Mp60-02 Real World Treatment Sequence and Survival in Localized or Locally Advanced Prostate Cancer and Postprogression Disease States

You have accessJournal of UrologyProstate Cancer: Advanced (Including Drug Therapy) III (MP60)1 May 2024MP60-02 REAL WORLD TREATMENT SEQUENCE AND SURVIVAL IN LOCALIZED OR LOCALLY ADVANCED PROSTATE CANCER AND POSTPROGRESSION DISEASE STATES Stephen J. Freedland, Sandhya Nair, Xiwu Lin, Francesco De Solda, Ravi Potluri, Sharon A. McCarthy, Suneel D. Mundle, and Neeraj Agarwal Stephen J. FreedlandStephen J. Freedland , Sandhya NairSandhya Nair , Xiwu LinXiwu Lin , Francesco De SoldaFrancesco De Solda , Ravi PotluriRavi Potluri , Sharon A. McCarthySharon A. McCarthy , Suneel D. MundleSuneel D. Mundle , and Neeraj AgarwalNeeraj Agarwal View All Author Informationhttps://doi.org/10.1097/01.JU.0001008804.84010.ec.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Despite definitive primary treatment (tx) with radical prostatectomy (RP) or radiotherapy (RT), patients (pts) with localized or locally advanced prostate cancer (LPC/LAPC) are at risk of progression. This real-world study describes tx sequence and overall survival (OS) in LPC/LAPC and postprogression disease states. METHODS: US Optum claims and electronic health record (EHR) data were retrospectively analyzed between 2008 and 2022 for pts diagnosed with LPC/LAPC (defined as LPC/LAPC if they received tx RP, RT within 180 days of PC diagnosis or prior to progression to nmCRPC, mCRPC, or mCSPC if earlier than 180 days of PC diagnosis). Tx sequences, from definitive RP or RT to subsequent (subs) tx, were evaluated. OS was analyzed by Kaplan-Meier methods. RESULTS: Data from 62,529 and 62,314 pts with LPC/LAPC who started with definitive RP or RT were retrieved from claims and EHR, respectively. During a median follow-up of 2.7/3.0 yrs (claims/EHR), 7696/6914 pts received sub tx of which ∼1600 had >10 yrs' follow-up. Of pts receiving subs tx, most received androgen deprivation therapy (ADT), RT, or RP alone or in combination (claims/EHR 79/75%) with almost all pts in this subgroup receiving ADT and/or RT (99/99%); other subs tx included androgen receptor signaling inhibitors (claims/EHR 5/6%) and chemotherapy (claims/EHR 8/10%; Figure 1). Of pts receiving subs tx from claims/EHR, the next disease state during follow-up was biochemical relapse (72/69%), nonmetastatic castration-resistant PC (nmCRPC; 2/5%), metastatic castration-sensitive PC (18/13%), or mCRPC (8/13%); most progressed within 3 yrs (82/81%) and almost all progressed within 5 yrs (93/94%). OS was less favorable for pts with subs tx vs without (5-yr OS: claims/EHR 83/84% vs 90/91%; Figure 2). CONCLUSIONS: Pts who did not progress and remained in the LPC/LAPC disease setting had better OS than those who progressed. The burden of subs tx after definitive RP/RT is very high and thus enhanced local control is critical. Download PPTDownload PPT Source of Funding: Janssen Pharmaceuticals, Inc © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e999 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Stephen J. Freedland More articles by this author Sandhya Nair More articles by this author Xiwu Lin More articles by this author Francesco De Solda More articles by this author Ravi Potluri More articles by this author Sharon A. McCarthy More articles by this author Suneel D. Mundle More articles by this author Neeraj Agarwal More articles by this author Expand All Advertisement PDF downloadLoading ...