TREATMENT INTENSIFICATION PATTERNS BASED ON REAL-WORLD EVIDENCE FOR METASTATIC CASTRATION-SENSITIVE PROSTATE CANCER BETWEEN 2012 AND 2025: A SYSTEMATIC LITERATURE REVIEW
Author(s)
Bougchiche Meïssa, MSc1, Félix Morin, MSc1, Valentyn Litvin, PhD1, Ivan Yanev, PhD2, Alice Dragomir, PhD1.
1Université de Montréal, Montreal, QC, Canada, 2McGill University, Montreal, QC, Canada.
1Université de Montréal, Montreal, QC, Canada, 2McGill University, Montreal, QC, Canada.
OBJECTIVES: The management of metastatic castration-sensitive prostate cancer (mCSPC) has evolved significantly with the introduction of treatments intensification (TI) with docetaxel in 2015 and novel hormonal therapies (NHTs) since 2016. However, the adoption of these therapies in real-world settings are heterogenous over time and across healthcare settings. This systematic literature review (SLR) aims to describe treatment patterns for mCSPC between 2012 and 2025 in real-world contexts.
METHODS: A SLR was conducted across EMBASE, MEDLINE, WOS, CINAHL, and grey literature for studies published in English or French from 2012 to 2025. Eligible studies included retrospective or prospective observational real-world studies, case-control and cross-sectional studies. Randomized clinical trials, case reports, SLR and conference abstracts were excluded. The review focused on TI patterns, including combinations with docetaxel and/or NHTs (abiraterone, apalutamide, enzalutamide, and darolutamide) in bi- and tri-therapy. Data synthesis involves qualitative analyses of treatment patterns across years and countries.
RESULTS: Fifty-one studies were included, covering data from 15 countries: Australia, Belgium, Canada, China, Colombia, France, Germany, Italy, Japan, Norway, Saudi Arabia, Singapore, Spain, USA and the UK. ADT+docetaxel was the first TI to be used in mCSPC between 2015-2017 with the lowest rates reported in Asia. ADT+NHTs surpassed ADT+docetaxel usage by 2018 and became the dominant combination among the treatments after 2022, reaching rates of 40.9% to 72.5%. Abiraterone was the most used NHTs followed by enzalutamide, apalutamide and darolutamide respectively. Tri-therapy was detected after 2020 with docetaxel+NHTs with rates lower than 3% only in Europe and North America. Darolutamide was mainly reported in the US and was mostly used in tri-therapy than double-therapy in 2023 at a 60% rate.
CONCLUSIONS: This review offers healthcare providers and decision makers valuable insights into mCSPC treatment trends. The findings aim to refine clinical guidelines, inform policymaking, improve resource allocation, and enhance market understanding globally.
METHODS: A SLR was conducted across EMBASE, MEDLINE, WOS, CINAHL, and grey literature for studies published in English or French from 2012 to 2025. Eligible studies included retrospective or prospective observational real-world studies, case-control and cross-sectional studies. Randomized clinical trials, case reports, SLR and conference abstracts were excluded. The review focused on TI patterns, including combinations with docetaxel and/or NHTs (abiraterone, apalutamide, enzalutamide, and darolutamide) in bi- and tri-therapy. Data synthesis involves qualitative analyses of treatment patterns across years and countries.
RESULTS: Fifty-one studies were included, covering data from 15 countries: Australia, Belgium, Canada, China, Colombia, France, Germany, Italy, Japan, Norway, Saudi Arabia, Singapore, Spain, USA and the UK. ADT+docetaxel was the first TI to be used in mCSPC between 2015-2017 with the lowest rates reported in Asia. ADT+NHTs surpassed ADT+docetaxel usage by 2018 and became the dominant combination among the treatments after 2022, reaching rates of 40.9% to 72.5%. Abiraterone was the most used NHTs followed by enzalutamide, apalutamide and darolutamide respectively. Tri-therapy was detected after 2020 with docetaxel+NHTs with rates lower than 3% only in Europe and North America. Darolutamide was mainly reported in the US and was mostly used in tri-therapy than double-therapy in 2023 at a 60% rate.
CONCLUSIONS: This review offers healthcare providers and decision makers valuable insights into mCSPC treatment trends. The findings aim to refine clinical guidelines, inform policymaking, improve resource allocation, and enhance market understanding globally.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HSD38
Topic
Health Service Delivery & Process of Care, Organizational Practices, Real World Data & Information Systems
Disease
Oncology