT exposure of 2 years or longer, or those with metastatic prostate cancer.
Uro‐oncologists in the UK generally do not use bone supportive agents for men with metastatic hormone‐naïve prostate cancer or those with non‐metastatic disease. However, increasing the duration of ADT and the presence of castration‐resistant metastatic prostate cancer increases use.
Financed by the National Centre for Research and Development under grant No. SP/I/1/77065/10 by the strategic scientific research and experimental development program:
SYNAT - “Interdisciplinary System for Interactive Scientific and Scientific-Technical Information”.