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Published on: March 6, 2018
Treatment Patterns and Clinical Outcomes Among Patients With Metastatic Prostate Cancer Harboring Homologous
Priyanka J Bobbili1, Jasmina Ivanova2, David B Solit3
1Analysis Group, Inc., Boston, MA.
Background:
There is currently limited literature assessing the real-world treatment patterns and clinical outcomes of patients with metastatic castration-resistant prostate cancer (mCRPC) and homologous recombination repair (HRR) mutations.
Methods:
Medical charts were abstracted for mCRPC patients with ≥ 1 of 12 HRR somatic gene alterations treated at US oncology centers participating in the American Association for Cancer Research Project Genomics Evidence Neoplasia Information Exchange. Treatment patterns and clinical outcomes were assessed from the initiation of first-line or later (1L+) mCRPC therapy received on or after July 1, 2014.
Results:
Among 138 patients included in the study, the most common somatic HRR mutations were CDK12 (47.8%), BRCA2 (22.5%), and ATM (21.0%). Novel hormonal therapy and taxane chemotherapy were most commonly used in 1L; taxane use increased in later lines. Median overall survival (95% confidence interval [CI]) was 36.3 (30.7-47.8) months from initiation of 1L therapy and decreased for subsequent lines. Similarly, there was a trend of decreasing progression-free survival and prostate-specific antigen response from 1L to 4L+ therapy.
Conclusions:
Treatment patterns identified in this study were similar to those among patients with mCRPC regardless of tumor HRR mutation status in the literature.
Insights
Treatment patterns for metastatic castration-resistant prostate cancer (mCRPC) with homologous recombination repair (HRR) mutations were similar to those without mutations. Survival decreased with later lines of therapy.
Area of Science:
- Oncology
- Genetics
- Prostate Cancer Research
Background:
- Limited data exists on real-world treatment patterns and outcomes for metastatic castration-resistant prostate cancer (mCRPC) patients with homologous recombination repair (HRR) mutations.
- HRR mutations are increasingly recognized as important biomarkers in mCRPC.
Purpose of the Study:
- To assess real-world treatment patterns and clinical outcomes in mCRPC patients with HRR mutations.
- To identify common HRR mutations and their impact on therapy and survival.
Main Methods:
- Retrospective chart review of 138 mCRPC patients with ≥1 of 12 HRR somatic gene alterations.
- Analysis of treatment patterns and clinical outcomes from first-line (1L+) mCRPC therapy initiated on or after July 1, 2014.
Main Results:
- CDK12, BRCA2, and ATM were the most frequent HRR mutations.
- Novel hormonal therapy and taxanes were common in 1L therapy; taxane use increased in later lines.
- Median overall survival was 36.3 months from 1L initiation, decreasing with subsequent lines. Progression-free survival and PSA response also declined.
Conclusions:
- Treatment patterns in HRR-mutated mCRPC were similar to those in the general mCRPC population.
- Understanding these patterns is crucial for optimizing care in this subgroup.
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