Treatment and Outcomes of Patients With Metastatic Castration-resistant Prostate Cancer by Race, Initial Diagnosis, and Family History: Results From the TRUMPET Registry.

INTRODUCTION: To better understand how treatment patterns, clinical outcomes, health-related quality of life, and healthcare resource utilization are impacted by initial prostate cancer diagnosis, prostate cancer family history, and race. PATIENTS: We conducted three subgroup analyses using the TRUMPET US registry of metastatic castration-resistant prostate cancer (mCRPC) patients: 1) initial diagnosis of non-metastatic hormone-sensitive prostate cancer (HSPC) versus de novo metastatic HSPC; 2) with prostate cancer family history versus none; 3) Caucasians versus African Americans. METHODS: Baseline characteristics, treatment patterns, health-related quality of life, and healthcare resource utilization were analyzed descriptively. Time-to-event outcomes were analyzed using the Kaplan-Meier method and Cox proportional hazards models, adjusted based on clinically important variables, including disease biology factors and selected variables showing large standardized mean differences between groups. RESULTS: This study included 832 patients with mCRPC. Patients with non-metastatic HSPC at initial diagnosis had a 32% lower risk of death than patients with de novo metastatic HSPC at initial diagnosis (adjusted HR: 0.68; 95% CI: 0.51, 0.91). Patients with prostate cancer family history had a significantly lower risk of death than patients with none (adjusted HR: 0.68; 95% CI: 0.51, 0.90). No statistically significant outcomes differences were identified between African American and Caucasian patients. Health-related quality of life changes were similar across all subgroups. CONCLUSION: Our analyses suggest that initial diagnosis and prostate cancer family history may meaningfully impact patients' survival and clinical outcomes. Future dedicated, prospective research should further elucidate how each of these factors affectclinical outcomes in the mCRPC context.