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

Emad Tashkandi College of Medicine, Umm Al-Qura University, Makkah, Saudi ArabiaCorrespondence: Emad Tashkandi, Email [email protected]: 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.Keywords: chemotherapy, metastatic hormone-sensitive prostate cancer, novel hormonal agents, overall survival, pattern, Prostate cancer