Health-related quality of life in patients with metastatic prostate cancer: Results from an international real-world survey.
Authors: Castro Elena , Amin Suvina , Niyazov Alexander , Kirker Melissa , Ribbands Amanda , Butcher Jake , Walley Maria , Munir Maryam , Barata Pedro C. 
Published: February 2025

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Background:
Although novel treatments (tx) for metastatic prostate cancer (PC) are prolonging patient (pt) overall survival, data are limited on disease specific and general health-related quality of life (HRQoL) that can vary with pt disease stage and type of tx received. This analysis explores the HRQoL of pts diagnosed with metastatic castration-sensitive PC (mCSPC) and metastatic castration-resistant PC (mCRPC).
Methods:
Data were drawn from the Adelphi Real World Metastatic PC V Disease Specific Programme, an independent cross-sectional survey with retrospective data collection, of physicians and pts with mCSPC or mCRPC in France, Germany, Italy, Spain, the United Kingdom, and the United States from Nov’22 – Jul’23. Physicians reported pt demographics, clinical characteristics and tx history for their next four (mCSPC) and eight (mCRPC) consecutively seen pts. Pts voluntarily self-completed a survey including the EORTC QLQ-C30 and PR25. Pts with physician reported chart data, and an EORTC global health status/quality of life (GHS/QoL) score were included in analysis. Pt demographics, mean GHS/QoL and EORTC QLQ-C30/PR25 scale scores are reported descriptively.
Results:
Overall, 145 physicians reported data on 889 pts (median age 71 years (interquartile range 68 – 76), 75% ECOG 0–1, 88% had bone metastases and 24% visceral metastases). At data collection, 282 pts were receiving mCSPC tx, 482 first line (1L) mCRPC tx and 125 second line or later (2L+) mCRPC tx. Mean (SD) GHS/QoL scores for pts receiving mCSPC, 1L mCRPC and 2L+ mCRPC tx were 58.3 (19.9), 57.8 (17.7) and 55.5 (20.1) respectively, where high scores show high HRQoL. Of the symptom scales, pain was notable with mean (SD) scores of 29.9 (22.8) in mCSPC, 30.3 (20.6) in 1L mCRPC and 38.6 (23.6) in 2L+ mCRPC where high scores show worse symptomology. EORTC QLQ-C30/PR25 function scale scores are shown (Table).
Conclusions:
In pts who received life prolonging therapies for mCSPC and mCRPC, those with more advanced disease reported low HRQoL scores and high pain levels, suggesting that HRQoL remains an unmet need within the advanced disease setting.

Metastatic prostate cancer patient EORTC QLQ-C30/PR25 function scale response.

Function scales*mean (SD)
mCSPC txn=282
1L mCRPC txn=482
2L+ mCRPC txn=125

Physical functioning
75.3(21.0)
75.7(18.7)
72.5(21.1)

Role functioning
68.0(26.7)
69.3(23.7)
61.8(23.8)

Emotional functioning
73.6(21.0)
75.9(20.6)
66.2(21.5)

Cognitive functioning
80.0(21.9)
81.1(20.4)
77.0(21.8)

Social functioning
75.0(24.2)
74.8(22.7)
65.5(25.7)

Sexual activity
81.1(24.3)
81.4(23.9)
78.1(28.1)

Sexual functioning
54.5(22.6)
57.2(21.1)
48.5(27.9)

*High scores show high functioning.

1L: first line; 2L+: second line and later; mCSPC: metastatic castration-sensitive prostate cancer; mCRPC: metastatic castration-resistant prostate cancer; SD: standard deviation; tx: treatment.