Real-world first-line (1L) treatment patterns in patients (pts) with metastatic castration-sensitive prostate cancer (mCSPC) in a U.S. health insurance database.

• DOI: 10.1200/jco.2021.39.15_suppl.5072
• Publication Date: 2021-06-02T14:15:18Z
• Authors: Umang Swami; Agnes Hong; Nader N. El-Chaar; David Nimke; Krishnan Ramaswamy; Elizabeth J. Bell; Rickard Sandin; Neeraj Agarwal
• Keywords: Enzalutamide; Regimen; Abiraterone acetate

5072 Background: Over the past 6 years, intensification of androgen deprivation therapy (ADT) with docetaxel (DOC) and novel hormonal therapies (NHT) [abiraterone, enzalutamide, apalutamide], has been shown to improve survival outcomes in men mCSPC. This study assessed real-world utilization effective combination as 1L treatment insured pts U.S. Methods: retrospective used Optum health insurance claims database, which includes pt data from both commercially Medicare Advantage populations. Eligible were adult ≥1 claim a metastatic International Classification Diseases diagnostic code (first was index date) within 90 days (d) prior to, or any time after, prostate cancer diagnosis between January 2014 June 2019. Pts evidence systemic anticancer during 1-year pre-index baseline period excluded, unless first drug occurred d disease. The treatments identified for mCSPC pre-index, plus other received 180 first, grouped by regimen: ADT only; + first-generation antiandrogens (AA); DOC; NHT; NHT DOC. Results: Of 4221 mCSPC, 2364 (56.0%) 892 (21.1%) AA; 577 (13.7%) 348 (8.2%) 40 (0.9%) who DOC generally younger than groups (Table). By 2019, use only AA had declined, while increased However, 2018 majority still either alone, AA, including those visceral metastases Survival analysis across cohorts is ongoing. Conclusions: Despite level 1 demonstrating improved intensified (ADT NHT), this shows its underutilization evident even more aggressive disease (visceral metastases) recently These highlight that minority optimal life-prolonging population. Further studies are needed identify reasons treatments.[Table: see text]