A Study of Participants With Advanced Prostate Cancer in Canada

Study Overview
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Brief Summary
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The purpose of this study is to document the course of advanced prostate cancer in Canada in terms of disease progression, real-world treatment, and patient management.

Official Title
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A Multicentre Cohort Study of Patients With Advanced Prostate Cancer in Canada

Conditions
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Prostatic Neoplasms

Intervention / Treatment
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* Other: Standard of Care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Participant must have a confirmed diagnosis of adenocarcinoma of the prostate Participant must have prostate cancer, as follows: a) nonmetastatic castrate-resistant prostate cancer (nmCRPC): nmCRPC diagnosis at any time; documented castration resistance per Prostate Cancer Working Group 3 criteria23 (elevated prostate specific antigen [PSA] despite testosterone less than (<) 50 nanograms per deciliter [ng/dL] [<1.7 nano moles per liter {nmol/L}]); Negative for metastases on conventional imaging (computerized tomography, Magnetic resonance imaging, bone scans); Prostate specific antigen doubling time (PSADT) less than equal to (<=) 12 months within the last 6 months or beginning treatment with approved next-generation ARAT for treatment of nmCRPC; b) Metastatic castrate-sensitive prostate cancer (mCSPC): new mCSPC diagnosis in the past 6 months (can be de novo or primary progressive recurrent following local radical therapy); documented metastatic prostate cancer; no more than 12 months of androgen deprivation therapy (ADT) in any setting; no more than 6 months of systemic treatment for mCSPC (example, approved next generation androgen receptor targeted therapy or chemotherapy]); c) Metastatic castrate-resistant prostate cancer (mCRPC): mCRPC diagnosis at any time; documented metastatic prostate cancer; documented castration resistance per Prostate Cancer Working Group 2 criteria (elevated prostate specific antigen [PSA] despite testosterone less than [<]50 nanogram per deciliter [ng/dL] [<1.7 nmol/L]); the first treatment for mCRPC was started in the past 6 months or is scheduled to begin; d) mCRPC (treatment-experienced in the nmCRPC or mCSPC setting): mCRPC diagnosis at any time; documented metastatic prostate cancer; documented castration resistance per Prostate Cancer Working Group 2 criteria (elevated PSA despite testosterone <50 ng/dL [<1.7 nmol/L]); the first treatment for mCRPC clinical state was started in the past 6 months or is scheduled to begin; disease progression occurred while receiving active treatment (androgen receptor-axis therapy [ARAT] or chemotherapy) in the prior nmCRPC or mCSPC clinical state Participant must have a life expectancy of more than 6 months Participant must sign (and/or their legally acceptable representative, if applicable) a participation agreement/informed consent form (ICF) allowing data collection and source data verification in accordance with local requirements and/or sponsor policy Exclusion Criteria: At the time of screening, patient is currently enrolled in other Janssen sponsored clinical study (any indication) or an interventional clinical trial investigating a non Health Canada approved drug and/or procedure for the treatment and/or monitoring of prostate cancer (Janssen or non-Janssen company sponsored) Participant is currently enrolled in any observational study sponsored or managed by a Janssen company

Ages Eligible for Study
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Minimum Age: 21 Years

Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Metastatic Castrate-Sensitive Prostate Cancer (mCSPC)<br>Participants will be defined as having mCSPC if there is a new mCSPC diagnosis in the past 6 months, documented metastatic prostate cancer, no more than 12 months of androgen deprivation therapy (ADT) in any setting and no more than 6 months of systemic treatment for mCSPC (example, next generation androgen receptor targeted therapy or chemotherapy). | Other: Standard of Care<br>* Participants will not receive any intervention in this study. Participants will receive standard of care therapy.<br>|
| Metastatic Castrate-Resistant Prostate Cancer (mCRPC)<br>Participants will be defined as having mCRPC if there is mCRPC diagnosis at any time, documented metastatic prostate cancer, documented castration resistance per Prostate Cancer Working Group 2 criteria (elevated prostate specific antigen [PSA] despite testosterone less than [<]50 nanogram per deciliter [ng/dL] [<1.7 nano moles per liter{nmol/L}]), the first treatment for mCRPC was started in the past 6 months or is scheduled to begin. | Other: Standard of Care<br>* Participants will not receive any intervention in this study. Participants will receive standard of care therapy.<br>|
| NonMetastatic Castrate-Resistant Prostate Cancer (nmCRPC)<br>Participants will be defined as having nmCRPC if there is nmCRPC diagnosis at any time, documented non-metastatic prostate cancer, documented castration resistance per Prostate Cancer Working Group 3 criteria (elevated PSA despite testosterone <50 ng/dL [<1.7 nmol/L]). nmCRPC, defined as a prostate specific antigen doubling time (PSADT) of less than or equal to 12 months, or beginning next generation ARAT for nmCRPC. | Other: Standard of Care<br>* Participants will not receive any intervention in this study. Participants will receive standard of care therapy.<br>|
| mCRPC (Treatment-experienced in the nmCRPC or mCSPC Setting)<br>Participants will be defined as having mCRPC (treatment-experienced in the nmCRPC or mCSPC setting) if there is nmCRPC diagnosis at any time, documented non-metastatic prostate cancer, documented metastatic prostate cancer, documented castration resistance per Prostate Cancer Working Group 2 criteria (elevated PSA despite testosterone <50 ng/dL [<1.7nmol/L]), the first treatment for mCRPC clinical state was started in the past 6months or is scheduled to begin, disease progression occurred while receiving active treatment (ARAT or chemotherapy) in the prior nmCRPC or mCSPC clinical state. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time to Prostate Specific Antigen (PSA) Progression | Time to PSA progression is defined as the time interval from the date of start of study enrollment to the date of first evidence of PSA progression. In participants whose PSA level has decreased, PSA progression is defined as at least a 25 percent (%) increase from nadir (lowest value including the most recent value prior to study enrollment) and an increase in the absolute value of 2 nanogram per milliliter (ng/mL) or greater, confirmed by a subsequent measurement at least 3 weeks after the increase. In participants whose PSA level has not decreased, PSA progression is defined as at least a 25% increase from the most recent value prior to study enrollment and an increase in the absolute value of 2 ng/mL or greater after 12 weeks. | Approximately up to 5 years | 
| Time to Radiographic Evidence of Disease Progression | Time to radiographic evidence of disease progression is defined as the time interval from the date of start of study treatment to the date of first appearance of 2 or more new bone lesions on bone scan or enlargement of a soft tissue lesion using the Response Evaluation Criteria in Solid Tumors (RECIST). | Approximately up to 5 years | 
| Time to Skeletal-Related Events | Time to skeletal-related events is defined as the time interval from the date of start of study treatment to the date of first skeletal-related event. | Approximately up to 5 years | 
| Time to Death | Time to death is defined as the time interval from the date of start of study enrollment to death. | Approximately up to 5 years | 
| Number of Participants with Different Primary Causes of Death | The number of participants with different primary causes of death will be reported. | Approximately up to 5 years | 
| Time to Progression from mCSPC to mCRPC in Participants with mCSPC | In participants with mCSPC, time to progression from mCSPC to mCRPC is defined as the time interval which is either calculated from date when mCSPC was first documented or from the date of start of study treatment, if participant receives treatment for mCSPC to the progression to mCRPC. | Approximately up to 5 years | 
| Time from Biochemical Recurrence (BCR) to Nonmetastatic Castrate-Resistant Prostate Cancer (nmCRPC) and nmCRPC to mCRPC | In participants with mCRPC, time from BCR to nmCRPC and nmCRPC to mCRPC will be analyzed retrospectively. BCR is defined as PSA greater than (>)0.2 nanogram per milliliter (ng/mL) after radical prostatectomy and PSA >2 ng/mL above the nadir (lowest value including the most recent value prior to study enrollment) after radical radiotherapy. | Approximately up to 5 years | 
