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IRONMAN: International Registry of Men With Advanced Prostate Cancer

By: Victoria Kuhr, BA
Posted: Monday, January 30, 2023

Since its initiation in 2017, the International Registry for Men with Advanced Prostate Cancer (IRONMAN) recruited more than half of the minimum required 5,000 patients with metastatic hormone–sensitive prostate cancer or castration-resistant prostate cancer. Additionally, Daniel J. George, MD, of Duke University, Durham, North Carolina, and colleagues proposed this study was the first international cohort of people newly diagnosed with advanced prostate cancer designed to describe variations in patient management, experiences, and outcomes. These findings were published in the Journal of Clinical Oncology.

“IRONMAN can elucidate which populations experience quality-of-life issues related to their treatments or disease by recruiting a diverse population and maintaining high levels of patient-reported outcome measures [and] patient-related experience measures compliance,” said the study authors.

The study recruited patients with advanced prostate cancer from 16 eligible countries: Australia, the Bahamas, Barbados, Brazil, Canada, Ireland, Jamaica, Kenya, Nigeria, Norway, South Africa, Spain, Sweden, Switzerland, the United Kingdom, and the United States. The study analyzed variations in care and treatment across countries, and across academics, community-based, and government practices. These practices focused on clinical outcomes, patient-reported outcomes, epidemiologic data, biologic subtypes, and clinician questionnaires.

Through July 2022, a total of 2,682 patients were included in the study. Patients were enrolled from 11 of the 12 active countries. Of them, 1,006 patients were enrolled from sites in the United States. Overall, 66% of patients had metastatic hormone-sensitive prostate cancer and 34% had castration-resistant prostate cancer. The median age at patient diagnosis was 70 years. Based on patient self-reports, 11% are Black and 9% are Hispanic. In the United States, five Veterans Affairs Medical Centers were activated to enroll patients. Globally, 23% of patients reported being veterans of military service. The study authors plan to extend diversity representation among patients of the Black, Hispanic, and Asian communities amid setbacks from the European Union’s General Data Protection Regulation and the COVID-19 pandemic.

Disclosure: For full disclosures of the study authors, visit ascopubs.org.


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