OBJECTIVES: The mCRPC treatment landscape has evolved significantly with the approval of new therapies. This observational study assessed treatment sequences, patient characteristics, and OS in post-docetaxel mCRPC patients. METHODS: mCRPC patients (N=629) receiving docetaxel, cabazitaxel, abiraterone, or enzalutamide, following first-line docetaxel, between May 2011 and October 2014 were identified using electronic medical records obtained from US community oncology practices. OS, evaluated from second-line therapy initiation, was assessed using Cox regressions adjusting for site of metastasis, prostate-specific antigen (PSA), hemoglobin, alkaline phosphatase (ALP), albumin levels, and year of second-line therapy initiation. RESULTS: After first-line docetaxel, 123 patients (20%) received second-line cabazitaxel (median age: 72 years) and 506 (80%) received second-line androgen receptor-targeted therapy (ART) (abiraterone: 330, enzalutamide: 173, combination: 3; median age: 73 years). Subsequently, 54 and 141 patients received additional treatment lines following cabazitaxel or ART, respectively. Although patients receiving second-line cabazitaxel versus ART had similar disease prognosis profiles at first-line therapy initiation, at second-line therapy initiation they had higher mean PSA (387 vs 234 ng/mL) and ALP (182 vs 167 u/L), lower mean hemoglobin (10.8 vs 11.5 g/dL), and more presented with a intermediate or high Halabi risk score (62% vs 48%; JCO 2014:32;671–7); all p<0.05. Although not statistically significant, a trend suggested longer OS for patients receiving second-line cabazitaxel (hazard ratio [HR] for cabazitaxel vs ART: 0.79, 95% CI: 0.59–1.06). Among selected patient subgroups, cabazitaxel was associated with significantly longer OS: Halabi high-risk (HR 0.48, 0.24–0.93, p=0.0296); albumin < lower limit of normal (HR 0.43, 0.23–0.80, p=0.0077); hemoglobin <11 g/dL (HR 0.60, 0.40–0.90, p=0.0135). CONCLUSIONS: Most patients (80%) received ART post-docetaxel. Although patients receiving cabazitaxel post-docetaxel had more poor-prognosis characteristics, for patients with Halabi high-risk scores or low albumin or hemoglobin, cabazitaxel may be associated with longer OS compared with ART. Funding: Sanofi.