Characteristics, treatment patterns, and outcomes of patients with metastatic prostate cancer during 2014–2022 in Pirkanmaa, Finland: an observational study

Abstract

Background: The prognosis of patients with metastatic prostate cancer (mPC) has changed profoundly in recent years. However, observational studies are required to understand the real-world outcomes of patients with mPC. Objectives: In this retrospective single-center observational study, we aimed to describe characteristics, treatments, and outcomes of patients with mPC in Pirkanmaa Hospital District (PHD), Finland, an area with a population of 0.5 million (10% of the Finnish population). Design: The incident patients with mPC treated in PHD during 2014–2022 were identified and stratified into patients with metastatic hormone-sensitive PC (mHSPC) and castration-resistant disease PC (mCRPC). Methods: Patients with mPC were identified from electronic healthcare data using diagnoses, treatments, procedures, and patient texts. Data on demographics, diagnoses, procedures, treatments, laboratory and pathology tests, and specialized healthcare contacts were collected from specialty care records. Due to changes in treatment practices over time, treatments and outcomes were analyzed in different time periods (mHSPC: 2014–2016 and 2017–2022, mCRPC: 2014–2017 and 2018–2022). Results: In total, 1083 incident patients with mPC were identified, of which 88% received treatment indicated for mPC. Out of the 795 patients with mHSPC, and 558 patients with mCRPC, 84% (N = 668) and 95% (N = 532) received treatment, respectively. The median overall survival (mOS) for all treated patients was 40.1 months. The mOS of treated patients with mHSPC increased from 32.6 months during 2014–2016 to 54.6 months during 2017–2022. Conclusion: Since the approval of enzalutamide as a first-line treatment for mCRPC, it has become the most common first-line treatment for mCRPC in PHD. Novel therapeutics, including docetaxel, enzalutamide, and abiraterone, have been adapted into clinical practice and are being used at earlier phases of the disease. Changes in treatment practices correlate with improved outcomes in patients with mHSPC in the PHD area. Trial registration: ClinicalTrials.gov NCT05701007.