Key Take Home Message
- •This study explored real-world first-line treatment patterns and selection by medical oncology and urology providers in patients with metastatic castration-sensitive prostate cancer using the prospective IQVIATM claims-based dataset.
- •Treatment intensification with novel hormonal therapy was prescribed 32% of the time by oncology providers but only 12% of the time by urology providers.
- •Both medical oncology and urology providers need to improve their treatment intensification efforts for men with metastatic castration-sensitive prostate cancer to increase their patients' overall survival.
Patients with mCSPC experience a longer overall survival with treatment intensification by addition of novel hormonal therapy (NHT) or docetaxel to androgen deprivation vs androgen deprivation alone. Real-world data report, however, that nearly half of mCSPC patients do not receive treatment intensification. In this study, treatment patterns and utilization of treatment intensification in mCSPC patients were described using the IQVIA Anonymized Patient Longitudinal Data, a dataset of fully adjudicated pharmacy and medical claims.
Patients and Methods
Reports on first line (1L) treatment patterns were obtained for years 2015 to 2021. Medicaid, Medicare, Medicare part D, cash transactions, and commercial data were included for years 2012 to 2021.
Nationwide, of 66,844 men with newly diagnosed mCSPC since 2015, on average 25% were prescribed NHT, and another 12% were prescribed chemotherapy. No differences were noted in treatment patterns based on U.S. regions and/or rural vs. urban communities. The disparity was observed in prescribing patterns between oncology and urology providers. Oncology providers prescribed 1L NHT on average 32% of the time, while urology providers did so 12% of the time. Furthermore, oncology providers prescribed chemotherapy on average 20% of the time, resulting in 52% of men with mCSPC receiving treatment intensification as 1L therapy. Patients’ age group, community or health insurance did not account for the disparity between the 2 specialties.
Both medical oncology and urology providers need to improve their treatment intensification efforts for men with mCSPC to increase their patients’ overall survival.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Clinical Genitourinary Cancer
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- ARCHES: a randomized, phase III study of androgen deprivation therapy with enzalutamide or placebo in men with metastatic hormone-sensitive prostate cancer.J Clin Oncol. 2019; 37: 2974-2986https://doi.org/10.1200/JCO.19.00799
- Apalutamide for metastatic, castration-sensitive prostate cancer.N Engl J Med. 2019; 381: 13-24https://doi.org/10.1056/NEJMoa1903307
- Abiraterone acetate plus prednisone in patients with newly diagnosed high-risk metastatic castration-sensitive prostate cancer (LATITUDE): final overall survival analysis of a randomised, double-blind, phase 3 trial.Lancet Oncol. 2019; 20: 686-700https://doi.org/10.1016/s1470-2045(19)30082-8
- Enzalutamide with standard first-line therapy in metastatic prostate cancer.N Engl J Med. 2019; 381: 121-131https://doi.org/10.1056/NEJMoa1903835
- Abiraterone for prostate cancer not previously treated with hormone therapy.N Engl J Med. 2017; 377: 338-351https://doi.org/10.1056/NEJMoa1702900
- Chemohormonal therapy in metastatic hormone-sensitive prostate cancer: long-term survival analysis of the randomized phase III E3805 CHAARTED trial.J Clin Oncol. 2018; 36: 1080-1087https://doi.org/10.1200/JCO.2017.75.3657
- Darolutamide and survival in metastatic, hormone-sensitive prostate cancer.N Engl J Med. 2022; https://doi.org/10.1056/NEJMoa2119115
- Abiraterone plus prednisone added to androgen deprivation therapy and docetaxel in de novo metastatic castration-sensitive prostate cancer (PEACE-1): a multicentre, open-label, randomised, phase 3 study with a 2 × 2 factorial design.Lancet. 2022; https://doi.org/10.1016/S0140-6736(22)00367-1
- NCCN guidelines insights: prostate cancer, version 1.2021.J Natl Compr Canc Netw. 2021; 19: 134-143https://doi.org/10.6004/jnccn.2021.0008
- Advanced prostate cancer: AUA/ASTRO/SUO guideline PART I.J Urol. 2021; 205: 14-21https://doi.org/10.1097/JU.0000000000001375
- Real-world utilization of advanced therapies and racial disparity among patients with metastatic castration-sensitive prostate cancer (mCSPC): a Medicare database analysis [abstract 5073].J Clin Oncol. 2021; https://doi.org/10.1200/JCO.2021.39.15_suppl.5073
- Real-world treatment patterns among patients diagnosed with metastatic castration-sensitive prostate cancer (mCSPC) in community oncology settings [abstract 5074].J Clin Oncol. 2021; https://doi.org/10.1200/JCO.2021.39.15_suppl.5074
- Real-world first-line (1L) treatment patterns in patients (pts) with metastatic castration-sensitive prostate cancer (mCSPC) in a U.S. health insurance database [abstract 5072].J Clin Oncol. 2021; https://doi.org/10.1200/JCO.2021.39.15_suppl.5072
- Treatment patterns and survival in metastatic castration-sensitive prostate cancer in the US Veterans Health Administration.Cancer Med. 2021; 10: 8570-8580https://doi.org/10.1002/cam4.4372
- Management of patients with metastatic castration-sensitive prostate cancer in the real-world setting in the United States.J Urol. 2021; 206: 1420-1429https://doi.org/10.1097/Ju.0000000000002121
- A phase III trial with a 2x2 factorial design in men with de novo metastatic castration-sensitive prostate cancer: Overall survival with abiraterone acetate plus prednisone in PEACE-1 [abstract LBA5_PR].Ann Oncol. 2021; https://doi.org/10.1016/j.annonc.2021.08.2099
- Systemic triple therapy in metastatic hormone-sensitive prostate cancer (mHSPC): ready for prime time or still to be explored?.Cancers (Basel). 2021; : 14https://doi.org/10.3390/cancers14010008
- Underutilization of standard of care (SOC) treatment intensification in patients (pts) with metastatic castration-sensitive prostate cancer (mCSPC) by specialty [abstract 183].J Clin Oncol. 2022; https://doi.org/10.1200/JCO.2022.40.6_suppl.183
Published online: June 27, 2022
Accepted: June 22, 2022
Received in revised form: June 22, 2022
Received: April 22, 2022
© 2022 Elsevier Inc. All rights reserved.