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The role of the caregiver in older patients with advanced prostate cancer: results from the ADHERE Prospective Study of the Meet-URO network

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Abstract

Purpose

To assess caregivers’ characteristics and influence of the presence or absence of the caregiver on clinical outcomes of older (≥70 years) metastatic castration-resistant prostate cancer (mCRPC) patients treated with abiraterone (ABI) or enzalutamide (ENZ).

Methods

Patients from the Meet-URO 5 ADHERE study were assessed with a 5-item caregiver evaluation questionnaire focusing on the presence, age, degree of kinship, working status and qualification of the caregiver. We investigated the association between the presence of a caregiver and the clinical characteristics and outcomes of enrolled patients.

Results

No differences were found in the main clinical characteristics between patients with or without a caregiver, except for a lower median G8 score (p = 0.0453) in the caregiver group. A longer radiographic PFS (rPFS) was observed in the group without a caregiver, with a trend towards more prolonged overall survival (OS) in the same group.

Conclusion

Our work suggests a detrimental effect of caregivers in managing older mCRPC patients treated with ABI or ENZ, especially those identified as frail by the geriatric G8 screening score. Further work is needed to identify and address patients’ vulnerability areas, which could have a detrimental effect on prognosis.

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Data Availability

The data that support the findings of this study are not openly available and are available from the corresponding author upon reasonable request.

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Funding

S.E.R. and G.F. would like to thank the Italian Ministry of Health (Ricerca Corrente 2018–2021 grants), which financially supports their current research on identifying prognostic and predictive markers for patients with genitourinary tumours. P.R.’s work is funded by Prostate Cancer Foundation through a PCF YI award and by the FPRC 5 PER MILLE—Ministero della Salute 2017—PTCRC SEE PROS ONCOLOGIA and ‘Italian Ministry of Health, Ricerca Corrente 2022’.

Author information

Author notes

  1. Pasquale Rescigno and Giuseppe Luigi Banna contributed equally as co-last authors.

Authors and Affiliations

  1. Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’, Meldola, Italy

    Emilio Francesco Giunta & Ugo De Giorgi

  2. Psycho-Oncology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori’, Meldola, Italy

    Silvia De Padova

  3. Portsmouth Hospitals University NHS Trust, Portsmouth, PO6 3LY, UK

    Shobana Anpalakhan & Giuseppe Luigi Banna

  4. Medical Oncology 1 Unit, Department of Oncology, Istituto Oncologico Veneto IOV IRCCS, Padua, Italy

    Marco Maruzzo, Davide Bimbatti & Umberto Basso

  5. Medical Oncology Unit, Ospedale San Paolo, Savona, Italy

    Sara Elena Rebuzzi

  6. Department of Internal Medicine and Medical Specialties (Di.M.I.), University of Genova, Genova, Italy

    Sara Elena Rebuzzi

  7. Department of Oncology, ASUFC Santa Maria Della Misericordia, Udine, Italy

    Marika Cinausero, Arianna Dri & Paola Ermacora

  8. Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano CRO-IRCCS, Aviano, Italy

    Lucia Fratino

  9. Division of Medical Oncology, Cannizzaro Hospital, Catania, Italy

    Helga Lipari

  10. Medical Oncology, Mauriziano Hospital, Turin, Italy

    Teresa Gamba & Francesca Vignani

  11. Department of Medicine, University of Udine, Udine, Italy

    Arianna Dri

  12. Oncology Unit, University Hospital of Parma, Parma, Italy

    Sebastiano Buti

  13. Department of Medicine and Surgery, University of Parma, Parma, Italy

    Sebastiano Buti

  14. Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genova, Italy

    Annalice Gandini, Malvina Cremante & Giuseppe Fornarini

  15. Candiolo Cancer Institute, FPO-IRCCS, SP142, km 3,95, 10060, Candiolo, Turin, Italy

    Pasquale Rescigno

Authors
  1. Emilio Francesco Giunta
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  2. Silvia De Padova
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  3. Shobana Anpalakhan
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  4. Ugo De Giorgi
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  5. Marco Maruzzo
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  6. Sara Elena Rebuzzi
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  7. Marika Cinausero
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  8. Lucia Fratino
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  9. Helga Lipari
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  10. Teresa Gamba
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  11. Davide Bimbatti
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  12. Arianna Dri
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  14. Francesca Vignani
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  15. Umberto Basso
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  16. Sebastiano Buti
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  17. Annalice Gandini
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  18. Malvina Cremante
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  19. Giuseppe Fornarini
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  20. Pasquale Rescigno
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  21. Giuseppe Luigi Banna
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Contributions

E.F.G.: conceptualization, data collection, methodology, statistical analysis, writing, figures and tables; S.D.P.: conceptualization, data collection, methodology; S.A.: writing; U.D.G.: methodology, review and editing; M.M., S.E.R., M.C., H.L., T.G., D.B., A.D., P.E., F.V., U.B., S.B., A.G., M.C., G.F.: data collection, review and editing; L.F.: conceptualization, methodology, data collection, review and editing; P.R.: conceptualization, methodology, review and editing; G.L.B.: conceptualization, data collection, methodology, review and editing.

Corresponding author

Correspondence to Pasquale Rescigno.

Ethics declarations

Ethics approval

The study was approved by the Catania-1 ethical committee (n.12/2019/CA of the 15th of February 2019). The study was performed in accordance with the Good Clinical Practice guidelines of the International Conference on Harmonization and the Declaration of Helsinki.

Consent to participate

All patients provided the protocol written informed consent.

Consent for publication

Participants were informed that the questionnaire results would be used for publications and provided their consent.

Conflict of interest

Emilio Francesco Giunta received personal fees from Novartis and travel accommodation from Janssen. Ugo De Giorgi received honoraria for advisory boards or speaker fees for Pfizer, BMS, MSD, PharmaMar, Astellas, Bayer, Ipsen, Roche, Novartis, Clovis, GSK, AstraZeneca, institutional research grants from AstraZeneca, Sanofi and Roche. Sara Elena Rebuzzi received honoraria as a speaker at scientific events and travel accommodation from Amgen, GSK, BMS and MSD. Davide Bimbatti received personal fees for Talks or Advisory/Consultant Role from Ipsen, Astellas, Janssen, Novartis, BMS and MSD outside the submitted work. Giuseppe Fornarini serviced as advisory boards for Astellas, Janssen, Pfizer, Bayer, MSD and Merck and received travel accommodation from Astellas, Janssen and Bayer. Giuseppe Luigi Banna reported personal fees from Astellas and AstraZeneca. Pasquale Rescigno has served as a consultant/advisory board member for MSD and Astra Zeneca. The other authors declare that they have no conflict of interest.

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Giunta, E.F., De Padova, S., Anpalakhan, S. et al. The role of the caregiver in older patients with advanced prostate cancer: results from the ADHERE Prospective Study of the Meet-URO network. Support Care Cancer 31, 425 (2023). https://doi.org/10.1007/s00520-023-07867-4

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