856P - Real-world analysis of patients (pts) with metastatic castration-resistant prostate cancer (mCRPC) receiving vs not receiving chemotherapy in the treatment sequence

Abstract

BackgroundDocetaxel and cabazitaxel prolong survival in mCRPC however less is known about their utilisation patterns and impact in the setting of androgen receptor-targeted agents (ARTAs; abiraterone and enzalutamide). We evaluated whether receipt of chemotherapy is associated with better survival in pts with mCRPC. MethodsOptum® de-identified Electronic Health Record dataset was used to identify pts with mCRPC who received first-line docetaxel or an ARTA between 01/05/11 and 30/09/17, followed by chemotherapy (docetaxel, cabazitaxel) and/or ARTA. Pts receiving chemotherapy in≥1line of treatment (any chemotherapy) vs pts not receiving chemotherapy in any treatment line (no chemotherapy) were assessed. Overall survival (OS) was calculated from start of first-line mCRPC treatment until death from any cause. ResultsIn total, 1,961 pts were identified (any chemotherapy 823; no chemotherapy 1,138). Some baseline characteristics differed numerically between treatment groups. Chemotherapy-treated pts had a younger median age, greater pain medication utilisation, more metastases (including liver and lung) and a higher comorbidity score, compared with pts not receiving chemotherapy (Table). For any vs no chemotherapy, median OS was 25.4 months (95% CI 22.3–27.4 ) vs 22.4 months (95% CI 20.4–25.0 ) and the respective 12- and 24-month survival rates were 77.2% (95% CI 0.74–0.80) vs 71.3% (95% CI 0.68–0.74) and 52.1% (95% CI 0.48–0.56) vs 47.4% (95% CI 0.44–0.51). ConclusionsIn this real-world data analysis, less than half of pts with mCRPC received chemotherapy. Pts receiving chemotherapy were younger but had more reported metastases and comorbidities, and were more frequently prescribed pain medication. Despite these higher risk disease characteristics, median OS was observed to be higher in pts receiving any vs no chemotherapy.Table856PTableAny chemotherapy N=823No chemotherapy N=1138Median age at prostate cancer diagnosis, years (range)63.2 (25–87)68.0 (22–89)Median age at first-line mCRPC treatment, years (range)70.5 (43–88)77.5 (48–90)Charlson comorbidity index, median (range)N=819 9 (2–18)N=1122 8 (0–18)Opioid analgesic use at first-line mCRPC treatment, n (%)532 (64.6)619 (54.4)Number of metastases at first-line mCRPC treatment, median (range)N=762 7 (1–26)N=1032 6 (1–36)Visceral metastases, n (%) Liver lung lymph missingN=762 57 (7.5) 63 (8.3) 115 (15.1) 61 (3.1)N=1032 38 (3.7) 51 (4.9) 111 (10.8) 106 (4.4) Editorial acknowledgementDanielle Lindley and Mark Cockerill, Meditech Media. Legal entity responsible for the studyThe authors. FundingSanofi. DisclosureA.K. Morgans: Honoraria (self): Astellas; Honoraria (self): AstraZeneca; Honoraria (self), Research grant / Funding (self): Bayer; Honoraria (self): Sanofi; Honoraria (self): Janssen; Honoraria (self): Genentech. H.A. Divan: Full / Part-time employment: Sanofi. A.J. Birtle: Advisory / Consultancy: Janssen; Advisory / Consultancy, Non-remunerated activity/ies: Astellas; Advisory / Consultancy, Non-remunerated activity/ies: Bayer; Advisory / Consultancy: Sanofi Genzyme; Advisory / Consultancy, Non-remunerated activity/ies: Roche; Advisory / Consultancy: MSD; Non-remunerated activity/ies: Novartis; Non-remunerated activity/ies: Ferring; Non-remunerated activity/ies: Sanofi. T. Dorff: Advisory / Consultancy, Research grant / Funding (institution): Bayer; Advisory / Consultancy: Janssen; Speaker Bureau / Expert testimony: Exelixis; Advisory / Consultancy: EMD Serono; Advisory / Consultancy: Eisai; Speaker Bureau / Expert testimony: Pfizer; Speaker Bureau / Expert testimony: Prometheus; Advisory / Consultancy: AstraZeneca; Advisory / Consultancy: Roche. A. Ozatilgan: Full / Part-time employment: Sanofi. J.N. Graff: Research grant / Funding (self), Travel / Accommodation / Expenses, Non-remunerated activity/ies: Sanofi; Research grant / Funding (self), Travel / Accommodation / Expenses, Non-remunerated activity/ies: Merck; Advisory / Consultancy, Research grant / Funding (self): Astellas/Pfizer; Research grant / Funding (self), Investigator initiated trial funding: Janssen; Honoraria (self), Expert witness testimony: Bergman Draper Oslund; Honoraria (self), CME activity: i3 Health.