Treatment patterns and clinical outcomes among patients with metastatic castration-resistant prostate cancer: a multinational retrospective medical record review.

BACKGROUND: To document treatment patterns, clinical outcomes, and healthcare resource use among European patients with metastatic castration-resistant prostate cancer (mCRPC) in real-world practice settings. METHODS: Data from patients with mCRPC initiating first line treatment between 2018-2020 in Europe were retrospectively abstracted from medical charts in 2023. Demographic and clinical characteristics were summarized descriptively. Real-world progression free survival (rwPFS) and overall survival (OS) were analyzed using Kaplan-Meier method. RESULTS: 260 physicians contributed data from 1 218 patients. Mean (standard deviation) age at mCRPC diagnosis was 69.3 (8.4) years; 198 (16%) had an Eastern Cooperative Oncology Group score ≥2. Most (90.0%) were metastatic hormone-sensitive prior to mCRPC diagnosis; most had not received a taxane or androgen receptor pathway inhibitor (ARPI) (73.6%); 14.1% were ARPI exposed. Enzalutamide (30.8%), abiraterone (39.0%), and docetaxel (25.3%) were most common first-line therapies; this differed based on prior treatment experience. Median rwPFS was 20.9 months (95% confidence interval [CI], 19.1-23.2) on first-line, 11.1 months (95% CI, 10.4-12.9) on second-line, and 7.6 months (95% CI, 6.6-8.4) on third-line treatment. Estimated OS rate from first-line initiation was 91.8% (standard error = 0.8) at 12 months and 79.5% (standard error = 1.2) at 24 months. CONCLUSIONS: In a population where few had received treatment intensification for metastatic hormone-sensitive prostate cancer, real-world outcomes were aligned with those observed previously and in clinical trials. However, there remains significant need to broaden access to effective systemic therapy in mCRPC and to find new treatments to improve outcomes.