Barriers and Facilitators of Treatment Intensification in Metastatic Castration-Sensitive Prostate Cancer

What barriers and facilitators underlie US-based urologists’ and oncologists’ decisions to intensify first-line treatment for patients with metastatic castration-sensitive prostate cancer (mCSPC)?In this mixed-methods study of 352 urologists and oncologists, 17 barriers and 14 facilitators underlying first-line treatment intensification for mCSPC were identified from the phase 1 analysis of 36 health care practitioners, including knowledge, decision processes, and beliefs about consequences. Notable differences existed between urologists and oncologists and the resources they considered helpful for supporting intensification; cross-specialty tumor boards were identified as the top-rated solution for improving treatment intensification uptake in both specialties.These findings suggest that concrete, specialty-tailored tools that address the barriers and capitalize on the facilitators are needed to increase first-line treatment intensification uptake for mCSPC.

Corresponding Author: Stacy Loeb, MD, MSc, Department of Urology, New York University Langone Health, 227 E 30th St, 6th Floor, New York, NY 10016 (stacyloeb@gmail.com).

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