Die Behandlung älterer Patienten erfordert eine besondere Aufmerksamkeit für Arzneimittelinteraktionen, da mit einer Zunahme der altersbedingten Morbidität eine Polypharmazie immer relevanter wird. Insbesondere bei Medikamenten mit einer geringen therapeutischen Breite können Arzneimittelinteraktionen klinische Konsequenzen haben, die eine Anpassung der Dosis oder das Beenden oder Wechseln der Begleitmedikation erfordern. Oft sind diese Interaktionen auf eine pharmakokinetische Veränderung des Arzneimittelabbaus über das Cytochrom-P450(CYP)-Enzymsystem zurückzuführen, vor allem über CYP3A4. Diese Enzymisoform ist an dem Metabolismus von etwa der Hälfte der therapeutisch verwendeten Arzneimittel beteiligt, sodass sich auch viele CYP3A4-Substrate unter den eingesetzten Medikamenten bei Prostatakrebspatienten befinden. Unter den starken CYP3A4-Induktoren Apalutamid und Enzalutamid sind in diesem Zusammenhang – im Gegensatz zu Darolutamid – in vielen Fällen deutlich erniedrigte Plasmakonzentrationen bei den gleichzeitig verabreichten Arzneimitteln zu erwarten. Bei Abirateron handelt es sich hingegen um einen moderaten CYP2D6-Inhibitor. Da über dieses Isoenzym deutlich weniger Wirkstoffe biotransformiert werden, ist das Interaktionsspektrum anders zu bewerten. Um im Vorfeld einer Pharmakotherapie das Ausmaß einer Wechselwirkung besser abschätzen zu können, ist es hilfreich, die Abbauwege der einzelnen Wirkstoffe besser zu verstehen, um im Zweifel rechtzeitig das Therapiemonitoring intensivieren, Dosisveränderungen und Wechsel einer Pharmakotherapie vornehmen zu können.

Background Extremely high baseline prostate-specific antigen (bPSA) values in the range of 100 to >= 1000 ng/ml prior to the start of systemic therapy pose a challenge, as they can lead to the impression of a very unfavorable prognosis. ObjectiveWe investigated factors influencing 5-year overall survival (5-yOS) and the treatment modalities of patients with bPSA levels >= 100 ng/ml using retrospective data. Materials and methodsWe defined items from a limited initial collective, which we then used for a query in the UroCloud database. A total of 695 patients were included. Results and conclusionFor the entire collective, the 5-yOS was 68.5% +/- 2.7%. The bPSA value had a significant (p < 0.001) influence on 5-yOS in the following groups: 100-149 ng/ml, 150-249 ng/ml, 250-649 ng/ml, and >= 650 ng/ml (5-yOS: 77.0% +/- 4.9% vs. 76.9% +/- 4.5% vs. 61.4% +/- 6.0 vs. 57.4% +/- 6.1%, respectively). Age <= 70 years compared to > 70 years at first diagnosis resulted in a significant difference regarding 5-yOS (74.8% +/- 3.5% vs. 60.1% +/- 4.4, respectively). A PSA response of > 90%, which was achieved in 79.0% of cases, had a significant influence on 5-yOS compared to a response of <= 90% (73.5% +/- 2.9% vs. 48.6% +/- 6.7%, respectively). There was also a significant 5-yOS advantage if a first PSA nadir of <= 0.20 ng/ml was achieved (in 22.2%) compared to a first PSA nadir of > 0.20 ng/ml (89.8% +/- 3.3% vs. 60.4% +/- 3.5%, respectively). In 49.4% (n = 343) of cases, androgen deprivation therapy (ADT) monotherapy was started as first-line systemic therapy. Between 1999 and 2023, we saw an increase in escalated and initial combination therapies. The analysis shows that an extreme bPSA value is not in itself an expression of an unfavorable prognosis.

