Metastatic castration-resistant prostate cancer (mCRPC) presents significant treatment challenges. Although androgen deprivation therapy (ADT) has been the standard treatment for metastatic prostate cancer for over 80 years, its efficacy is often limited to the initial treatment phase for most patients.
Recent clinical trials have investigated various therapeutic options for mCRPC; however, real-world evidence is essential for a comprehensive understanding of the current treatment landscape and to identify unmet clinical needs.
A multi-country, retrospective, non-interventional study was conducted across 31 centres in Latin America, the Middle East and Asia. Adults diagnosed with mCRPC between January 2016 and December 2018 were enrolled as the study subjects. Treatment patterns were thoroughly analysed, including those used when patients were at the metastatic castration-sensitive prostate cancer (mCSPC) and non-metastatic castration-resistant prostate cancer (nmCRPC) settings.
Among 795 enrolled patients with mCRPC (most aged ≥ 65 years), significant attrition was observed between treatment lines: approximately 50% of patients on first-line (1L) therapy advanced to second line (2L) but only 23.5% proceeded to third line (3L). New hormonal agent (NHA)-based therapies were the most prevalent choice for 1L and 2L, with post-chemotherapy NHA being the most common 1L-2L sequence. Disease progression, the primary reason for discontinuation across all regimens, occurred in > 60% of patients during mCRPC treatment. Generally, median real-world progression-free survival (rwPFS) decreased with each subsequent line of therapy. This study also highlights the inadequacy of prostate cancer screening in these regions.
This study offers valuable insights into the current treatment landscape of patients with mCRPC in non-US and non-European settings within a real-world context.
NCT04801186.
Advances in therapy. 2026 Jan 12 [Epub ahead of print]
Ray Manneh, Tarek Hashem, Joung Jae Young, Amit Joshi, Sahin Bahadir, Ayman Omar, Salem Eid, Ayman Elsayes, Francisco Gonzalez, Mohamed Elsayed, Pushpalatha Kantharaju
Sociedad de Oncologia y Hematologia del Cesar, Genitourinary Cancer, Cra. 15 #14-91, Valledupar, Colombia. ., Menoufia University Hospital, Shebin El Kom, Oncology, Egypt., National Cancer Center, Urologic Oncology, Goyang-Si, South Korea., Tata Memorial Hospital, Oncology, Mumbai, India., Marmara University School of Medicine, Urology, Istanbul, Turkey., King Faisal Specialist Hospital and Research Center, Oncology, Riyadh, Saudi Arabia., National Cancer Institute Cairo University, Oncology, Cairo, Egypt., AstraZeneca Singapore Pte Ltd, Singapore, Singapore., AstraZeneca AG, Baar, Switzerland., AstraZeneca FZ LLC, Dubai, UAE., AstraZeneca Pharma India, Delhi, India.
PubMed http://www.ncbi.nlm.nih.gov/pubmed/41525044