Combination Therapy for Metastatic Hormone-Sensitive Prostate Cancer Shows Significant Increase in US Real-World Practice

Strategic Insights -

A new study on the treatment of metastatic hormone-sensitive prostate cancer (mHSPC) has highlighted the evolving landscape of clinical trial evidence and real-world practice. The researchers, from Bayer HealthCare, conducted a retrospective study using administrative claims data in the Komodo Research Dataset from January 2016 to September 2023. The study found that the use of combination therapy, including androgen receptor pathway inhibitors (ARPIs) and/or docetaxel (DOC), increased significantly between 2017 and 2023, with 47% of patients receiving combined hormonal therapy with ARPI and 15% receiving ARPI plus DOC.

Key Takeaways:

  • The study examined the use of combination therapy for mHSPC in US real-world practice, involving 10,717 individuals with a median age of 65 years and 62% de novo mHSPC cases at diagnosis.
  • The study population received combination therapy as follows: 28% with ARPI, 9% with DOC, and 2.5% with ARPI plus DOC.
  • From 2017 to 2023, combined hormonal therapy with ARPI increased from 13% to 47% and with ARPI plus DOC from 0.8% to 15%.
  • Key factors associated with combination therapy were younger age, fewer chronic comorbidities, de novo mHSPC, and bone metastases.
  • The study concluded that one third of men received ADT alone in 2023, but the use of combination hormonal therapy with ARPI and/or DOC increased between 2017 and 2023.

Statistics:

  • 10,717 individuals were involved in the study.
  • Median age of the study population was 65 years.
  • 62% of patients had de novo mHSPC at diagnosis.
  • 28% of patients received combination therapy with ARPI.
  • 9% of patients received combination therapy with DOC.
  • 2.5% of patients received combination therapy with ARPI plus DOC.
  • Combined hormonal therapy with ARPI increased from 13% to 47% between 2017 and 2023.
  • Combined hormonal therapy with ARPI plus DOC increased from 0.8% to 15% between 2017 and 2023.
  • Use of ADT plus DOC declined from 12% to 3% and ADT alone from 74% to 36% between 2017 and 2023.

Sources:

  • "Real-World Evidence of Combination Therapy Use in Metastatic Hormone-Sensitive Prostate Cancer in the United States From 2017 to 2023." JCO Oncology Practice, 2025;21(8):1174-1184.
  • Bayer HealthCare, Whippany, NJ.
  • Lippincott Williams & Wilkins, Two Commerce Sq, 2001 Market St, Philadelphia, PA 19103, USA.