The metastatic castration-sensitive prostate cancer (mCSPC) treatment landscape in Sweden has evolved in recent years. The purpose of this study is to provide contemporary registry data on outcomes and treatment patterns in a nationwide cohort of Swedish patients with de novo mCSPC. Patient/material and methods: This retrospective cohort study included patients in Sweden with a clinical diagnosis of de novo mCSPC registered between January 1, 2017 and December 31, 2023. The primary outcome was time from de novo mCSPC diagnosis to mCRPC or death (2017-2023). Secondary outcomes included overall survival (OS), comorbidities, co-medication use, and treatment sequencing. OS, time to progression or death, and treatment sequencing for the 2017-2020 and 2021-2023 time periods were also analyzed.
A total of 2421 patients with de novo mCSPC were included in the primary analysis (mean age: 72.8 years). The median time to progression or death was 22.7 months (95% CI: 21.2-24.1), and the median OS was 49.8 months (95% CI: 47.0-52.6). Median time to progression or death increased from 19.9 months (95% CI: 18.6-21.2) in 2017-2020 to 30.0 months (95% CI: 26.6-33.3) in 2021-2023, while the proportion of patients receiving initial doublet or triplet therapy rose from 42.5 to 68.8%. No differences in OS were observed between different time periods.
In Sweden (2017-2023), increased time to progression or death was observed in patients with de novo mCSPC.
Acta oncologica (Stockholm, Sweden). 2026 May 21*** epublish ***
Johan Styrke, Åsa Jellvert, Marie Hjälm Eriksson, Fredrik Sandin, Elin Axén, Sam Jabbar, Kamilla Juhl Norgaard
Department of Diagnostics and Intervention, Urology and Andrology, Umeå University, Umeå, Sweden. ., Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Surgery, Region Västra Götaland, NU Hospital Group, Uddevalla, Sweden., Department of Surgery and Oncology, Capio St. Görans Hospital, Karolinska Institute, Department of Pathology and Oncology, Stockholm, Sweden., Regional Cancer Centre, Mid Sweden, Uppsala, Sweden., Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Urology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden., Astellas Pharma A/S, Copenhagen, Denmark.