Abstract 344P
Background
The treatment landscape in mHSPC has rapidly evolved with new standards of care being combination androgen deprivation therapy (ADT) and androgen receptor pathway inhibitors (ARPIs) with or without docetaxel (DOC) chemotherapy. Given the emerging data and increased availability of ARPIs within Asia, we aimed to analyse the real-world treatment patterns in Asian patients with mHSPC.
Methods
We interrogated the electronic Prostate Cancer Australian and Asian Database (ePAD), a multi-national prospective clinical registry, to identify patients with mHSPC. Clinical data are collected from 3 sites in Singapore and South Korea. Descriptive statistics were used to report treatment selection, patient and disease characteristics, PSA response and adverse events. Time to CRPC was analysed using the Kaplan Meier method and treatment groups were compared through log-rank tests.
Results
We identified 236 patients with mHSPC enrolled from 7th Jun 2022 and 31st March 2024. 116 (49%) received ADT+ARPI, 84 (36%) ADT alone, 17 (7%) ADT+DOC, and 12 (5%) ADT+ARPI+DOC. All 12 patients who received ADT+ARPI+DOC had de novo metastatic disease (100%) vs 105 (91%) on ADT+ARPI and 58 (70%) on ADT alone; p=0.03. A greater proportion of those on ADT+ARPI+DOC had visceral disease N=2 (17%) vs 14 (12%) with ADT+ARPI and 3 (4%) on ADT alone; p=0.1. After a median follow up of 27 months, 95 patients developed CRPC, including 59 (70%) of ADT alone, 29 (25%) in ADT+ARPI and 1(8%) in ADT+ARPI+DOC groups. Median time to CRPC was 23.7 months in those who received ADT alone and not reached in other cohorts, favouring ADT+ARPI+DOC (HR 0.13; 95%CI 0.19-0.97; p=0.047) and ADT+ARPI (HR 0.49; 95%CI 0.31-0.76; p=0.002) groups over ADT alone.
Conclusions
Treatment patterns reflect timely adoption of clinical trial data into real-world practice and favourable early outcomes with combination therapies are consistent within our real-world cohort. Further follow up will allow comparison of longer-term outcomes between treatment choices.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
MSD.
Disclosure
R. Kanesvaran: Financial Interests, Institutional, Invited Speaker: Astellas, Johnson and Johnson, Ipsen, Amgen, BMS, MSD, Novartis, AstraZeneca, Sanofi, Merck; Financial Interests, Institutional, Advisory Board: Johnson and Johnson, Pfizer, Ipsen, Amgen, BMS, MSD, Bayer, AstraZeneca, Ferring; Financial Interests, Institutional, Research Grant: Sanofi, Eisai, Johnson and Johnson; Non-Financial Interests, Personal, Leadership Role, Past President: Singapore Society of Oncology, SIOG; Non-Financial Interests, Personal, Leadership Role, Vice Chairman: Singapore Cancer Society; Non-Financial Interests, Personal, Leadership Role, Medical Advisory Board Member: International Kidney Cancer Coalition. A. Anton: Financial Interests, Institutional, Research Funding: AstraZeneca, Astellas, Amgen, Mundipharma, Johnson & Johnson , MSD, Bayer ; Financial Interests, Personal, Invited Speaker: AstraZeneca, Bayer , Astellas. B. Tran: Financial Interests, Personal, Advisory Board: Amgen, AstraZeneca, Astellas, Bayer, BMS, Ipsen, IQVIA, Janssen, Merck, MSD, Novartis, Pfizer, Roche, Sanofi, Tolmar, Sanofi Ammunix; Financial Interests, Personal, Invited Speaker: Amgen, Astellas, AstraZeneca, Bayer, BMS, Merck, Pfizer; Financial Interests, Institutional, Research Grant: Amgen, Astellas, AstraZeneca, Bayer, BMS, Genentech, Ipsen, Janssen, Pfizer, MSD; Financial Interests, Personal, Steering Committee Member: CG Oncology, Janssen, MSD. All other authors have declared no conflicts of interest.