Global management of drug-drug interaction in patients with prostate cancer: international survey by Meet-URO group and ONCOassist

Abstract Background Patients with prostate cancer (PC) frequently receive multiple medications for comorbidities, increasing the risk of drug–drug interactions (DDIs). Despite guidelines highlighting DDI relevance, data on real-world management are limited. This international survey aimed to characterize current practices, barriers, and needs in this setting. Materials and methods A self-administered, multiple-choice online survey was sent to 3342 Italian oncologists (AIOM/Meet-URO members) and 19139 global healthcare professionals via the ONCOassist app. A part of the survey included optional case studios completed only by Italian respondents. Results Responses were received by 69 healthcare professionals in Italy and 1064 worldwide. Overall, DDIs were widely recognized as clinically relevant in PC care. Digital tools (online databases and smartphone applications) were the most frequently used resources for DDI assessment in both cohorts, whereas AI-based tools were limited. Italian oncologists reported limited on-site pharmacologist access (29%), while global respondents reported more frequent pharmacologist support (76%). Common barriers included time constraints, uncertain reliability of sources, and lack of training. When DDI checkers conflicted, Italian and global respondents favored pharmacologist consultation, although global users relied also on literature (31%) and clinical judgment (26%). Proposed solutions differed between cohorts: Italian clinicians emphasized the need for greater access to pharmacologists’ support, whereas the global cohort highlighted institutional training and educational initiatives. Clinical scenarios demonstrated awareness of specific DDI risks, with cautious selection of ARTAs and co-medications in line with current recommendations. Conclusion Although limited by potential selection bias and restricted generalizability, these findings suggest that strengthening multidisciplinary collaboration could enhance patient safety and optimize therapy outcomes.