Secondary Treatment for Men with Localized Prostate Cancer: a pooled analysis of PRIAS and ERSPC-Rotterdam data within the PIONEER data platform

Katharina Beyer* (Corresponding Author), Vera Straten, Sebastiaan Remmers, Steven MacLennan, Giorgio Gandaglia, Peter-Paul M. Willemse, Ronald Herrera, Muhammad Imran Omar, Beth Russell, Johannes Huber, Markus Kreuz, Alex Asiimwe, Tom Abbott, Alberto Briganti, Mieke Vanhemelrijck, Monique J Roobol, Sara MacLennan, The PRIAS Consortium, The ERSPC Rotterdam Study Group, The PIONEER Consortium

*Corresponding author for this work

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INTRODUCTION: Treatment choice for localized prostate cancer is complicated, as each treatment option comes with various pros and cons. It is well established that active surveillance (AS), may be ended with a change to curative treatment at the time of disease progression, but it is less clear whether secondary treatment after initial curative treatment is required. As part of the PIONEER project, we quantified the probabilities of treatment change.

METHODS: A cohort study based on PRIAS and ERSPC-Rotterdam data was conducted. Patients were followed up for 10 years or until the 31st of December 2017. The primary outcome was the incidence of treatment change following initial treatment (i.e., a change to curative treatment following AS or secondary treatment after initial RP/RT).

RESULTS: Over a period of 1 to 5 years after initial treatment, the cumulative incidence of treatment change ranged from 3.8% to 42.8% for AS, from 7.6% to 12.1% for radical prostatectomy (RP) and from no change to 5.3% for radiation therapy (RT). While the possibility of treatment change in AS is known, the numbers within a five-year period were substantial. For RP and RT, the rate of change to secondary treatment was lower, but still non-neglectable, with 5 (10)-year incidences up to 12% (20%) and 5% (16%), respectively.

CONCLUSION: This is one of the first studies comparing the incidence of guideline-recommended treatment changes in men receiving different primary treatments (i.e., AS, RT, or RP) for localized prostate cancer (PCa).

Original languageEnglish
Article number751
Number of pages8
JournalJournal of Personalized Medicine
Issue number5
Early online date5 May 2022
Publication statusPublished - 5 May 2022
EventEAU21 Virtual Congress - Virtual
Duration: 8 Jul 202112 Aug 2021

Bibliographical note

PIONEER is funded through the IMI2 Joint Undertaking and is listed under grant agreement No. 777492. This joint undertaking receives support from the European Union’s Horizon 2020 research and innovation program and EFPIA. The views communicated within are those of PIONEER. Neither the IMI nor the European Union, EFPIA, or any Associated Partners are responsible for any use that may be made of the information contained herein.

Data Availability Statement

Supplementary Materials
The following are available online at, Figure S1: Cumulative Incidence of RP, Figure S2: Cumulative Incidence of RT. Figure S3: Cummuclative Incidence of AS; Figure S4: Cumulative Incidence of AS after discontinuation of AS.

Data Availability Statement
Data are not available to other researchers since the data originate from patients providing routinely collected data.


  • prostate cancer
  • active surveillance
  • treatment choice
  • patient decision-making
  • oncology
  • treatment selection


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