Treatment and Outcomes of Patients With Metastatic Castration-resistant Prostate Cancer by Race, Initial Diagnosis, and Family History: Results From the TRUMPET Registry

Introduction To better understand how treatment patterns, clinical outcomes, health-related quality of life, and healthcare resource utilization are impacted by initial prostate cancer diagnosis, family history of prostate cancer, and race. Patients We conducted three subgroup analyses using the TRUMPET US registry of metastatic castration-resistant prostate cancer (mCRPC) patients: 1) with non-metastatic hormone-sensitive prostate cancer (HSPC) at initial diagnosis versus de novo metastatic HSPC at initial diagnosis; 2) with family history of prostate cancer versus no family history; 3) Caucasians versus African Americans. Methods Baseline characteristics, treatment patterns, health-related quality of life, and healthcare resource utilization were analyzed descriptively. Time-to-event outcomes were analyzed using the Kaplan–Meier method and Cox proportional hazards models, with adjustments made based on clinically important variables, including disease biology factors and selected variables showing large standardized mean differences between groups. Results This study included 832 patients with mCRPC. Patients with non-metastatic HSPC at initial diagnosis had a 32% lower risk of death than patients with de novo metastatic HSPC at initial diagnosis (adjusted HR: 0.68; 95% CI: 0.51, 0.91). Patients with family history of prostate cancer had a significantly lower risk of death than patients without family history (adjusted HR: 0.68; 95% CI: 0.51, 0.90). No statistically significant differences in outcomes were identified between African American and Caucasian patients. Changes in health-related quality of life were similar across all subgroups. Conclusion Our analyses suggest that initial diagnosis and family history of prostate cancer may meaningfully impact patients' survival and clinical outcomes. Future dedicated, prospective research should aim to further elucidate how clinical outcomes are affected by each of these factors in the context of mCRPC. Micro-abstract We conducted analyses among 832 patients with metastatic castration-resistant prostate cancer to evaluate the impact of initial diagnosis, family history, and race on treatment patterns, clinical outcomes, health-related quality of life, and healthcare utilization. Initial diagnosis of non-metastatic disease and family history of prostate cancer were associated with better clinical outcomes. No significant differences in outcomes were identified between races.