Real-World Treatment Patterns in the Metastatic Hormone-Sensitive Prostate Cancer Setting Across Europe

OBJECTIVES: To explore real-world treatment patterns for patients in the metastatic hormone-sensitive prostate cancer (mHSPC) setting as treatment patterns for patients with metastatic prostate cancer (PC) continue to evolve.

METHODS: Data were drawn from the Adelphi Real World PC Disease Specific Programme™, a cross-sectional survey with retrospective data collection of physicians and their patients with mHSPC in France, Germany, Italy, Spain, and the United Kingdom from November 2022 – May 2023. Physicians completed patient record forms for four consecutively consulting patients with mHSPC, reporting demographics, clinical characteristics and treatment patterns. Patients with PC as their only malignancy were included. Analyses were descriptive. NHA/chemotherapy refers to monotherapy usage (± androgen deprivation therapy [ADT]).

RESULTS: Overall, 221 physicians (84% oncologists, 16% urologists) reported on 875 patients. At data collection, median (interquartile range; IQR) age was 71.0 (66.0–77.0) years, 59% were diagnosed metastatic at initial diagnosis, 39% of patients had high-volume disease and 81% had an ECOG score 0–1.

Most patients received an NHA (45%; apalutamide 21%; enzalutamide 13%; abiraterone 11%). Treatment regimens also included ADT alone (21%), chemotherapy (13%; docetaxel 13%), NHA + chemotherapy + ADT (8%) and other treatments (13%). The median (IQR) time since mHSPC treatment start to data collection was 170.0 (82.2–338.0) days.

Overall survival and progression free survival were the most common physician-reported reasons for choice of NHA (44% and 39%, respectively). Suitability for patients with high-volume disease and overall survival were the most common physician-reported reasons for choice of chemotherapy (38% and 36% respectively).

CONCLUSIONS: In this real-world analysis of mHSPC treatment patterns, NHA was the most common treatment, driven by overall survival and progression-free survival. Although low, usage of ADT alone is present and further research should be conducted to assess the changing treatment patterns in the mHSPC setting as the landscape evolves.