Open AccessTreatment evolution for metastatic castration‐resistant prostate cancer with recent introduction of novel agents: retrospective analysis of real‐world data
Author(s) -
Flaig Thomas W.,
Potluri Ravi C.,
Ng Yvette,
Todd Mary B.,
Mehra Maneesha
Publication year - 2016
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.576
Subject(s) - enzalutamide , medicine , docetaxel , abiraterone acetate , prostate cancer , cabazitaxel , mitoxantrone , oncology , cohort , regimen , retrospective cohort study , population , cancer , androgen deprivation therapy , chemotherapy , androgen receptor , environmental health
Despite increasing drug treatment options for metastatic castration‐resistant prostate cancer ( mCRPC ) patients, real‐world treatment data are lacking. We conducted retrospective analyses of commercial claims and electronic medical record ( EMR ) databases to understand how treatment patterns for mCRPC have changed in a US ‐based real‐world population. Truven Health Analytics MarketScan ® (2000–2013) and EMR (2004–2013) databases were used to identify patients with an index prostate cancer diagnosis ( ICD ‐9 codes 185X or 233.4X) and prescription claims for an mCRPC drug (mitoxantrone, estramustine, docetaxel, sipuleucel‐T, cabazitaxel, abiraterone acetate, enzalutamide, or radium‐223). Regimen analyses for first line of therapy ( LOT 1), second line of therapy, and beyond were performed among cohorts based on year of first mCRPC drug usage. mCRPC drug usage and treatment duration were compared across cohorts and age groups within each cohort. The commercial claims cohort yielded 3437 evaluable patients. Most men (91%) commencing mCRPC treatment had docetaxel as LOT 1 in 2010; this number had declined to 15% in 2013. In 2013, 67% and 9% of patients used abiraterone acetate and enzalutamide, respectively, as LOT 1. Among both commercial claims and EMR cohorts, treatment pattern changes were most pronounced in men aged >80 years, and median treatment duration for some mCRPC drugs was shorter than expected based on available clinical trial information. These results demonstrate a shift in mCRPC treatments during the past 5 years, with greater use of newer noncytotoxic treatments than docetaxel. These real‐world data aid in understanding the changing role of chemotherapy in the management of mCRPC .