REAL-WORLD TREATMENT PATTERNS AND TREATMENT INTENSIFICATION IN METASTATIC HORMONE-SENSITIVE PROSTATE CANCER (MHSPC) BY DISEASE VOLUME AND PRESENTATION
Author(s)
Zin Myint, MD1, Jeetvan Patel, PhD2, Barinder Kang, PhD2, Diego Ospina Gonzalez, MD2, Magdaliz Gorritz, MPH3, Zifan Zhou, MS3, Jennifer Nguyen, PharmD2;
1Univeristy of Kentucky, Albert B. Chandler Hospital, Lexington, KY, USA, 2Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA, 3IQVIA, Wayne, PA, USA
1Univeristy of Kentucky, Albert B. Chandler Hospital, Lexington, KY, USA, 2Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA, 3IQVIA, Wayne, PA, USA
OBJECTIVES: As prostate cancer is the second most common cancer in men, the aim of this study was to describe real-world treatment patterns and treatment intensification (defined as adding a therapy >120 days after treatment initiation [claims-based definition]) among patients with mHSPC, overall and stratified by disease presentation (de novo vs recurrent) and disease volume.
METHODS: This retrospective, non-interventional cohort study used PharMetrics® Plus data from 01/01/2017 to 03/31/2025. Adult males with mHSPC treated with androgen deprivation therapy (ADT) between 01/01/2020 and 12/31/2024 were included (index=date of ADT initiation). High volume disease (HVD) was defined using claims-based proxies, including receipt of chemotherapy during the post-index period or having ≥1 visceral metastasis. Low volume disease (LVD) was defined as patients who did not meet the HVD criteria.
RESULTS: Of 3683 patients with mHSPC, 29.0% had HVD and 71.0% had LVD; 18.3% and 10.7% had de novo and recurrent HVD, respectively, and 40.0% and 31.0% had de novo and recurrent LVD. Overall, use of ADT monotherapy as initial treatment decreased from 37.5% to 25.3% from 2020 to 2024, while ADT + ARPI increased from 33.3% to 42.9% and triplet therapy (ADT + ARPI + docetaxel) increased from 1.2% to 10.1%. Triplet therapy was mainly used in patients with HVD (de novo HVD, 19.9%; recurrent HVD, 17.5%). Overall, 13.5% of patients with mHSPC had treatment intensification. The rate of treatment intensification differed by disease volume and de novo status (p<0.0001). Patients with HVD were more likely to have treatment intensification (21.5% vs 10.3%) and had shorter time to treatment intensification than those with LVD.
CONCLUSIONS: Patients with mHSPC demonstrate heterogeneous treatment patterns by disease volume and de novo status. Despite increased use of ADT + ARPI and triplet therapy over time, many patients still initiated ADT monotherapy, suggesting potential gaps between treatment guidelines and real-world practice.
METHODS: This retrospective, non-interventional cohort study used PharMetrics® Plus data from 01/01/2017 to 03/31/2025. Adult males with mHSPC treated with androgen deprivation therapy (ADT) between 01/01/2020 and 12/31/2024 were included (index=date of ADT initiation). High volume disease (HVD) was defined using claims-based proxies, including receipt of chemotherapy during the post-index period or having ≥1 visceral metastasis. Low volume disease (LVD) was defined as patients who did not meet the HVD criteria.
RESULTS: Of 3683 patients with mHSPC, 29.0% had HVD and 71.0% had LVD; 18.3% and 10.7% had de novo and recurrent HVD, respectively, and 40.0% and 31.0% had de novo and recurrent LVD. Overall, use of ADT monotherapy as initial treatment decreased from 37.5% to 25.3% from 2020 to 2024, while ADT + ARPI increased from 33.3% to 42.9% and triplet therapy (ADT + ARPI + docetaxel) increased from 1.2% to 10.1%. Triplet therapy was mainly used in patients with HVD (de novo HVD, 19.9%; recurrent HVD, 17.5%). Overall, 13.5% of patients with mHSPC had treatment intensification. The rate of treatment intensification differed by disease volume and de novo status (p<0.0001). Patients with HVD were more likely to have treatment intensification (21.5% vs 10.3%) and had shorter time to treatment intensification than those with LVD.
CONCLUSIONS: Patients with mHSPC demonstrate heterogeneous treatment patterns by disease volume and de novo status. Despite increased use of ADT + ARPI and triplet therapy over time, many patients still initiated ADT monotherapy, suggesting potential gaps between treatment guidelines and real-world practice.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
SA5
Topic
Study Approaches
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Oncology