Contemporary real-world treatment in metastatic hormone-sensitive prostate cancer: US, four European countries, and UK
Creators: name: Goebell, Peter J.
name: Chen, Stephanie
name: Jhaveri, Jay
Publisher: name: Taylor & Francis
Year: 2025
Subjects: subject: Medicine
subject: Pharmacology
subject: Biotechnology
subject: Chemical Sciences not elsewhere classified
subject: Sociology
subject: FOS: Sociology
subject: Mathematical Sciences not elsewhere classified
subject: Cancer

description: To characterize contemporary global real-world metastatic hormone-sensitive prostate cancer (mHSPC) treatment, guideline concordance, trends, and potential trend drivers. Retrospective data from the Ipsos Global Oncology Monitor database for the United States, Germany, France, Spain, Italy, and the United Kingdom were used for descriptive analysis of mHSPC patients, treating physicians, and treatment utilization. Statistical testing of differences among treatment cohorts for the final study period was conducted. Of 15,662 total mHSPC patients across countries (2019–2024), the 1404 patients from the most recent and relevant study period (August 2023–January 2024) had an average age of 72–74 years, good baseline functioning, high-risk prostate cancer features, and cardiometabolic conditions as top comorbidities. Treatment mostly occurred in hospital/institutional settings and urban locales by oncologists versus urologists. Monotherapy androgen deprivation therapy (mADT) use declined while use of novel androgen receptor inhibitor (nARI) combination therapies, especially doublets, increased. Concordance between real-world and guideline-recommended treatment varied by country, ranging from 43.8% to 61.6%. Concordance with guidelines improved globally driven by nARIs. Persistent use of mADT, a non-guideline-recommended therapy, indicates physicians’ concern about the safety and trade-offs with current options. New therapies delivering greater net benefits are needed, along with education on guideline adherence. <b>What is this article about?</b> Prostate cancer is a common and fatal disease among men worldwide, with cases expected to double between 2020 and 2040, and late diagnosis is a widespread problem. Metastatic hormone-sensitive prostate cancer (mHSPC) refers to an advanced stage of the disease where the cancer has spread to other parts of the body (“metastatic”) but still responds to hormonal therapies (“hormone-sensitive”), such as androgen deprivation therapy (ADT). There are multiple treatments available and guidelines on how they should be used. Because guideline-based treatment is associated with better outcomes, we conducted this study using Ipsos real-world data from six major/large countries from as recently as January 2024 to investigate how well real-world and guideline-recommended practices align. This study builds on an earlier analysis of five countries covering 2018–2020. <b>What were the results?</b> We found that, in the data analyzed, use of historical mainstay ADT monotherapy (mADT) decreased while use of newer hormonal therapies, such as novel androgen receptor inhibitors (nARIs), increased, leading to an overall improvement in guideline-aligned practices over time in the included countries. However, non – guideline-aligned practices persist, mostly as mADT, driven by concerns over the safety/tolerability and net benefits of available treatments. <b>What do the results of the study mean?</b> New therapies that deliver greater net benefits are needed to optimize care and outcomes for patients with mHSPC.