| Number of Participants with PSA Testing from BCR to nmCRPC and nmCRPC to mCRPC, in Participants with mCRPC | In participants with mCRPC, number of participants having PSA testing from BCR to nmCRPC and nmCRPC to mCRPC will be reported. | Approximately up to 5 years | 
| Number of Participants with Frequency of Imaging from Time of BCR to nmCRPC and nmCRPC to mCRPC | In participants with non metastatic castrateresistant prostate cancer (nmCRPC), number of participants having imaging from BCR to nmCRPC and mCRPC to nmCRPC will be reported. | Approximately up to 5 years | 
| PSA Level at Start of Androgen Deprivation Therapy (ADT) in Participants with mCRPC | In participants with mCRPC, PSA level at start of ADT will be reported. | Approximately up to 5 years | 
| PSA Doubling Time (PSADT) at the Detection of Castration Resistance in Participants with mCRPC | In participants with mCRPC, PSADT at the detection of castration resistance will be reported. PSADT is the length of time it takes for a PSA to double based on an exponential growth pattern. | Approximately up to 5 years | 
| Time from nmCRPC to High-Risk (HR) nmCRPC | Time from nmCRPC to HR nmCRPC is defined as prostate specific antigen doubling time (PSADT) less than or equal to (<=) 10 months. | Approximately up to 5 years | 
| Time from ADT Initiation to nmCRPC | Time from ADT initiation to nmCRPC will be reported. | Approximately up to 5 years | 
| Median Absolute prostate specific antigen (PSA) at onset of HR-nmCRPC | Median absolute PSA at onset of HR-nmCRPC will be reported. | Approximately up to 5 years | 
| Time to Initiation of Subsequent Prostate Cancer Treatment | Time to initiation of subsequent prostate cancer treatment is defined as the time interval from the date of start of study treatment to the date of start of subsequent prostate cancer treatment. | Approximately up to 5 years | 
| Duration of Each Therapy | Duration for each therapy will be reported for all participants. | Approximately up to 5 years | 
| Percentage of Participants Receiving Chemotherapy, Other Drug Treatments, or no Drug Treatment | Percentage of participants receiving chemotherapy, other drug treatments, or no drug treatment, will be reported for all participants. | Approximately up to 5 years | 
| Time to Treatment Initiation | Time to treatment initiation, will be reported for all participants. | Approximately up to 5 years | 
| Time to Dose Modification | Time to dose modification, will be reported for all participants. | Approximately up to 5 years | 
| Number of Participants who Switch the Treatment | Number of participants who switch the treatment, will be reported. | Approximately up to 5 years | 
| Number of Participants who Discontinued the Treatment | Number of participants who discontinued the treatment, will be reported. | Approximately up to 5 years | 
| Most Common Sequences for Lines of Therapy in Participants with mCRPC | In participants with mCRPC, most common sequences for lines of therapy will be reported. | Approximately up to 5 years | 
| Number of Participants Retreated with Docetaxel in Participants with mCRPC | In participants with mCRPC, number of participants having retreatment with docetaxel will be reported. | Approximately up to 5 years | 
| Percentage of Participant with Radiographic Imaging Modality | Percentage of participants with radiographic imaging modality which includes bone scan, magnetic resonance imaging, ultrasound, X-ray will be reported. | Approximately up to 5 years | 
| Number of Days Hospitalized for Prostate Cancer or Treatment of Prostate Cancer | Number of days for which participant was hospitalized for prostate cancer or treatment of prostate cancer, will be reported for all participants. | Approximately up to 5 years | 
| Number of Visits to Emergency Department for Prostate Cancer or Treatment of Prostate Cancer | Number of visits to emergency department for prostate cancer or treatment of prostate cancer, will be reported for all participants. | Approximately up to 5 years | 
| Number of Outpatient Visits to Specialists Involved in Management of Prostate Cancer | Number of outpatient visits to specialists (urologist, medical oncologist, uro-oncologist, radiation oncologist) involved in management of prostate cancer, will be reported for all participants. | Approximately up to 5 years | 
| Dates of Genomic or Genetic Testing | Dates of genomic or genetic testing (including dopa-responsive dystonia [DRD]/ homologous recombination repair [HRR]/ breast cancer gene-1 [BRCA1]/ BRCA2/ataxia-telangiesctasia mutated [ATM]/partner and localizer of the BRCA2 gene [PALB2]/ androgen receptor [AR]) will be reported. | Approximately up to 5 years | 
| Types of Genomic or Genetic Testing | Types of genomic or genetic testing (including DRD/HRR/ BRCA1/ BRCA2/ATM /PALB2/AR) will be reported. | Approximately up to 5 years | 
| Charlson Comorbidity Index Score | Charlson Comorbidity Index score will be summarized descriptively. The Charlson Comorbidity Index is a 19-item measure assessing comorbid conditions. The total possible score on the Charlson Comorbidity Index ranges from 0 to 37. If a condition is not present, the score for that condition is zero. The higher scores indicate greater comorbidity. | Approximately up to 5 years |