INTRODUCTION:LEAN is a prospective, multicenter, noninterventional, German cohort study in patients with locally advanced and metastatic hormone-sensitive prostate cancer (PC). This analysis explores the efficacy and safety of leuprorelin in patients with PC and an indication for androgen deprivation therapy (ADT) in routine practice. METHODS:Safety assessment focused on the incidence of major adverse cardiovascular (CV) events (MACEs; a composite of all-cause death, myocardial infarction, or stroke) over the 12-month study period. Patients initiating ADT before enrollment were excluded from the analysis. RESULTS:Of the 1,372 patients included, MACEs occurred in 57 (4.2%) patients and in 18/532 (3.4%) versus 39/840 (4.6%) patients without and with a pre-existing CV comorbidity, respectively (p = 0.264). Of the 57 MACEs, 17 were CV events and 20 were considered PC-related events; in 20 patients, events were classed as "other" or the context remained unknown. Only one MACE, nonserious arrhythmia, was considered drug related by the urologist. Of the 52 deaths reported in patients with MACEs, 12 were related to a CV event and 20 were related to disease progression. CONCLUSION:In a large European patient cohort, leuprorelin-based ADT demonstrated an acceptable safety profile, with a low incidence of CV events.

706 Background: Avelumab 1LM is standard of care for patients with la/mUC without disease progression after 1L platinum-based chemotherapy (PBC) based on results from the JAVELIN Bladder 100 phase 3 trial. The AVENUE study is evaluating the effectiveness and safety of avelumab 1LM treatment in routine clinical practice in Germany, Spain, Switzerland, and Russia. Previous results showed the acceptable safety profile of avelumab 1LM in a heterogeneous real-world population. Here, we report initial effectiveness data and updated baseline and safety data from the second interim analysis. Methods: AVENUE is a prospective, noninterventional study in patients with la/mUC without disease progression after 1L PBC. Initiation of avelumab 1LM is decided by the treating physician prior to enrollment per local approval. Patients are followed for 36 mo. The primary objective is to evaluate the overall survival (OS) rate at 12, 24, and 36 mo. Secondary objectives include assessment of median OS, progression-free survival (PFS), tumor response, and safety. Results: By data cutoff (May 9, 2024), 177 patients had received avelumab 1LM (median follow-up, 10.0 mo). Median age was 70 years (range, 43-89) and 78% were male. ECOG PS was 0-1 in 89.3%, ≥2 in 5.1%, and not reported (NR) in 5.6%. Primary tumor site was upper or lower tract in 28.2% and 71.8%, respectively. 1L PBC regimen was gemcitabine + cisplatin in 61.0% (split dose in 8.5%), gemcitabine + carboplatin in 36.2%, and other/switch in 3.4%. Number of prior PBC cycles was <4, 4-6, >6, and NR in 12.4%, 84.2%, 2.8%, and 0.6%, respectively. Median time to avelumab 1LM initiation was 6.1 weeks (range, 0.3-80.4) and median treatment duration was 6.0 mo (range, 0.5-30.8). Median OS was not reached (95% CI, 17.0-not estimable) and 6- and 12-mo OS rates (95% CI) were 80.6% (73.9-85.7) and 69.1% (61.1-75.7), respectively. Median PFS was 5.8 mo (95% CI, 4.6-9.1) and 6- and 12-mo PFS rates (95% CI) were 50.0% (42.1-57.3) and 33.1% (25.2-41.2). Disease control rate (assessed up to 6 mo) was 66.9% (95% CI, 58.8-74.3). Treatment-related adverse events (TRAEs) occurred in 57.6%, were grade ≥3 in 15.8%, serious in 15.3%, and led to permanent discontinuation in 10.7%. The most common TRAEs of any grade (≥4.0%) were fatigue (9.6%), hyperthyroidism (5.1%), pruritus (4.5%), and diarrhea (4.0%). Grade ≥3 immune-related AEs and infusion-related reactions occurred in 6.2% and 3.4%, respectively. At last follow-up, 28.8% of patients remained on avelumab, and 34.5% and 8.5% had received second- or third-line treatment (enfortumab vedotin in 21.5% and 2.3%), respectively. Conclusions: Data from the second interim analysis of AVENUE confirm the effectiveness and acceptable safety profile of avelumab 1LM in patients with la/mUC treated in routine clinical practice, consistent with previous studies.

