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Treatment Patterns and Outcomes in Patients With Metastatic Castration-resistant Prostate Cancer in a Real-world Clinical Practice Setting in the United States.

Publication ,  Journal Article
George, DJ; Sartor, O; Miller, K; Saad, F; Tombal, B; Kalinovský, J; Jiao, X; Tangirala, K; Sternberg, CN; Higano, CS
Published in: Clin Genitourin Cancer
August 2020

BACKGROUND: Clinical trials have demonstrated the efficacy of several life-prolonging therapies for metastatic castration-resistant prostate cancer (mCRPC); however, real-world data on their use, survival effect, and safety are limited. Using electronic health record data from the Flatiron Health database, we studied real-world treatment patterns and health outcomes in patients with mCRPC. PATIENTS AND METHODS: We conducted a retrospective, non-interventional cohort analysis of electronic health record data of patients with confirmed mCRPC between January 2013 and September 2017. The primary objective was to describe real-world treatment patterns, including treatment type, duration, and sequencing. Secondary objectives included describing patient characteristics and clinical outcomes. RESULTS: Of 2559 patients with mCRPC, 1980 (77%) received at least 1 line of life-prolonging therapy (abiraterone, enzalutamide, docetaxel, cabazitaxel, sipuleucel-T, or radium-223). Of patients receiving first-line therapy, 49% received second-line therapy, and of these, 43% received third-line therapy. Abiraterone/prednisone and enzalutamide accounted for 65% of first-line therapies and 54% of second-line therapies. Docetaxel was the most common third-line therapy (24%). Back-to-back use of abiraterone/prednisone and enzalutamide was common. Radium-223 monotherapy use was 2% in the first-line setting, 3% in the second-line setting, and 8% in the third-line setting. The median overall survival was longer in patients who received life-prolonging therapies (23.7 months; 95% confidence interval: 22.3-25.1 months) than in those who did not (10.1 months; 95% confidence interval: 9.1-11.5 months). CONCLUSION: These real-world insights on over 2500 patients with mCRPC supplement findings from randomized controlled trials and may help to inform clinical trial design, treatment guidelines, and clinical decision-making.

Duke Scholars

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Published In

Clin Genitourin Cancer

DOI

EISSN

1938-0682

Publication Date

August 2020

Volume

18

Issue

4

Start / End Page

284 / 294

Location

United States

Related Subject Headings

  • Tissue Extracts
  • Taxoids
  • Survival Rate
  • Retrospective Studies
  • Prostatic Neoplasms, Castration-Resistant
  • Prognosis
  • Phenylthiohydantoin
  • Oncology & Carcinogenesis
  • Nitriles
  • Male
 

Citation

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George, D. J., Sartor, O., Miller, K., Saad, F., Tombal, B., Kalinovský, J., … Higano, C. S. (2020). Treatment Patterns and Outcomes in Patients With Metastatic Castration-resistant Prostate Cancer in a Real-world Clinical Practice Setting in the United States. Clin Genitourin Cancer, 18(4), 284–294. https://doi.org/10.1016/j.clgc.2019.12.019
George, Daniel J., Oliver Sartor, Kurt Miller, Fred Saad, Bertrand Tombal, Ján Kalinovský, Xiaolong Jiao, Krishna Tangirala, Cora N. Sternberg, and Celestia S. Higano. “Treatment Patterns and Outcomes in Patients With Metastatic Castration-resistant Prostate Cancer in a Real-world Clinical Practice Setting in the United States.Clin Genitourin Cancer 18, no. 4 (August 2020): 284–94. https://doi.org/10.1016/j.clgc.2019.12.019.
George DJ, Sartor O, Miller K, Saad F, Tombal B, Kalinovský J, et al. Treatment Patterns and Outcomes in Patients With Metastatic Castration-resistant Prostate Cancer in a Real-world Clinical Practice Setting in the United States. Clin Genitourin Cancer. 2020 Aug;18(4):284–94.
George, Daniel J., et al. “Treatment Patterns and Outcomes in Patients With Metastatic Castration-resistant Prostate Cancer in a Real-world Clinical Practice Setting in the United States.Clin Genitourin Cancer, vol. 18, no. 4, Aug. 2020, pp. 284–94. Pubmed, doi:10.1016/j.clgc.2019.12.019.
George DJ, Sartor O, Miller K, Saad F, Tombal B, Kalinovský J, Jiao X, Tangirala K, Sternberg CN, Higano CS. Treatment Patterns and Outcomes in Patients With Metastatic Castration-resistant Prostate Cancer in a Real-world Clinical Practice Setting in the United States. Clin Genitourin Cancer. 2020 Aug;18(4):284–294.
Journal cover image

Published In

Clin Genitourin Cancer

DOI

EISSN

1938-0682

Publication Date

August 2020

Volume

18

Issue

4

Start / End Page

284 / 294

Location

United States

Related Subject Headings

  • Tissue Extracts
  • Taxoids
  • Survival Rate
  • Retrospective Studies
  • Prostatic Neoplasms, Castration-Resistant
  • Prognosis
  • Phenylthiohydantoin
  • Oncology & Carcinogenesis
  • Nitriles
  • Male