Real-world clinical and economic outcomes in chemotherapy-naïve patients with metastatic castration-resistant prostate cancer.

BACKGROUND

Real-world treatment and outcomes for patients with metastatic castration-resistant prostate cancer (mCRPC) are evolving.

RESEARCH DESIGN AND

METHODS

This retrospective study used data from the US Surveillance, Epidemiology, and End Results-Medicare Database (01/01/2009-12/31/2019). Patients with mCRPC who previously received one androgen receptor pathway inhibitor (ARPI) followed by either a second ARPI (ARPI cohort) or a taxane (taxane cohort) were included. Treatment patterns, serious adverse events (SAEs [based on hospitalization or emergency room (ER) claim]), healthcare resource utilization (HCRU), and costs were evaluated descriptively, with Kaplan-Meier analysis for overall survival (OS).

RESULTS

Of 923 patients, 714 were in the ARPI cohort and 209 in the taxane cohort. Overall, 33.3% vs 53.6% of patients in the ARPI vs taxane cohorts received a subsequent treatment (p < 0.001), most commonly taxanes in both cohorts. Median OS was ≈1 year in both cohorts. SAEs were more frequent in the taxane cohort (66.0% vs 42.2%; p < 0.001). The taxane cohort had more ER, outpatient, and pharmacy visits (p < 0.0001), while the ARPI cohort had more hospitalizations (p < 0.0001).

CONCLUSIONS

Results demonstrate that patients with mCRPC receiving common treatment sequences have suboptimal survival, frequent SAEs, and high HCRU and costs. Interpretation is limited by historical data and residual confounding.