Identifying and Characterizing Metastatic Hormone-Sensitive Prostate Cancer (mHSPC) Population in Finland

OBJECTIVES: The treatment landscape of metastatic hormone-sensitive prostate cancer (mHSPC) has changed substantially in recent years. However, the prevalence of mHSPC and characteristics of patients with mHSPC are poorly known. This study aimed to characterize men with mHSPC and to estimate the number of men with mHSPC in Finland utilizing real-world data (RWD).

METHODS: Patients living with prostate cancer (PC) in 2015-2019 were identified from Finnish Cancer Registry and/or Care Register for Health Care (Hilmo). Of them (N=55567), 7245 (13%) patients used androgen deprivation therapy (ADT) according to the Prescription Register in 2015-2020 and had prostate-specific antigen (PSA) measurements in one of the three university hospital data lakes that provided data for this study. Docetaxel initiation in a data lake was used as a proxy for metastatic disease. Hormone sensitivity was evaluated based on a PSA relapse between first ADT purchase and docetaxel initiation, and those with a relapse were excluded. Demographics and cardiovascular comorbidities were measured at ADT initiation. The number of men with mHSPC in Finland was estimated assuming that the proportion of docetaxel treated men with mHSPC among ADT users is the same in the whole population and in the data lakes.

RESULTS: Of 7245 ADT users identified from the data lakes, 418 had mHSPC at docetaxel initiation. Median age of these patients at ADT initiation was 69 years (Q1-Q3: 64-73). One fourth of them were diagnosed with a cardiovascular disease before ADT initiation. The number of docetaxel treated men with mHSPC in Finland at least in some point in 2015-2020 was estimated at ~1200 (around 200 annually).

CONCLUSIONS: This study illustrates how RWD can be utilized as a tool for identifying mHSPC population. Cardiovascular disease, a potential contraindication for mHSPC medication, is prevalent in mHSPC population.