Treatment and progression of patients in Sweden with metastatic castration-sensitive prostate cancer

BACKGROUND AND PURPOSE: The metastatic castration-sensitive prostate cancer (mCSPC) treatment landscape in Sweden has evolved in recent years. The purpose of this study is to provide contemporary registry data on outcomes and treatment patterns in a nationwide cohort of Swedish patients with de novo mCSPC. Patient/material and methods: This retrospective cohort study included patients in Sweden with a clinical diagnosis of de novo mCSPC registered between January 1, 2017 and December 31, 2023. The primary outcome was time from de novo mCSPC diagnosis to mCRPC or death (2017-2023). Secondary outcomes included overall survival (OS), comorbidities, co-medication use, and treatment sequencing. OS, time to progression or death, and treatment sequencing for the 2017-2020 and 2021-2023 time periods were also analyzed. RESULTS: A total of 2421 patients with de novo mCSPC were included in the primary analysis (mean age: 72.8 years). The median time to progression or death was 22.7 months (95% CI: 21.2-24.1), and the median OS was 49.8 months (95% CI: 47.0-52.6). Median time to progression or death increased from 19.9 months (95% CI: 18.6-21.2) in 2017-2020 to 30.0 months (95% CI: 26.6-33.3) in 2021-2023, while the proportion of patients receiving initial doublet or triplet therapy rose from 42.5 to 68.8%. No differences in OS were observed between different time periods. INTERPRETATION: In Sweden (2017-2023), increased time to progression or death was observed in patients with de novo mCSPC.