Receiving treatment in certified oncological centers and obtaining a second medical opinion has been proven to enhance both the quality and cost-effectiveness of care for oncological patients. Interdisciplinary care optimizes the treatment of oncological patients by validating the diagnosis and treatment recommendation, emphasizes translational research, and applies oncological therapies in a more target-oriented manner. This study aims to examine the extent of patient adherence to second medical opinions provided at the Comprehensive Cancer Center Erlangen–Metropolitan Area Nuremberg (CCC Erlangen-EMN) and investigates how specific patient characteristics such as age, gender, and type of cancer diagnosis influence the likelihood of adhering to a second opinion. This is a prospective, single-center observational study supported by the local statutory health-insurance body (Allgemeine Ortskrankenkasse, AOK). A total of 584 male and female patients with cancer in the fields of urology, gynecology, gastroenterology, or sarcoma, seeking a second medical opinion were assessed for their adherence to the second opinion. Levels of adherence in patient subgroups were compared using appropriate statistical tests. Correction for multiple testing was not performed, due to the exploratory nature of the study. Almost 75

Das Update der Leitlinie Prostatakarzinom wurde und wird mit all seinen Facetten, auch leidenschaftlich, diskutiert. Eine Quelle des Disputes um einige Inhalte der aktuellen Leitlinie ist ganz sicher die mangelnde Präzision, mit der Begrifflichkeiten in der Vergangenheit eingeführt und bis zum heutigen Tag in der Breite fehlerhaft und unscharf kommuniziert werden. Der Berufsverband der Deutschen Urologie (BvDU) erörtert in dem Beitrag fünf Kernpunkte mit berufspolitischer Relevanz und bei denen die Umsetzung der Leitlinie auf die Versorgungsrealität trifft.

The update of the guideline on prostate cancer has been and continues to be discussed in all its facets, even with passion.One source of the dispute about some of the content of the current guideline is undoubtedly the lack of precision with which terms were introduced in the past and are still communicated incorrectly and vaguely to this day.In this article, the Professional Association of German Urology (BvDU) discusses five key points with professional policy relevance and where the implementation of the guideline meets the reality of care.

AIM:To characterize contemporary global real-world metastatic hormone-sensitive prostate cancer (mHSPC) treatment, guideline concordance, trends, and potential trend drivers. MATERIALS AND METHODS:Retrospective data from the Ipsos Global Oncology Monitor database for the United States, Germany, France, Spain, Italy, and the United Kingdom were used for descriptive analysis of mHSPC patients, treating physicians, and treatment utilization. Statistical testing of differences among treatment cohorts for the final study period was conducted. RESULTS:Of 15,662 total mHSPC patients across countries (2019-2024), the 1404 patients from the most recent and relevant study period (August 2023-January 2024) had an average age of 72-74 years, good baseline functioning, high-risk prostate cancer features, and cardiometabolic conditions as top comorbidities. Treatment mostly occurred in hospital/institutional settings and urban locales by oncologists versus urologists. Monotherapy androgen deprivation therapy (mADT) use declined while use of novel androgen receptor inhibitor (nARI) combination therapies, especially doublets, increased. Concordance between real-world and guideline-recommended treatment varied by country, ranging from 43.8% to 61.6%. CONCLUSIONS:Concordance with guidelines improved globally driven by nARIs. Persistent use of mADT, a non-guideline-recommended therapy, indicates physicians' concern about the safety and trade-offs with current options. New therapies delivering greater net benefits are needed, along with education on guideline adherence.

Objective Professor Michael Droller is stepping down as Editor-in-chief of Urologic Oncology: Seminars and Original Investigations, a journal that he co-founded. This manuscript describes his relation with the International Bladder Cancer Network (IBCN) and reviews his impact on the development of this association. Material and Methods Reviewing its 25-year long history, the IBCN reconsiders Michael Droller´s relevance for the unexpected development of the association and highlights his contributions. Results The IBCN gratefully acknowledges the invaluable support of Michael Droller in its goal to foster interdisciplinary collaboration among scientists dedicated to advancing the diagnosis and treatment of bladder cancer, and to cultivate the next generation of researchers in this field. Conclusions Michael Droller's legacy within the IBCN is profound. His guidance, critical insights, and unwavering commitment have been pivotal in establishing the network as a leading force in bladder cancer research.

