Table 2.
Treatment patterns before the mCRPC setting stratified by clinical states
| Treatments patterns, n (%) | All patients n = 5213 |
Patients diagnosed with mHSPC before mCRPC n = 3784 |
Patients diagnosed with nmCRPC before mCRPC n = 1365 |
Patients diagnosed with mPC and CRPC at the same time n = 64 |
||
|---|---|---|---|---|---|---|
| Any time pre-mCRPC | nmHSPC clinical state (PC dx → mHSPC dx) |
mHSPC clinical state (mHSPC dx → mCRPC dx) |
nmHSPC clinical state (PC dx → nmCRPC dx) |
nmCRPC clinical state (nmCRPC dx → mCRPC dx) |
nmHSPC clinical state (PC dx → mCRPC dx) |
|
| Patients with observed treatment during the specified pre-mCRPC perioda, b | 4765 (91.4) | 1714 (45.3) | 2711 (71.6) | 1214 (88.9) | 844 (61.8) | 54 (84.4) |
| Therapy use by treatment class | ||||||
| Hormonal therapy | 4043 (77.6) | 821 (21.7) | 2403 (63.5) | 718 (52.6) | 789 (57.8) | 34 (53.1) |
| First-generation anti-androgens (bicalutamide, flutamide, nilutamide) | 3313 (63.6) | 737 (19.5) | 1731 (45.7) | 637 (46.7) | 378 (27.7) | 27 (42.2) |
| NHA (abiraterone, enzalutamide, apalutamide, darolutamide) | 1,100 (21.1) | 42 (1.1) | 564 (14.9) | 55 (4.0) | 466 (34.1) | 6 (9.4) |
| LHRH agonists (leuprolide, triptorelin, goserelin, histrelin) | 1792 (34.4) | 114 (3.0) | 1,332 (35.2) | 124 (9.1) | 228 (16.7) | 8 (12.5) |
| LHRH antagonists (degarelix) | 106 (2.0) | 7 (0.2) | 82 (2.2) | 7 (0.5) | 10 (0.7) | 0 (0.0) |
| Other androgen-suppressing drugs (ketoconazole, estrogens) | 130 (2.5) | 26 (0.7) | 28 (0.7) | 16 (1.2) | 60 (4.4) | 0 (0.0) |
| Chemotherapyc | 644 (12.4) | 24 (0.6) | 540 (14.3) | 25 (1.8) | 57 (4.2) | 2 (3.1) |
| Sip-T | 90 (1.7) | 1 (0.0) | 54 (1.4) | 1 (0.1) | 34 (2.5) | 0 (0.0) |
| Other therapyd | ||||||
| Any | 1533 (29.4) | 31 (0.8) | 1390 (36.7) | 29 (2.1) | 87 (6.4) | 2 (3.1) |
| Bone therapy agent | 1521 (29.2) | 29 (0.8) | 1379 (36.4) | 28 (2.1) | 87 (6.4) | 2 (3.1) |
| Radium-223 | 23 (0.4) | 0 (0.0) | 23 (0.6) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Pembrolizumab | 2 (0.0) | 0 (0.0) | 2 (0.1) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Other immunotherapy | 15 (0.3) | 5 (0.1) | 8 (0.2) | 1 (0.1) | 1 (0.1) | 0 (0.0) |
Dx diagnosis, EHR electronic health record, LHRH luteinizing hormone-releasing hormone, mCRPC metastatic castration-resistant prostate cancer, mHSPC metastatic hormone-sensitive prostate cancer, NHA next-generation hormonal agent, nmCRPC non-metastatic castration-resistant prostate cancer, nmHSPC non-metastatic hormone-sensitive prostate cancer, PC prostate cancer, Sip-T sipuleucel-T
aIncludes primary treatment reported at initial PC diagnosis
bTreatments received before the patient was transferred to an oncology center in Flatiron network (where applicable) may not be recorded in EHR data; thus, treatments reported in this table may be underestimated
cChemotherapy agents included docetaxel, carboplatin, cabazitaxel, cisplatin, etoposide, estramustine, mitoxantrone, and other chemotherapy agents
dOther therapy classes include thalidomide, bcg vaccine, nivolumab, atezolizumab, lenolidomide, durvalumab, ipilimumab, pembrolizumab, targeted therapies, radium-223, bone therapy agent, and clinical study drugs