Work

Real-World Treatment Patterns and Survival in People With Metastatic Castration-Resistant Prostate Cancer Following Metastatic Hormone-Sensitive Disease Between 2020 and 2023 in the United States

Year: 2025

Type: article

Abstract: PURPOSE To examine treatment patterns and survival in people with metastatic castration-resistant prostate cancer (mCRPC) that had previously progressed from metastatic hormone-sensitive prostate cancer (mHSPC) in the United States. METHODS People diagnosed with mCRPC between January 1, 2020 to June 30, 2023 were retrospectively identified in the ConcertAI NLP360™ electronic medical records (EMR) database. People were required to have a prior diagnosis of mHSPC and ≥1 EMR encounter ≥12 months pre-mCRPC and ≥6 months post-mCRPC. RESULTS Among the 609 people identified, the most common prior treatment for mHSPC was androgen deprivation therapy (ADT) alone (53%); others included ADT plus abiraterone (ABI; 19%), ADT plus a non-ABI androgen receptor pathway inhibitor (ARPI; 18%) and ADT plus docetaxel (10%). Overall, the most common first-line (1L) therapies for mCRPC were a non-ABI ARPI (37%; most commonly enzalutamide [24%]), ABI (25%), and chemotherapy (22%). These were also the most common 1L mCRPC therapies for those who had received ADT alone or ADT plus docetaxel for mHSPC. Among those who had received ADT plus ABI or ADT plus a non-ABI ARPI for mHSPC, 50% and 40%, respectively, also received an ARPI 1L for mCRPC. 1L chemotherapy for mCRPC was more common following ADT combination regimens (24–41%) than ADT alone (12%) for mHSPC. Median real-world overall survival was 27.2 months from mCRPC diagnosis and 20.8 months from 1L therapy. CONCLUSION Back-to-back ARPI use from mHSPC to mCRPC is common in current clinical practice and survival remains below 3 years. Alternative mCRPC treatments, such as intensified combination regimens beyond androgen receptor targeting, require exploration to improve survival in mCRPC. Micro abstract We used the ConcertAI database to retrospectively identify 609 people with a prior diagnosis of metastatic hormone-sensitive prostate cancer (mHSPC) who were later diagnosed with metastatic castration-resistant prostate cancer (mCRPC) to examine real-world treatment patterns and survival. Back-to-back androgen receptor pathway inhibitor use from mHSPC to mCRPC is common and survival remains <3 years. Alternative treatments beyond androgen receptor targeting are required to improve survival in mCRPC.

Source: Clinical Genitourinary Cancer

DOI: 10.1016/j.clgc.2025.102386

Authors: Amit D. Raval, Guifang Chen, Matthew J. Korn, Andreas Bernthaler, Niculae Constantinovici, Stephen J. Freedland