BACKGROUND AND OBJECTIVE:A growing body of evidence suggests that the intensity of current follow-up in non-muscle-invasive bladder cancer (NMIBC) patients greatly exceeds clinical necessities. The UroFollow trial investigated the diagnostic accuracy of marker-based follow-up in patients with low/intermediate-risk NMIBC against the standard of care (SOC) for noninferiority (margin: <20%). METHODS:Patients with Ta low- and high-grade (G1-2) NMIBC were randomized to the SOC or 6-monthly marker-based follow-up (algorithm comprising urine markers and ultrasound; marker-based surveillance regimen [MA]). After a negative 3-mo cystoscopy (white light cystoscopy [WLC]), only patients with a positive algorithm underwent WLC in the MA. End-of-study WLC was recommended at 3 yr to recurrence-free patients. Simultaneously, several innovative urine markers were examined. KEY FINDINGS AND LIMITATIONS:In total, 214 patients were randomized to the SOC (n = 109) and MA (n = 105). The median follow-up was 2.4 yr; 30 and 29 cases of tumor recurrence were diagnosed in the SOC and MA arms, respectively. Sensitivity was 96.5% versus 81.5% (p = 0.1), with one and five Ta low-grade tumors being overlooked in the SOC and MA patients, respectively. No tumor progressing in stage or grade was missed. A total of 589 WLC procedures were performed in the SOC and 148 in the MA arm (p < 0.001). Among five other markers (ADX-Bladder, CellDetect, Bladder EpiCheck, UBC rapid, and Xpert bladder cancer monitor [BC-M]), Bladder EpiCheck and the Xpert BC-M showed similar performance to the algorithm. CONCLUSIONS AND CLINICAL IMPLICATIONS:UroFollow is the first urine marker-based randomized trial in low/intermediate-risk NMIBC patients. We conclude that 6-monthly marker-based follow-up after negative 3-mo WLC is safe in this cohort. Results of contemporary urine markers suggest that their potential for use in marker-based surveillance, however, requires prospective confirmation.

TPS274 Background: Prostate cancer remains the most common malignancy among men and the fifth leading cause of cancer-related mortality globally. Over the past 15 years, advances in imaging techniques and therapeutic options have significantly transformed the management of recurrent, advanced, and metastatic prostate cancer. However, treatment efficacy and toxicity are highly influenced by prior therapy sequences, highlighting the need for a deeper understanding of the optimal treatment sequence. The prospective real-world evidence registry, PROCARE, addresses this gap by documenting treatment patterns, imaging exams, oncologic outcomes, and safety profiles in routine clinical practice. Methods: This study focuses on four distinct patient cohorts: biochemical recurrence after local treatment with curative intent (e.g. radical prostatectomy, radiotherapy of the prostate or combination thereof), non-metastatic castration-resistant prostate cancer (nmCRPC), metastatic hormone-sensitive prostate cancer (mHSPC), and metastatic castration-resistant prostate cancer (mCRPC). PROCARE is a comprehensive long-term follow-up registry designed to document treatment patterns and outcomes in patients receiving systemic treatment. The study aims to enroll 5,000 patients across 50 sites in Germany. Recruitment is being conducted independently for each cohort, beginning with the mHSPC and mCRPC cohorts. First patient in was in January 2024. Patients will remain in the registry from the time of enrollment until death, withdrawal of consent, or study cohort closure. Throughout the study, additional blood samples will be collected at baseline and with each treatment change, respectively, and at first routine follow-up visit thereafter for exploratory research purposes, such as assessing circulating tumor DNA and RNA, as well as genome-wide single nucleotide polymorphisms (SNPs). This approach will enable a deeper understanding of treatment distribution, sequencing, efficacy, and safety in the real-world setting, contributing valuable insights into the evolving therapeutic landscape. Furthermore, analyses from liquid biopsies might provide important insights potentially guiding future therapeutic strategies for recurrent and metastatic prostate cancer. Clinical trial information: DRKS00033411 .

Extrem hohe Baseline-PSA-Werte (bPSA) im Bereich von 100 bis ≥ 1000 ng/ml vor Beginn der systemischen Therapie stellen eine Herausforderung dar, da der Eindruck einer sehr ungünstigen Prognose entstehen kann. Wir untersuchten Einflussfaktoren auf das 5‑Jahres-Gesamtüberleben (5-JGÜ) und die Therapiemodalitäten von Betroffenen mit bPSA-Werten von ≥ 100 ng/ml anhand retrospektiver Daten. Aus einem kleineren initialen Kollektiv legten wir Items fest, die wir für eine Abfrage aus der Datenbank UroCloud nutzten. Dabei wurden insgesamt 695 Betroffene eingeschlossen. Für das gesamte Kollektiv ergab sich ein 5‑JGÜ von 68,5

