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Treatment Intensification in Metastatic Hormone-Sensitive Prostate Cancer: An Analysis of Real-World Practice

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Treatment intensification for metastatic hormone-sensitive prostate cancer (mHSPC) is increasing, but Black patients receive it less often. Disparities in treatment intensification and docetaxel use persist for Black patients with mHSPC.

Keywords:
androgen deprivation therapyandrogen receptor signaling inhibitorsdocetaxelracial disparities

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Area of Science:

  • Oncology
  • Clinical Research
  • Health Disparities

Background:

  • Metastatic hormone-sensitive prostate cancer (mHSPC) management involves androgen deprivation therapy and treatment intensification.
  • Standard of care includes docetaxel and androgen receptor signaling inhibitors (ARSIs) for improved survival in mHSPC.
  • Understanding treatment patterns and disparities is crucial for optimizing patient outcomes.

Purpose of the Study:

  • To analyze trends in treatment intensification for de novo metastatic hormone-sensitive prostate cancer (mHSPC) in the US.
  • To identify factors associated with treatment intensification, including race and age.
  • To examine racial disparities in treatment intensification and specific drug use.

Main Methods:

  • Retrospective analysis of 3,684 patients with de novo mHSPC diagnosed between 2014-2023.
  • Data sourced from the de-identified CancerLinQ Discovery® clinical database.
  • Descriptive statistics and multivariable logistic regression used to analyze treatment intensification rates and associated factors.

Main Results:

  • Overall treatment intensification for mHSPC increased from 32.5% in 2014 to 67.5% in 2023.
  • Black patients with mHSPC were less likely to receive treatment intensification (OR 0.78).
  • Declining docetaxel use was observed, with disproportionately lower rates among Black patients compared to White patients.

Conclusions:

  • Treatment intensification is becoming standard for mHSPC, but significant racial disparities persist.
  • Black patients with mHSPC face barriers to receiving intensified treatment, including docetaxel.
  • Addressing these disparities is essential to ensure equitable care for all mHSPC patients.