ESMO 2021: Real-World Treatment Patterns in Metastatic Hormone-Sensitive Prostate Cancer Patients in the US

(UroToday.com) The European Society of Medical Oncology (ESMO) 2021 virtual annual meeting’s prostate cancer session included a presentation by Dr. Peter Goebell discussing real-world treatment patterns among patients with metastatic hormone-sensitive prostate cancer (mHSPC).

 

The mHSPC treatment landscape is rapidly evolving, most recently with the entry of second-generation anti-androgen receptor inhibitors. These medications are the most recent class of agents rapidly gaining approval and reimbursement, thereby expanding the set of mHSPC treatment options and paving the way for the treatment landscape evolution. The objective of this study was to describe mHSPC patients’ current treatment patterns, contextualized by their demographic and clinical characteristics and treating physician characteristics.

 This cross-sectional, retrospective, chart review study included mHSPC patients (aged ≥ 18 years) in the US, Germany, France, Japan, and China from the IPSOS Global Oncology Monitor Database (January 2018 - June 2020). Descriptive analyses were used to assess demographic, clinical, and current treatment patterns for mHSPC patients, along with characteristics of their treating physicians.  

 There were 6,198 mHSPC patients included in this study, including 3,893 from the US, 867 from Germany, 513 from France, 641 from Japan, and 284 from China. Patients were generally aged ≥70 years (69.5%), and well-functioning (ECOG score 0-1: 83.3%). Patients tended to be treated by urologists (73.9-99.4%) except in the US where a slight majority were treated by oncologists (56.3%). Additionally, these patients were mostly not co-managed in all countries except Japan where this data was not available. Patients in Europe (Germany, 69.4%; France, 76.6%) and the US (82.6%) were primarily treated with luteinizing hormone releasing hormone (LHRH) agonists, and in Asia, with a combination of LHRH agonist(s) (China, 71.8%; Japan, 82.6%) and first-generation androgen receptor inhibitors (China, 74.6%; Japan, 70.8%). With the exception of France (38.6%), the majority of patients were treated with combination therapy (57.4%) across the remaining four markets. Across the five countries, use of androgen synthesis inhibitor (14.3%) and second-generation anti-androgen receptor inhibitors (5.6%) was relatively infrequent, but increasing over the study period, as measured in successive cross-sectional data cuts. Chemotherapy was used consistently across the study period, with more use in Europe and China (Germany, 17.0%; France, 15.0%; 13.4%) than in the US (8.5%) or Japan (0.2%). As follows is a summary of utilization of mHSPC therapies by drug class:

 

real-world_mHSPC.png

 

Dr. Goebell concluded his presentation with the following summary statements: 

  • This is the first real world study examining treatment pattern among mHSPC patients across the US, Germany, France, China, and Japan
  • Taxane chemotherapy utilization reflected that it is and remains an important component of mHSPC standard of care in the US, Germany, France, and China, with further changes anticipated in Japan
  • Abiraterone was also relatively prevalent and with continued treatment evolution, it will be of interest to understand its potentially evolving place in mHSPC therapy
  • Differences in guideline evolution, regulatory approval and reimbursement during the study period likely explains some of the cross-country differences
  • In addition, the differences of disciplines involved in treatment may have an impact on utilization patterns

 

Presented by: Peter J. Goebell, MD, PhD, Division of Urology, University Hospital Erlangen, Erlangen, Germany

Written by: Zachary Klaassen, MD, MSc – Urologic Oncologist, Assistant Professor of Urology, Georgia Cancer Center, Augusta University/Medical College of Georgia, @zklaassen_md on Twitter during the 2021 European Society for Medical Oncology (ESMO) Annual Congress 2021, Thursday, Sep 16, 2021 – Tuesday, Sep 21, 2021.

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