Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY
Howard I. Scher , Fred Saad , Maneesha Mehra , Sandhya Nair , Lindsay Dearden , Ravi C. Potluri
Background: Novel hormonal therapies (nHTs) provide significant delay in disease progression in metastatic castration-sensitive prostate cancer (mCSPC) and non-metastatic (nm)CRPC. The impact of earlier use of these agents on the epidemiological burden of PC in the US was assessed. Methods: A disease stage transition model capturing pt flow through eight clinical states and tracking pt treatment history was used, with each nHT being used once. Progression-free survival (PFS) and overall survival (OS) data for each drug/regimen were derived from published sources where available. We analyzed scenarios 1) no nHTs and 2) with nHTs: (abiraterone acetate + prednisone [AAP], apalutamide [APA] and enzalutamide [ENZA] in high-risk mCSPC, and APA and ENZA in low-risk mCSPC and in high-risk nmCRPC). Resultant state progression parameters were compared, evaluating the impact of nHTs. The assumed nHT utilization was 17.2% in high-risk mCSPC, 7.1% in low-risk mCSPC, and 60.0% in high-risk nmCRPC. Results: For 2018, the model resulted in PC incidence of 240,150 and prevalence of 2,445,173; 49,450 pts progressed to mCRPC, 42% from PSA biochemical recurrence, 31% from mCSPC, and 27% from nmCRPC states. Longer PFS and OS afforded by novel treatments extended the mean time spent from 4.4 to 4.7 yrs in mCSPC and from 2.4 to 3.0 yrs in nmCRPC. This further resulted in reduction in inflow to mCRPC over 2019 – 2025 (table). Conclusions: Novel hormonal therapies are currently used earlier in PC, a trend anticipated to intensify. The disease model shows this change in the treatment paradigm to result in delaying progression to mCRPC and increasing OS in PC.
Clinical state | 2019 | 2022 | 2025 | 2019-2025 | |
---|---|---|---|---|---|
Without nHTs | nmCRPC high risk | 7,791 | 8,076 | 8,284 | 56,413 |
mCSPC high risk | 3,326 | 3,487 | 3,654 | 24,418 | |
mCSPC low risk | 12,506 | 12,949 | 13,571 | 90,914 | |
With nHTs | nmCRPC high risk | 7,338 | 6,836 | 7,545 | 49,710 |
mCSPC high risk | 3,372 | 3,426 | 3,558 | 24,118 | |
mCSPC low risk | 12,272 | 12,651 | 13,096 | 88,630 | |
Reduction in inflow, % | nmCRPC high risk | 5.8 | 15.4 | 8.9 | 11.9 |
mCSPC high risk | -1.4 | 1.7 | 2.6 | 1.2 | |
mCSPC low risk | 1.9 | 2.3 | 3.5 | 2.5 |
Disclaimer
This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org
Abstract Disclosures
2024 ASCO Genitourinary Cancers Symposium
First Author: Neeraj Agarwal
2022 ASCO Genitourinary Cancers Symposium
First Author: Daniel Joseph Khalaf
2024 ASCO Genitourinary Cancers Symposium
First Author: Xiaolin Zhu
2024 ASCO Genitourinary Cancers Symposium
First Author: Pier VItale Nuzzo