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Real-World First-Line Treatment Patterns in Commercially Insured Patients With CSPC
A study presented at the virtual 2021 ASCO Annual Meeting suggests that a majority of commercially insured and Medicare patients with metastatic castration-sensitive prostate cancer (CSPC) do not receive optimal life-prolonging therapies.
These findings were presented by Umang Swami, MD, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, lead author of the study.
Intensification of androgen deprivation therapy (ADT) with docetaxel and novel hormonal therapies are associated with improved survival outcomes in patients with metastatic CSPC. In this retrospective study, Dr Swami and colleagues aimed to assess the real-world utilization of effective combination therapies as first-line treatment in insured patients with metastatic CSPC.
Observing patient claims data from both commercially insured and Medicare Advantage populations through the Optum health insurance claims database, this study included patients with one or more claims with a metastatic International Classification of Diseases diagnostic code within 90 days before or after a prostate cancer diagnosis. Eligible patients received this diagnosis between January 2014 and June 2019.
Any first-line treatment for metastatic CSPC received within 90 days pre-index, and any other treatment received within 180 days of the first were included in this study. Treatments were grouped by regimen and evaluated.
Of the 4221 patients with metastatic CSPC included in this study, 56% received ADT only, 21.1% received ADT plus antiandrogens, 13.7% received ADT plus novel hormonal therapies, 8.2% received ADT plus docetaxel, and 0.9% received ADT plus novel hormonal therapies plus docetaxel. While use of ADT alone and ADT plus antiandrogens declined by 2019, ADT plus novel hormonal therapies, and ADT plus novel hormonal therapies plus docetaxel use increased. However, In 2018 and 2019, most patients with metastatic CSPC received either ADT alone, or ADT plus antiandrogens.
Results of this stuffy revealed the underutilization of intensified treatment in patients with, even though it is associated with improved survival. “This is evident in those with more aggressive disease (visceral metastases) as recently as 2019” wrote Dr Swami and colleagues, concluding, “These data highlight that a minority of patients with metastatic CSPC received optimal life-prolonging therapies in a commercially insured and Medicare Advantage US population.”—Marta Rybczynski
Swami U, Hong A, El-Chaar NN, et al. Real-World first-line (1L) treatment patterns in patients (pts) with metastatic castration-sensitive prostate cancer (mCSPC) in a U.S. health insurance database. ASCO Annual Meeting; June 4-8, 2021; virtual. Abstract 5072.
