Abstract

ABSTRACT Background Non-metastatic (M0) castration-resistant prostate cancer (CRPC) is a growing public health burden that has not been adequately quantified. The increased incidence of prostate cancer (PC) in Europe in the last two decades is a result of widespread prostate-specific antigen (PSA) screening, and associated with declines in mortality and improved survival as more men are diagnosed with M0 disease. A proportion of men with M0 PC will receive medical or surgical androgen deprivation therapy (ADT). Many ADT-treated men eventually relapse to develop M0 CRPC, characterized by rising PSA without evidence of metastases while on ADT. We report results of a model to estimate the prevalence of M0 CRPC in key populations in Europe. Methods The model uses age-specific incidence and survival data from population-based national cancer registries to estimate 5-, 10-, and 20-year limited duration prevalence of PC and M0 PC in each country, each year from 2008 to 2026. ADT rates for M0 PC by country reported by the literature and IMS Oncology Analyser™ and disease relapse and progression rates from the literature are applied to estimate prevalence of ADT-treated and M0 CRPC subgroups. Results For EU-5 countries (France, Germany, Italy, Spain, and UK), the model projects that 5-year prevalence of PC will increase from approximately 1.0 million in 2012 to 1.3 million in 2026 as a result of wider adoption of PSA testing and aging of the populations. M0 PC, which comprises about 85% of total PC 5-year prevalence, will increase from approximately 0.8 million in 2012 to 1.0 million by 2026. In 2012, prevalence of M0 CRPC (4-7% of total PC, depending on ADT use in the M0 setting) in EU-5 is estimated to reach up to 70,000 with a projected increase to 110,000 patients by 2026. Conclusion This model provides the first understanding of how many men in Europe are living with M0 CRPC. Although M0 CRPC represents a small subset of the PC population, the model predicts an increase in the prevalence of M0 CRPC over the next 14 years. As men with M0 CRPC have an increased risk of developing metastases (particularly to bone) resulting in a shortened lifespan, these findings highlight the need for clinical trials to establish standards of care for these patients, and for new therapeutic options. Disclosure A. Liede: Employed by and own stock in Amgen Inc. The study was funded by Amgen Inc. O. Gunther: Employed by Amgen Ltd and own stock in Amgen. The study was funded by Amgen Inc. B. Bennett: Consultant at Plan A, Inc. S. Wong: Consultants at Plan A, Inc.

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