Why carry out this study?

Metastatic castration-resistant prostate cancer (mCRPC) represents the most advanced form of prostate cancer and is associated with a poor prognosis.

Although therapeutic options for mCRPC are rapidly advancing, there is limited real-world data on contemporary treatment patterns to benchmark the changes and inform clinical practice.

To identify current gaps in the therapeutic landscape, the present retrospective study used a large oncology electronic medical records database from the US to describe treatment patterns among patients with mCRPC during the study period spanning from 2013 to 2019 (n = 5213).

What was learned from this study?

Post-mCRPC diagnosis, consecutive lines of therapy (LOT) with next-generation hormonal agents (NHA; e.g., abiraterone and enzalutamide) were the preferred treatment option in first and second line (1L and 2L; 29.4% of patients with ≥ 2 LOTs), followed by consecutive lines with NHA and chemotherapy (16.5% of patients with ≥ 3 LOTs); beyond third line (3L), there was an increasing dependence on chemotherapy.

Treatment duration was short across all LOTs (median: < 6 months per LOT) and median overall survival (OS) became shorter with each successive LOT (median OS estimated in Kaplan–Meier analyses: 19.4, 14.6, and 11.1 months post-1L, 2L, and 3L start, respectively); approximately 50% of patients in the study did not receive a subsequent LOT after 1L.

The study results highlight the aggressive nature of mCRPC and the unmet need for life-prolonging treatments in this population of patients.