Real-World Overall Survival and Treatment Patterns by Status in Metastatic Castration-Resistant Prostate Cancer.

PURPOSE

It is estimated that the tumor suppressor gene is functionally lost in 40%-50% of patients with metastatic castration-resistant prostate cancer (mCRPC). There is limited information on the prognostic significance of status identified with genomic testing. This real-world cohort study assessed as a genetic biomarker using data from US-based oncology practices.

METHODS

This retrospective real-world cohort study used a deidentified US-based metastatic prostate cancer clinicogenomic database linked to longitudinal clinical data derived from electronic health records. Patients were aged 18 years and older and diagnosed with mCRPC between January 1, 2018, and June 30, 2021. Comprehensive genomic profiling (CGP) of tumor specimens was performed using next-generation sequencing. First-line (1L) and second-line (2L) treatment patterns were assessed and stratified by status. Kaplan-Meier methods and a multivariable Cox model were used to compare the real-world overall survival by status among patients who received 1L novel hormone therapy or taxanes.

RESULTS

In patients with mCRPC who underwent CGP, loss of function (LOF) was associated with decreased survival compared with intact (hazard ratio, 1.61 [95% CI, 1.07 to 2.42]; = .024). The results were not influenced by 1L treatment type. 1L treatment patterns were similar between intact and LOF subgroups, with abiraterone and enzalutamide being the two most common treatments in both groups. Patients with LOF were less likely to receive 2L treatments than patients with intact .

CONCLUSION

LOF, identified with genomic testing, was associated with decreased survival and negative prognoses in patients with mCRPC.