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Treatment Intensification Patterns and Utilization in Patients with Metastatic Castration-Sensitive Prostate Cancer

      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.

      Abstract

      Introduction

      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.

      Results

      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.

      Conclusion

      Both medical oncology and urology providers need to improve their treatment intensification efforts for men with mCSPC to increase their patients’ overall survival.

      Keywords

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