TARGETED LITERATURE REVIEW (TLR) OF THE REAL-WORLD TREATMENT PATTERNS AND OUTCOMES AMONG MCRPC PATIENTS IN THE US
Author(s)
Shore ND1, Oliver L2, Shui I3, Gayle A4, Wong OY5, Kim J3, Payne S4, Amin S6, Ghate S3
1Carolina Urologic Research Center, Myrtle Beach, SC, USA, 2Adelphi Values Ltd, Bollington, UK, 3Merck & Co., Kenilworth, NJ, USA, 4AstraZeneca, Cambridge, UK, 5Adelphi Values Ltd, Manchester, UK, 6AstraZeneca, Gaithersburg, MD, USA
OBJECTIVES The treatment landscape of metastatic castration resistant prostate cancer (mCRPC) has rapidly evolved. Six single agents have received FDA approval since 2004; however, optimal sequencing of therapies for mCRPC is not clear. The objective of this TLR was to summarize the published literature on the real-world treatment patterns and outcomes among patients diagnosed with mCRPC. METHODS A TLR was conducted across nine databases in OVID to capture English language non-randomized studies published 01/2014–05/2019 on treatment patterns and outcomes for mCRPC patients according to systematic principles. 4,732 papers were identified and systematically screened for prespecified inclusion. Grey literature searches included 10 conference proceedings from 2014–2019. RESULTS 22 studies met the inclusion criteria and reported on treatment patterns or outcomes of agents approved for mCRPC by the FDA. Many treatment sequences were identified, including AA-ENZ and AA-docetaxel; treatment with abiraterone acetate (AA) and enzalutamide (ENZ) in either sequential order was the most commonly reported. In the 1L setting, AA was used in 7 studies and in 6 of the 7 studies patients were subsequently treated with ENZ. 8 studies were identified where AA was used as a 2L treatment and 5 of the 8 studies reported that ENZ was used prior to AA. 1 study reported the treatment duration which was 9.8 months with 1L AA and 3.0 with ENZ when used post AA. In 1L, AA-ENZ compared to ENZ-AA had the highest median combined progression-free survival (PFS) (19.5 versus 13.0 months, p=0.65) and median overall survival (OS) (33.3 versus 29.9, p=0.08). No significant difference was found for combined PFS (HR=0.82, p=0.41) and OS (HR=0.79, p=0.31) between docetaxel-AA and AA-docetaxel. CONCLUSIONS Limited real-world sequencing studies are available that assess the corresponding outcomes for mCRPC patients. Real-world studies reflecting current treatment patterns and outcomes with newer agents are needed.
Conference/Value in Health Info
2020-05, ISPOR 2020, Orlando, FL, USA
Value in Health, Volume 23, Issue 5, S1 (May 2020)
Code
PCN9
Topic
Clinical Outcomes
Topic Subcategory
Comparative Effectiveness or Efficacy
Disease
Oncology