Advances in treatment circa 2009-2011 have led to increases in survival for men with metastatic prostate cancer, according to a poster presentation at the American Urological Association’s 2022 annual meeting in New Orleans, Louisiana.
Using the Surveillance, Epidemiology, and End Results (SEER) database, investigators identified 21,558 men with metastatic prostate cancer diagnosed from 2000 to 2008 and 30,063 men diagnosed after 2011. The eras occurred before and after FDA approval of therapies, such as abiraterone and cabazitaxel.
Median overall survival was significantly longer for men diagnosed after 2011 compared with 2000-2008 (37 vs 30 months), Camilo Arenas Gallo, MD, of Case Western Reserve University, Cleveland, Ohio, reported for his team. Survival increased by 1.0 month for every year of diagnosis after 2011 compared with 0.02 months annually from 2000 to 2008.
Receiving a diagnosis of metastatic prostate cancer after 2011 compared with the earlier era was significantly associated with 20% lower all-cause mortality and 25% lower cancer-specific mortality.
“Survival among men with metastatic prostate cancer has improved markedly with advances in medical therapy,” Dr Gallo said in an interview. “The therapeutic arsenal has grown dramatically over the past decade.”
These include drugs with different mechanisms of action, such as upfront chemotherapy (cabazitaxel, approved in 2010), androgen biosynthesis inhibitor (abiraterone, 2011), pure androgen-receptor signaling inhibitor (enzalutamide, 2012), radionuclide therapy (radium-223, 2013), and cellular-based immunotherapy (sipuleucel-T, 2013), he said. He acknowledged that their study was limited to 2000-2018, so it did not capture more recently approved therapies, such as 177Lu-PSMA-617 (approved in 2022).
“There is still much room for improvement, as metastatic prostate cancer continues to claim more than 34,000 American men’s lives per year,” Dr Gallo said.
Prior work demonstrates that many approved therapies for metastatic prostate cancer are adopted slowly, according to Dr Gallo. This is due to numerous factors, including cost and reluctance by patients and providers to utilize unfamiliar treatments with complex side effects.
“Practicing urologists, who may be the first to encounter patients with advanced prostate cancer, are encouraged to educate patients on options that can improve survival. It is important for us to be a part of these conversations. Medical professionals must also continue to advocate for insurers to cover the cost of advanced therapies once their efficacy has been demonstrated.”
Omil-Lima DO, Wu X, Kent MA, et al. Effect of advances in treatment on population-level survival of patients with metastatic prostate cancer. Presented at: AUA 2022; May 13-16, 2022, New Orleans, Louisiana. Abstract PD03-10.