Abstract
293 Background: Surgical or medical castration is an important component of prostate cancer treatment. However, resistance develops in almost all men and poor prognosis has been established once the disease metastasizes. A systematic literature review (SLR) was conducted to explore the treatment options and survival outcomes associated with non-metastatic castration-resistant prostate cancer (CRPC) and to understand the humanistic and economic impact of developing metastasis. Methods: The SLR was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines and guidance from the National Institute of Health and Care Excellence, Centre for Reviews and Dissemination and Institute for Quality and Efficiency in Healthcare. The search designed to identify clinical and humanistic evidence from all countries and epidemiology, guidelines and economic evidence in Brazil, China, France, Germany, Japan, UK, and US. Results: Median overall survival for non-metastatic CRPC patients ranged from 44 to 74 months; median progression-free survival from 9 to 22 months; and median metastasis-free survival from 16 to 53 months. The most common form of metastasis was bone metastasis, which was associated with an increased risk of skeletal-related events (SREs). Quality-of-life was widely reported to decrease upon metastasis, driven by increased pain and SREs. Higher healthcare costs associated with metastatic CRPC were attributable to physician visits and treating bone-metastasis-related complications. Conclusions: Currently, there is a lack of approved therapies specifically for non-metastatic CRPC patients, who will invariably develop metastases with associated adverse clinical and economic implications. Delaying the onset of metastasis is an unmet clinical need for improved patient outcomes and couldl also lead to economic benefits for healthcare delivery systems.
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