SAN FRANCISCO—Survival of patients with newly diagnosed metastatic prostate cancer (PCa) has improved only slightly since the introduction of new agents shown to decrease death risk among men with advanced PCa, according to study data presented at the 2020 Genitourinary Cancers Symposium.
Using the Surveillance, Epidemiology and End Results (SEER) database, investigators conducted a real-world study of 34,034 patients diagnosed with de novo metastatic PCa from 2000 to 2016. They stratified patients according to different treatment eras: 2000 to 2003 (T1), 2004 to 2010 (T2), and 2011 to 2016 (T3). In multivariable analyses that adjusted for age and race, the risk of death was only 8% lower among T3 patients compared with T1 and T2 patients, Carlo Cattrini, MD, and colleagues at the IRCCS Ospedale Policlinico San Martino in Genoa, Italy, reported.
The median overall survival time was 29 months for the entire study population and 28, 28, and 31 months for the T1, T2, and T3 groups, respectively. Median cancer-specific survival (CSS) times were 36, 34, 34, and 38 months for these groups, respectively. Compared with T1 and T2 patients, T3 patients had a 7% and 8% decreased risk of cancer-specific death, respectively.
“Basically, this real-world analysis using the SEER database highlights that, despite the introduction of several new drugs in the treatment landscape of advanced prostate cancer, only a slight survival improvement is evident in patients with newly diagnosed metastatic prostate cancer from 2000 to 2016,” Dr Cattrini told Renal & Urology News.
The small improvement in survival is “quite disappointing,” but might be due to a lack of wide access to expensive drugs, insurance issues, and intrinsic aggressiveness of de novo PCa, he said.
Recent approvals of novel oral antiandrogens for use in metastatic castration-sensitive PCa could lead to a more significant overall survival benefit, he said.
FDA approved abiraterone in 2018 and the androgen-receptor inhibitors enzalutamide and apalutamide in 2019 for use in this phase of the disease.
Dr Cattrini and his colleagues acknowledged that confounding factors not available in the SEER database, such as disease volume, number of metastatic sites, and type of treatment, were not included in their multivariable analysis.
Cattrini C, Zanardi E, Rubagotti A, et al. Real-world survival improvements in patients with newly diagnosed metastatic prostate cancer treated in the United States. Presented at the 2020 Genitourinary Cancers Symposium held February 13 to 15 in San Francisco. Poster B14.
This article originally appeared on Renal and Urology News