To characterize treatment patterns and attrition rates in metastatic castration-resistant prostate cancer (mCRPC) using a large dataset.
Approach:
Study Design: A retrospective cohort study utilizing the Flatiron Health Research Database, focusing on patients diagnosed with mCRPC and treated between January 1, 2021, and June 30, 2025.
Data Collection: Patient-level data were deidentified and curated, including demographics and treatment history, following ethical guidelines.
Outcomes: Primary outcomes included types of systemic therapies administered and attrition rates from first through fifth lines of treatment.
Key Findings:
5096 patients with mCRPC were included in the analysis.
Median age of patients was 75 years.
79.3% of patients progressed from metastatic hormone-sensitive prostate cancer (mHSPC).
Treatment patterns varied significantly, with some therapies being underused or overused compared to guidelines.
Interpretation:
The study highlights the complexity of treatment decisions in mCRPC and the need for improved access and treatment sequencing.
Limitations:
The study is based on a retrospective analysis, which may introduce biases.
Data were derived from electronic health records, which may not capture all clinical nuances.
Conclusion:
Understanding treatment patterns and attrition rates is crucial for informing clinical guidelines and improving patient outcomes in mCRPC.
by Gabriel Hooper, Yeonjung Jo, Varun Nandakumar, Georges Gebrael, Zeynep Irem Ozay, Micah Ostrowski, Tanner Hardy, Edwin Lin, Patrick Campbell, Ethan G. Murdock, Laxmi Upadhyay, Krishnam Goel, Vinay Mathew Thomas, Haoran Li, Alexandra O. Sokolova, Umang Swami, Neeraj Agarwal