BACKGROUND Transplantation using kidneys from older donors or those with specific risk factors (marginal kidneys) offers improved outcomes compared to remaining on dialysis. Matched-pair analysis potentiates control for confounding donor factors and the impact of recipient characteristics on transplant survival. MATERIAL AND METHODS Data from 200 transplants using marginal deceased donors were retrospectively analyzed. Paired comparisons between mate kidney recipients, McNemar's test, and multivariable Cox regression were performed to identify recipient factors and histological features from zero-time biopsy associated with graft survival. RESULTS Graft survival was significantly longer in recipients with shorter pre-transplant dialysis exposure (mean 58.10 vs 68.86 months, P=0.001) and fewer HLA mismatches (3.40 vs 3.78, P=0.013). Severe acute tubular injury (ATI) in pre-implantation biopsy was associated with reduced graft survival (P=0.04). In multivariable Cox regression, the presence of severe ATI (P<0.001), older recipient age (HR=0.1 per year, P=0.002), HLA mismatches (HR=1.21, P=0.011), and elevated 1-year serum creatinine level (HR=0.72, P=0.030) remained independently associated with shorter graft survival. CONCLUSIONS Matched-pair analysis and multivariable modelling identified recipient dialysis duration, age, HLA mismatches,1-year serum creatinine, and pre-transplant biopsy findings, particularly severe ATI, as key predictors of graft survival in marginal kidney transplantation. These insights may support improved recipient selection and post-transplant management of marginal-donor kidneys.

Use contemporary real-world data (RWD) on mHSPC to assess distinct utilization of androgen deprivation therapies (ADT) and whether patients are receiving doublet or triple therapy treatment intensification in accordance with recent approvals and guideline updates.

66 Background: In the last decade, intensification of ADT with chemotherapy or androgen receptor pathway inhibitors (ARPi) has shown clinical benefits for men with mHSPC compared to ADT alone and has been recommended for mHSPC in clinical guidelines. The transition of these guidelines into real-world practice was investigated by several studies; however, these data have not been systematically summarized across the globe. Thus, we conducted a systematic literature review of real-world database (RWD) studies to summarize treatment patterns in mHSPC. Methods: An electronic search was performed in PubMed and Embase (covering citations until July 2023) and for relevant conferences of the past 2 years to identify RWD studies examining treatment patterns in men with mHSPC. Treatment patterns were summarized by overall study population across major geographies and factors associated with ADT intensification were described. Results: Of 2,325 retrieved citations, 29 studies met the inclusion criteria, with a total of 344,473 men with mHSPC covering study periods from 2014 to 2021. Most were cohort studies (n=26), utilizing electronic medical records (EMR)/chart reviews (n=18), and with RWDs from the United States (US) (n=21), followed by Europe (n=8), and Asia (n=6). Most studies included men with a median age of ≥70 years (n=23) and >80% of men had an Eastern Cooperative Oncology Group performance status (ECOG PS) of 0/1 (n=5 of 8). In the US, most studies showed that ADT monotherapy was predominantly utilized (>50%), followed by ADT/ARPi (20-40%), and ADT/chemotherapy (10-20%). Abiraterone was the most frequently used ARPi followed by enzalutamide. In Europe, most studies also reported ADT monotherapy (>45%), followed by ADT/ARPi (11-25%), or ADT/chemotherapy (12-34%). In Asia, ADT monotherapy (>62%) was the most common treatment in most studies, with low use of ADT/ARPIs (<20%), and ADT/chemotherapy (<15%). A few studies with recent EMR data (covering the 2020-21 data period) from cancer centers/registries showed high use of ADT/ARPi (>40%) in both the US and Europe. Reported quantitative factors (n=13) associated with intensification beyond ADT were high disease burden (spread of metastases, high volume), young age, ECOG PS 0/1, low comorbidities, and treating physician specialty-oncologist; qualitative factors (n=2) were patient preference, unsatisfactory response to ADT treatment, ability to tolerate adverse events, and lack of cost barriers. Conclusions: This comprehensive review shows ADT monotherapy remained highly utilized across major geographies until 2021 despite new evidence and updated guideline recommendations. However, the utilization of intensified treatment with ARPi combinations is slowly increasing after the recent approvals in mHSPC.

