Abstract 360P
Background
With evolving treatment (Tx) options for mCRPC, it is important to understand the real-world Tx trends and associated effectiveness. REMPRO (NCT04801186) study determined the Tx patterns and survival outcomes in patients (pts) with mCRPC in Asia, MEA, and Latin America.
Methods
This retrospective study enrolled males, >18 years (y) diagnosed with mCRPC between Jan 2016 and Dec 2018 who progressed on androgen deprivation therapy alone and received ≥1 line of Tx (LOT, as mono- or combination) with ≥12 months (m) of follow-up data available. Primary objective was Tx patterns and secondary objectives were clinicodemographics and survival analyzed by Kaplan–Meier method. We present data from the MEA cohort.
Results
MEA included 212 pts (median age: 67 [range: 42–95] y) with 66.0% ≥65 y. At initial diagnosis, all had adenocarcinoma, 70.2% (125/178) had a Gleason score ≥8, 87.3% (185/212) were castration-sensitive, 81.6% (142/174) had de novo metastasis and 67.4% (128/190) had a bone-only metastasis. Post-mCRPC diagnosis, 95.8% (203/212) received LOT1, 43.8% (89/203) received LOT2, and 31.5% (28/89) received LOT3. Chemotherapy (CT)- and new hormonal agent (NHA)-based Tx were the most prescribed in 1L and 2L: CT-based (LOT1: 44.4%, 72/162; LOT2: 28.9%, 24/83) and NHA-based (LOT1: 27.8%, 45/162; LOT2: 53.0%, 44/83), respectively. For NHA users, the median duration of Tx (DoT) was 6.3, 8.9, and 6.0 m for 1L, 2L, and 3L with corresponding median real-world progression-free survival (rwPFS) of 24.6, 10.1, and 15.9 m, respectively. The median overall survival (OS) was highest in NHA users at 1L (34.2 m) decreasing to 26.4 m at 3L. Disease progression led to Tx discontinuation in >44% pts. Table: 360P
Tx and survival (m)
| Tx | N | DoT # | N | Events | *rwPFS | Events | *OS | |
| LOT1, 203 | All | 155 | 96 | 12.1, 8.6-15.8 | 59 | 34.2, 23.5-NA | ||
| BCT | 36 | 4.7 (0.8, 34.7) | 33 | 30 | 5.1, 3.0-7.0 | 16 | 22.4, 7.6-NA | |
| NHA | 45 | 6.3 (1.4, 31.3) | 36 | 17 | 24.6, 10.5-31.4 | 12 | 34.2, 24.6-NA | |
| CT | 72 | 3.7 (0, 21.3) | 56 | 24 | 18.1, 8.6-NA | 17 | NA | |
| LOT2, 89 | All | 73 | 52 | 8.7, 7.0-12.2 | 30 | 32.0, 12.5-NA | ||
| BCT | 1 | 1.8 (1.8, 1.8) | 1 | 1 | 1.9, NA | 1 | 1.9, NA | |
| NHA | 44 | 8.9 (0.6, 51.3) | 35 | 27 | 10.1, 7.9-12.9 | 14 | 37.2, 12.7-NA | |
| CT | 24 | 4.1 (0, 15.5) | 22 | 14 | 8.3, 4.1-15.8 | 8 | NA | |
| LOT3, 28 | All | 23 | 16 | 8.6, 5.0-18.4 | 8 | 26.4, 16.5-NA | ||
| NHA | 9 | 6.0 (1.6, 24.3) | 8 | 5 | 15.9, 1.2-NA | 3 | 26.4, 6.6-NA | |
| CT | 14 | 5.1 (1.2, 8.6) | 13 | 10 | 8.4, 4.0-10.0 | 4 | 31.6, 10.0-NA | |
BCT, bicalutamide; NA, not available; *median, 95% CI Egypt, 100; Saudi Arabia, 35; Türkiye, 53; UAE, 24 # median (range)
Conclusions
Our results highlight NHA- and CT-based Tx as the most common pattern for mCRPC at both LOT1 and 2. Less than 45% received LOT2. There was a progressive decline in OS with increasing LOT, indicating an unmet need for better Tx sequencing with novel agents in MEA.
Clinical trial identification
NCT04801186.
Editorial acknowledgement
Legal entity responsible for the study
AstraZeneca and Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA.
Funding
This study was supported by AstraZeneca and Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA.
Disclosure
H. Farag, A. Aboutaleb, V. Rajadhyaksha: Financial Interests, Institutional, Full or part-time Employment: AstraZeneca. All other authors have declared no conflicts of interest.