1824P - Treatment patterns among novel hormonal therapy-experienced patients with metastatic castration-resistant prostate cancer

Background

Patients with advanced prostate cancer are commonly treated with novel hormonal therapy (NHT). However, treatment patterns following NHT remained unclear. This study evaluated treatment patterns among metastatic castration-resistant prostate cancer (mCRPC) patients with prior NHT.

Methods

This study used the Flatiron Health electronic health records data between 1/1/2013-7/31/2022. NHT-experienced mCRPC patients with ≥ 1 line of therapy (LOT) in the mCRPC setting and without chemotherapy in the last 365 days were included. The first LOT in the post-NHT mCRPC setting was defined as index line. Treatment patterns in the post-NHT mCRPC setting were summarized.

Results

A total of 804 patients (median follow-up: 10.6 months) were included. Of these, 239 (30%) patients used enzalutamide as index LOT, 191 (24%) patients used abiraterone, 171 (21%) used docetaxel, and 203 (25%) used other treatment (Table). Patients receiving prior NHT in the non-metastatic castration-resistant or metastatic castration-sensitive settings were more likely to cycle to NHTs than those receiving prior NHT in the mCRPC setting. The median time on treatment for index LOT was 4.1 months. A total of 126 (16%) patients died within 90 days after index LOT while 494 (61%) patients received a 2^nd post-NHT LOT. Subsequently, 104 (13%) patients died within 90 days after the 2^nd post-NHT LOT while 265 (33%) patients received a 3^rd post-NHT LOT. Most patients received chemotherapy while fewer patients received NHTs in the 2^nd and 3^rd post-NHT LOTs. Commonly observed treatment sequences included index enzalutamide followed by docetaxel (N=62, 8%), index docetaxel followed by other chemotherapy (N=54, 7%), and index abiraterone followed by docetaxel (N=48, 6%).

Table: 1824P

Treatment patterns in the post-NHT mCRPC setting

Conclusions

The real-world treatment patterns in the post-NHT mCRPC setting are heterogeneous, but the majority of patients attempted additional NHT followed by chemotherapy.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

This study was undertaken by Analysis Group Inc. sponsored by Bristol Myers Squibb.

Disclosure

V.K. Narayan: Financial Interests, Institutional, Research Grant: Pfizer, Janssen Oncology, Merck, Regeneron, BMS, TMunity Therapeutics; Financial Interests, Personal, Advisory Board: BMS, Pfizer, Janssen Oncology, Exelixis, Myovant Sciences, Regeneron, Amgen, AstraZeneca. M. Patel, S. Teitsson, L.C. Rosenblatt: Financial Interests, Personal, Full or part-time Employment: BMS; Financial Interests, Personal, Stocks/Shares: BMS. X. Yin: Financial Interests, Personal, Full or part-time Employment: BMS. K.A. Betts: Financial Interests, Institutional, Funding, Keith A. Betts is an employee of Analysis Group. Other description if needed Analysis Group received consulting fees from BMS to conduct this study: BMS. I. Pivneva: Financial Interests, Institutional, Funding, I. Pivneva is a full-time employee of Analysis Group. Analysis Group received consulting fees from BMS to conduct this study: BMS. S. Gao: Financial Interests, Institutional, Funding, Sophie Gao is a full-time employee of Analysis Group. Analysis Group received consulting fees from BMS to conduct this study: BMS. M. Sundar: Financial Interests, Institutional, Funding, Manasvi Sundar is an employee of Analysis Group. Other description if needed Analysis Group received consulting fees from BMS to conduct this study: BMS.