OBJECTIVE:To conduct a systematic literature review of real-world data (RWD) studies to summarise treatment patterns among men with metastatic hormone-sensitive prostate cancer (mHSPC). While androgen-deprivation therapy (ADT) is a primary treatment strategy for mHSPC, ADT intensification with androgen receptor pathway inhibitors (ARPIs) and/or chemotherapy is recommended by current guidelines and has improved clinical outcomes in the last decade. METHODS:We searched electronic databases (PubMed; Excerpta Medica dataBASE [EMBASE]) for eligible studies (retrospective or prospective observational RWD studies examining mHSPC treatment patterns) between database inception and July 2023, and manually screened the past 2 years of relevant conference proceedings. RESULTS:Of 2336 retrieved citations, 29 studies met the inclusion criteria, covering North America (United States, n = 21; Canada, n = 2), Europe (n = 8), and Asia (n = 6). Most studies utilised retrospective cohorts (n = 26) and included men with a median age of ≥70 years (n = 20). ADT monotherapy was predominantly used across geographies, followed by ADT + ARPI and ADT + docetaxel in the United States and Europe but not in Asia, where use of each combination remained low. Studies with recent electronic medical record data from cancer centres/registries showed >40% use of ADT + ARPI in the United States and Europe. Abiraterone was the most frequently used ARPI, followed by enzalutamide. Quantitative factors associated with ADT intensification were high disease burden, younger age, Eastern Cooperative Oncology Group performance status score of 0 to 1, fewer comorbidities, and oncologist physician specialty; qualitative factors were patient preference, unsatisfactory response to ADT, ability to tolerate adverse events, and absence of cost barriers. CONCLUSION:While there was an increasing trend in ADT intensification for mHSPC over the study period across geographies, use remained suboptimal considering the high proportion of patients who were still receiving ADT monotherapy only. These findings highlight the need for interventions to further optimise current mHSPC therapies with high guideline concordance.

A plethora of urine markers for the management of patients with bladder cancer has been developed and studied in the past. However, the clinical impact of urine testing on patient management remains obscure. The goal of this manuscript is to identify scenarios for the potential use of molecular urine markers in the follow-up of patients with high-risk non-muscle-invasive BC (NMIBC) and estimate potential risks and benefits. Information on the course of disease of patients with high-risk NMIBC and performance data of a point-of-care test (UBC rapid™), an MCM-5 directed ELISA (ADXBLADDER™), and 2 additional novel assays targeting alterations of mRNA expression and DNA methylation (Xpert bladder cancer monitor™, Epicheck™) were retrieved from high-quality trials and/or meta-analyses. In addition, the sensitivity of white light cystoscopy (WLC) and the impact of a urine marker result on the performance of WLC were estimated based on fluorescence cystoscopy data and information from the CeFub trial. This information was applied to different scenarios in patient follow-up and sensitivity, estimated number of cystoscopies, and the numbers needed to diagnose were calculated. The sensitivity of guideline-based regular follow-up (SOC) at 1 year was calculated at 96%. For different marker-supported strategies sensitivities ranging from 77% to 97.9% were estimated. Calculations suggest that several strategies are effective for the SOC. While for the SOC 24.6 WLCs were required to diagnose 1 tumor recurrence (NND), this NND dropped below 5 in some marker-supported strategies. Based on the results of this simulation, a marker-supported follow-up of patients with HR NMIBC is safe and offers the option to significantly reduce the number of WLCs. Further research focusing on prospective randomized trials is needed to finally find a way to implement urine markers into clinical decision-making.

Ziel dieser Studie war die Bestimmung des Anteils der Patienten mit einem Prostatakarzinom (PCa), die nach Beginn einer Therapie für ein kastrationsresistentes Prostatakarzinom (KRPCa) die primäre Androgendeprivationstherapie (ADT) beibehielten sowie die Beschreibung ihrer Behandlungsmuster. Retrospektive Analyse von 609.308 Patienten in urologischen Praxen in Deutschland von 2011 bis 2020 auf Basis von anonymisierten Sekundärdaten des Webservers UROscience. PCa-Patienten waren für die Studie geeignet, wenn sie nach einer 6‑monatigen verschreibungsfreien Prä-Indexperiode eine ADT erhielten. Insgesamt wurden 3.112 Patienten (Durchschnittsalter: 75,5 [± 8,0] Jahre) eingeschlossen. Die meisten Patienten erhielten Gonadotropin-Releasing-Hormon (GnRH)-Agonisten (72,3