Real-World Treatment Patterns and Survival Outcomes in Metastatic Hormone-Sensitive Prostate Cancer: Insights From a Retrospective Cohort Study.

Background: Real-world data on treatment patterns and survival outcomes in metastatic hormone-sensitive prostate cancer (mHSPC) remain limited. This study aims to characterize treatment sequencing, duration across lines of therapy, and survival outcomes in patients with mHSPC.

Methods: This single-center, retrospective, non-interventional study included men newly diagnosed with mHSPC at King Abdullah Medical City Cancer Center between 2016 and 2023. Treatment patterns, including sequencing and duration of therapy, were described. Kaplan-Meier methods were used to estimate overall survival (OS) from mHSPC diagnosis to death or censoring at the end of follow-up.

Results: Among 102 patients, the mean age was 70 years, BMI of 26, with 53% having a performance status of 2. Comorbidities included hypertension (51%), diabetes (45%), and cardiovascular disease (20.6%). Nearly half (48%) had a Gleason score of nine, with 62.7% presenting with bone metastases. Novel hormonal therapy (NHT) was the predominant first-line treatment (86%), with abiraterone used in 43% of cases. Second- and third-line treatments were received by 34% and 13% of patients, respectively. The median durations of first-, second-, and third-line therapies were 21, 5, and 2.6 months, respectively. Median OS from diagnosis was 24 months.

Conclusion: Despite the predominant use of novel hormonal therapy (NHT), patients in this cohort exhibited aggressive disease and poor survival outcomes. These findings highlight a critical need for more intensive and tailored treatment strategies for mHSPC.