Contemporary Trends in Treatment Intensification for Men With Metastatic Hormone-Sensitive Prostate Cancer (mHSPC) in 4 European Countries & the United Kingdom (UK): Results From Patient Chart Reviews

OBJECTIVES: Use contemporary real-world data (RWD) on mHSPC to assess distinct utilization of androgen deprivation therapies (ADT) and whether patients are receiving doublet or triple therapy treatment intensification in accordance with recent approvals and guideline updates.

METHODS: This cross-sectional retrospective study included mHSPC patients in Germany, France, Spain, Italy, and the United Kingdom from the Ipsos Global Oncology Monitor, comprising data abstracted from patient charts and provided online by treating physicians. Data was descriptively analyzed for treatment utilization rates as moving quarterly totals from January-March 2021 (N=256) through April-June 2023 (N=289).

RESULTS: Utilization of androgen deprivation monotherapy (mADT), the predominant treatment historically, halved over the study period (76.2% to 38.2%) while that of novel androgen receptor inhibitors (nARI) + ADT steadily increased (4.9% to 35.8%). Use of abiraterone + ADT and first-generation ARI + ADT respectively increased (6.1% to 13.0%) and decreased (6.1% to 5.0%). Use of docetaxel + ADT remained at single digit rates. Chemo-hormonal triple therapy only initiated halfway through the study period and remained low throughout, likely owing to the recency of triple therapy approval, solely for darolutamide + ADT + docetaxel, and of related guideline updates from organizations like the European Society of Clinical Oncology. Among mHSPC patients newly initiating treatment (n=45-80), darolutamide triple therapy was the only form prescribed.

CONCLUSIONS: Up to 3 years post guideline updates on mHSPC treatment intensification, RWD still shows considerable non-concordance versus guidelines of nearly 50%, primarily as continued mADT. However, these utilization trends suggest a narrowing of the gap in the observed increase of nARI doublet therapy and the emergence of triple therapy in line with guideline recommendations. Continued assessments are important to ensure mHSPC patients are receiving optimized, timely care consistent with clinical evidence-based guidelines.