Radium-223 (Ra-223) received regulatory approval for castration-resistant prostate cancer (CRPC) with bone metastasis in Japan in 2016. This study aimed to reveal emerging symptoms, impacts, and concerns within the Japanese patient experience of living with mCRPC and the burden of bone metastasis prior to Ra-223 treatment, through patient and physician interviews.
This non-interventional, qualitative study consisted of interviews with 23 bone metastatic CRPC patients prior to their first Ra-223 treatment cycle, and 3 treating physicians in Japan. Patients were recruited via purposive sampling. Inclusion criteria were: (1) a diagnosis of bone metastatic CRPC, and (2) designated to start receiving Ra-223 in routine clinical practice. Physicians included those who had prescribed at least one Ra-223 treatment cycle in the past 12 months and are currently prescribing Ra-223. All interview data were entered into ATLAS.ti v8.0 for coding, assessment of concept frequency, themes and saturation analysis.
The patients’ mean age was 75.8 y.o., with 45% symptomatic at the time of enrolment. Forty-seven mCRPC symptoms were reported, including pain, fatigue, nocturia, muscle loss, and various side effects related to previous PC treatment and/or disease stage. Around mCRPC diagnosis, patients reported back pain (45%), hip pain (23%) and pain specifically in their bones (27%). Life impacts reported included 45 concepts, with the most frequently mentioned being worry for their disease progression and how it would impact their family and lives, the impact that mCRPC has on their daily, physical abilities (e.g. difficulty walking, muscle loss) and the impact a patients’ mCRPC has on the family and caregivers. Patients had high expectations from Ra-223 in terms of cessation of disease progression (32%) and pain alleviation (23%), but also worry about adjusting to the treatment. All 3 physicians cited the need for information sharing about Ra-223.
The symptoms and impacts of living with mCRPC and the associated burden of bone metastasis and skeletal-related symptoms are considerable and varied, and information sharing is key to easing concerns in utilizing Ra-223 treatment.
Bayer Yakuhin, Ltd.
Bayer Yakuhin, Ltd.
H. Uemura: Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony: Janssen Pharmaceutical; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony: Bayer Yakuhin, Ltd.; Honoraria (self), Speaker Bureau/Expert testimony: Astellas Pharmaceutical; Honoraria (self), Speaker Bureau/Expert testimony: Takeda Pharmaceutical; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony: AstraZeneca Pharmaceutical. K. Akakura: Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Bayer Yakuhin, Ltd.; Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Astellas Pharmaceutical; Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Takeda Pharmaceutical; Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: AstraZeneca Pharmaceutical; Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Janssen Pharmaceutical. A. Stroupe, C. Seo, A. Uzumcu, K. McCarrier: Advisory/Consultancy: Bayer Yakuhin, Ltd. D. Ledesma: Full/Part-time employment: Bayer Yakuhin, Ltd. All other authors have declared no conflicts of interest.