Real-world treatment of metastatic hormone-sensitive prostate cancer in the USA, Europe and Asia

Abstract

Aim: To characterize real-world patients with metastatic hormone-sensitive prostate cancer (mHSPC) and treating physicians and evaluate treatment trends and baseline concordance versus guidelines internationally. Materials & methods: Retrospective, cross-sectional data from the Ipsos Global Oncology Monitor database 2018–2020 were used for descriptive analysis of mHSPC patients, treating physicians and treatment utilization. Results: Among the 6198 mHSPC patients from five countries, the most common treatment was either androgen deprivation therapy (ADT) monotherapy or first-generation androgen receptor inhibitor + ADT. Second-generation androgen receptor inhibitor use was only initiating but increasing over the study period. Conclusion: Despite contemporaneous guidelines recommending treatment intensification of ADT in combination with novel antihormonals or docetaxel, 76.1% of reported mHSPC patients received non–guideline-concordant care.

Plain language summary

Prostate cancer is the second most common cancer among men worldwide and a leading cause of cancer-related death globally. Metastatic hormone-sensitive prostate cancer (mHSPC) refers to the stage of prostate cancer where it has spread to other parts of the body (’metastatic’) but still responds to hormonal therapy (’hormone-sensitive’), such as androgen deprivation therapy (ADT). Treatment guidelines around the world for men with mHSPC have changed over time, but there remains a lack of understanding of how well guidelines are followed in real-world practice. Consequently, this study analyzes real-world data from five countries between 2018 and 2020 to understand treatment patterns, baseline concordance versus guidelines and potential drivers of treatment trends. The study found prevalent use of ADT monotherapy and older antihormonal agents, and only marginal but increasing use of novel antihormonals in real-world practice. These practices deviate from guidelines from the study period, which generally recommended ADT combination with either newer antihormonal agents or docetaxel for patients with mHSPC. Overall, the proportion of the 6198 patients treated with non–guideline-concordant therapies was 76.1%. Since guideline-recommended care is associated with better outcomes, this baselining finding highlights the need for appropriate treatment selection and intensification for mHSPC patients.

Tweetable abstract

New study using real-world Ipsos data found that, between 2018 and 2020, three of four men with metastatic hormone-sensitive prostate cancer in five studied countries did not receive treatment for their prostate cancer according to clinical guidelines.

Keywords: :

• androgen antagonists, therapeutic use
• antineoplastic agents, hormonal, therapeutic use
• antineoplastic combined chemotherapy protocols, therapeutic use
• guideline adherence
• health care surveys, trends
• neoplasm metastasis
• practice guidelines as topic
• practice patterns, physicians’ trends
• prostatic neoplasms, drug therapy
• prostatic neoplasms, pathology

Author contributions

PJ Goebell: conception and design, data analysis and interpretation, revision of the manuscript, final approval of manuscript, agreement to be accountable for all aspects of the work. R Raina: conception and design, collection and/or assemblage of data, data analysis and interpretation, manuscript writing, final approval of manuscript, agreement to be accountable for all aspects of the work. S Chen: conception and design, provision of study materials, data analysis and interpretation, manuscript writing, final approval of manuscript, agreement to be accountable for all aspects of the work. S Rege: conception and design, collection and/or assemblage of data, data analysis and interpretation, manuscript writing, final approval of manuscript, agreement to be accountable for all aspects of the work. R Shah: conception and design, revision of the manuscript, final approval of manuscript, agreement to be accountable for all aspects of the work. J Partridge Grossman: conception and design, data analysis and interpretation, manuscript writing, final approval of manuscript, agreement to be accountable for all aspects of the work. A Reginald Waldeck: conception and design, manuscript writing, final approval of manuscript, agreement to be accountable for all aspects of the work.

Financial disclosure

This study was funded by Bayer Healthcare Pharmaceuticals, Inc., which also supported Open Access publication. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Competing interests disclosure

PJ Goebell has a consulting/advisory relationship with Bayer; received honoraria from Astellas, AstraZeneca, Bayer, BMS, Eisai, Ipsen, Janssen, Novartis, Pfizer, Roche and Sanofi; and received support for travel expenses from Astellas, AstraZeneca, Bayer, BMS, Eisai, Ipsen, Janssen, Novartis, Pfizer, Roche and Sanofi. R Raina is an employee of OPEN Health, which received funding from Bayer Healthcare Pharmaceuticals, Inc., to support this study. S Chen is an employee of and stockholder in Bayer Healthcare Pharmaceuticals, Inc. S Rege is a former employee of OPEN Health, which received funding from Bayer Healthcare Pharmaceuticals, Inc., to support this study. R Shah is a former employee of OPEN Health, which received funding from Bayer Healthcare Pharmaceuticals, Inc., to support this study. J Partridge Grossman is an employee of and stockholder in Bayer Healthcare Pharmaceuticals, Inc. A Reginald Waldeck is an employee of and stockholder in Bayer Healthcare Pharmaceuticals, Inc. The authors have no other competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Writing disclosure

Editorial assistance was provided by Christina DuVernay of OPEN Health, which received support for the study from Bayer Healthcare Pharmaceuticals, Inc.

Ethical conduct of research

Ethics approval was not required for this study as Ipsos Global Oncology Monitor data are de-identified and anonymized and do not contain any patient-identifiable information.

Data availability

The data underlying this article were provided by Ipsos under data license agreement with Bayer Healthcare Pharmaceuticals, Inc. Data will be shared on request to the corresponding author, A. Reginald Waldeck, with permission of Ipsos. Ipsos Global Oncology Monitor data are copyright Ipsos 2023, all rights reserved.

Open access

This work is licensed under the Attribution-NonCommercial-NoDerivatives 4.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/