Introduction

Therapeutic options for metastatic castration-resistant prostate cancer (mCRPC) patients are continuously advancing. We described mCRPC treatment patterns in the US from 2013 to 2019.

Methods

Patients with a confirmed mCRPC diagnosis and adenocarcinoma histology were included in the US Flatiron Health Electronic Health Record-derived de-identified database. Treatment patterns [including treatment per lines of therapies (LOTs), LOT sequences, and time on treatment] and overall survival (OS) have been described in mCRPC settings.

Results

Of 5213 patients (mean age: 72.6 years), 4374 (83.9%) were treated with ≥ 1 LOT post-mCRPC diagnosis (among those with ≥ 1 LOT, 55.3%, 29.5%, 14.7%, and 6.7% had ≥ 2, 3, 4, and 5 LOTs, respectively). In first line (1L), the main treatment class was next-generation hormonal agents (NHA; 62.5% of patients with ≥ 1 LOT), while the shortest and longest time on 1L were observed for chemotherapy (median 2.8 months) and NHA (median 5.1 months), respectively. The most common LOT sequences were NHA → NHA (29.4% of patients with ≥ 2 LOTs) and NHA → NHA → chemotherapy (16.7% of patients with ≥ 3 LOTs). In Kaplan–Meier analyses, the median OS was 19.4, 14.6, and 11.1 months post-1L, 2L, and 3L start, respectively. Patients who moved rapidly through LOTs had an increased risk of death.

Conclusions

NHA were widely used as 1L therapy in mCRPC patients from 2013 to 2019, but time on 1L NHA treatment was on average < 6 months. While NHA → NHA was the most observed 1L → 2L LOT sequence, a plethora of other LOT sequences were observed. OS was poor, highlighting an unmet need for life-prolonging treatments.

中文翻译：

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在使用 PARP 抑制剂之前，美国转移性去势抵抗性前列腺癌患者的真实治疗模式和总体生存率

介绍

转移性去势抵抗性前列腺癌 (mCRPC) 患者的治疗选择不断发展。我们描述了 2013 年至 2019 年美国的 mCRPC 治疗模式。

方法

已确认 mCRPC 诊断和腺癌组织学的患者被纳入美国 Flatiron Health 电子健康记录衍生的去标识化数据库。mCRPC 环境中已经描述了治疗模式 [包括每线治疗 (LOT)、LOT 序列和治疗时间] 和总生存期 (OS)。

结果

在 5213 名患者（平均年龄：72.6 岁）中，4374 名（83.9%）在 mCRPC 诊断后接受 ≥ 1 LOT 治疗（在 ≥ 1 LOT 的患者中，55.3%、29.5%、14.7% 和 6.7% 有≥2,分别为 3、4 和 5 批）。在一线（1L）中，主要治疗类别是下一代激素药物（NHA；62.5%的患者≥1 LOT），而观察到的最短和最长的1L治疗时间为化疗（中位2.8个月）和NHA（中位数 5.1 个月），分别。最常见的 LOT 序列是 NHA → NHA（29.4% 的患者≥ 2 LOT）和 NHA → NHA → 化疗（16.7% 的患者≥ 3 LOT）。在 Kaplan-Meier 分析中，中位 OS 在 1L、2L 和 3L 开始后分别为 19.4、14.6 和 11.1 个月。快速通过 LOT 的患者死亡风险增加。

结论

从 2013 年到 2019 年，NHA 被广泛用作 mCRPC 患者的 1L 治疗，但 1L NHA 治疗的时间平均<6 个月。虽然 NHA → NHA 是观察到最多的 1L → 2L LOT 序列，但观察到了过多的其他 LOT 序列。OS 很差，突显出对延长生命的治疗的需求未得到满足。