ASCO GU 2022: Treatment Trends Among Men With Metastatic Castration Sensitive Prostate Cancer: Results From the US Component of an International Study

( Clinical trials presented over the past seven years have led to novel hormonal therapies as well as taxane based chemotherapy being approved for treatment earlier in the disease course of advanced prostate cancer. Prior publications have examined treatment patterns since these new approvals but have been limited to treatment data up until 2019. To build on these prior publications,1,2 Dr. Barata and colleagues gathered data from patients by 50 participating physicians, each who aggregated information on four patients with mCSPC and four patients with mCRPC, a subset of the latter who had treatment information from their mCSPC disease. Treatments were categorized into 4 groups: (1) ADT plus first-generation anti-androgen, (2) ADT plus novel hormonal therapy such as abiraterone or AR antagonist, (3) ADT plus taxane chemotherapy with or without novel hormonal therapy, and (4) other. Treatments were divided by whether the patient started therapy between 2016-2018 or 2019-2020. A total of 239 men with mCSPC were included (146 who were being treated for this disease at time of enrollment in this study, 93 with mCRPC who had historical mCSPC data available).


The median patient age in this cohort was 69 years old. 75% of patients were treated by an oncologist, and the cohort was approximately evenly split between academic and community institutions. 69% of patients had bony metastases and 30% had visceral metastases at the time of data collection. 

Between time periods, the rate of use of first-generation anti-androgens dropped over time, whereas the percentage of patients that were treated with novel hormonal therapies increased. Concomitantly, the use of taxane or other therapies for mCSPC also decreased. The authors note that the covid-19 pandemic may have caused physicians to prescribe less chemotherapy over fears of infectious risk and favor novel hormonal therapies. Additionally, the overall sample size was small, and may have been biased towards patients who had more frequent visits. Nonetheless, with these caveats, this poster suggests that overall, more patients were treated with FDA-approved therapies with time. This highlights the need for developing new therapies for later disease states.  



Presented By: Pedro Barata, MD, MSc, Assistant Professor of Medicine, Hematology and Oncology, Tulane University Medical School, New Orleans, LA

Written By: Alok K. Tewari, MD, PhD, medical oncologist at Dana-Farber Cancer Institute, @aloktewar on Twitter during the 2022 American Society of Clinical Oncology Genitourinary (ASCO GU) Cancers Symposium, Thursday Feb 17 – Saturday Feb 19, 2022

1. George DJ, Agarwal N, Rider JR, et al. Real-world treatment patterns among patients diagnosed with metastatic castration-sensitive prostate cancer (mCSPC) in community oncology settings. JCO. 2021;39(15):suppl
2. Freedland SJ, Sandin R, Sah J, et al. Treatment patterns and survival in metastatic castration-sensitive prostate cancer in the US Veterans Health Administration. Cancer Med. 2021;10:8570-8580.