Overall survival (OS) improved among men with metastatic castration-sensitive prostate cancer (mCSPC) after the introduction of docetaxel and novel hormonal therapies (NHT; abiraterone, enzalutamide, apalutamide) for treating this disease state, according to study findings presented at the European Society for Medical Oncology 2022 Congress (ESMO 2022) in Paris, France.

Daniel J. George, MD, of Duke University Medical Center in Durham, North Carolina, and colleagues studied 39,292 men with mCSPC (33,641 with Medicare coverage and 5651 receiving care at Veterans Affairs [VA] medical facilities). The investigators divided patients into 3 cohorts of patients who received first-line treatment for mCSPC: those treated during 2010-2011 (prior to the introduction of NHT for metastatic castration-resistant prostate cancer); 2012-2014 (to reflect the introduction of NHT for metastatic castration-resistant prostate cancer); and 2015-2018 (for Medicare patients) and 2015-2019 (for VA patients) to capture the effects of the introduction of NHT and docetaxel for treating mCSPC.

Compared with Medicare and VA patients treated during 2010-2011, Medicare patients treated during 2015-2018 and VA patients treated during 2015-2019 had a significant 12% and 15% lower risk for death, respectively, the investigators reported in a poster presentation. OS survival did not improve during 2012-2014 compared with 2010-2011.

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Although treatment intensification with NHT or doctaxel for mCSPC is standard of care, the investigators found that as of 2018-2019, less than one-third of men with mCSPC received this regimen as first-line therapy. “The underutilization of these agents in mCSPC suggests that further OS improvements may be possible,” the authors concluded.

Disclosures: The study was funded by Pfizer and Astellas Pharma.


George DJ, Sandin R, Agarwal N, et al. Treatment patterns and overall survival (OS) in metastatic castration-sensitive prostate cancer (mCSPC) from 2010 to 2019. Presented at ESMO 2022, September 9-13, Paris, France. Abstract 1384P.