INTRODUCTION & OBJECTIVES: The tx paradigm has evolved with the introduction of tx intensification in metastatic castration sensitive prostate cancer (mCSPC). Limited RW data exist in mCRPC regarding tx patterns and clinical outcomes in Europe following incorporation of recent tx advances.
MATERIALS & METHODS: Data from pts with mCRPC initiating first line (1L) tx between 2018-2020 in UK, Spain, France, and Germany were retrospectively abstracted from medical records in 2023. Pt demographic and clinical characteristics were summarized descriptively. Rw progression free survival (rwPFS) was analyzed using Kaplan-Meier method.
RESULTS: A total of 1,218 pts with mCRPC were included. Mean (SD) age at mCRPC diagnosis (dx) was 69.3 (8.4) years; 87% had bone metastases; mean prostate-specific antigen at mCRPC dx was 66.3 (179.4) ng/mL. Genomic testing was done in 289 pts (24%). Most pts (90%) had mCSPC prior to mCRPC dx. Before mCRPC dx, 172 pts (14%) were novel hormonal therapy (NHT) exposed, 141 (12%) were taxane exposed, and 8 (1%) were NHT+taxane exposed. During mCSPC, more patients in the UK were exposed to taxane, while more NHTs were used in France. Abiraterone, enzalutamide, and docetaxel were the most common 1L txs for mCRPC; this differed based on prior tx experience and by country (Figure 1). Median rwPFS for 1L was 13.8 months in NHT exposed patients, 22.7 months in taxane exposed, 15.2 months in NHT+taxane exposed, and 22.8 months in NHT+taxane naïve patients.
CONCLUSIONS: NHT use prior to mCRPC dx was highest in France and lowest in UK while prior taxane use was most common in UK and lowest in Germany. Across countries, NHT was more commonly used than chemotherapy in 1L among pts who were NHT+taxane naïve. Tx practices in mCRPC varied across Europe; however, in all countries, there remains a need for novel tx in mCRPC that extend time to disease progression.
