Real-world treatment patterns in men with metastatic hormone-sensitive prostate cancer in Europe and Asia between 2020 and 2024

INTRODUCTION: The therapeutic landscape for metastatic hormone-sensitive prostate cancer (mHSPC) has changed significantly over the last decade with the introduction of combination strategies. However, recent real-world evidence on their use in practice is limited, especially in Europe and Asia. PATIENTS AND METHODS: This cross-sectional study included men with mHSPC receiving first-line therapy in EU4, the UK, Japan and China between January 1, 2020, and December 31, 2024. The IQVIA Oncology Dynamics database was used to derive patient-level data on physician-reported initial treatment for mHSPC. RESULTS: Of 23,101 men included, 15,275, 4,875, and 2,951 in EU4, the UK, and Asia, received treatment for mHSPC. Use of androgen deprivation therapy (ADT) monotherapy ranged from 29-44% in EU4/UK and 50-59% in Asia. ADT plus androgen receptor inhibitor (ARPI) was used in 47% of patients in EU4, 54% in the UK, and 35-38% in Asia. From 2020-2024, ADT monotherapy decreased from 60% to 24% in EU4, 54% to 23% in the UK, and 83% to 39% in Asia, with corresponding increases in ADT plus ARPI use. ADT plus ARPI plus docetaxel use increased throughout the study, becoming more prominent from 2023 in EU4/UK; usage went from 0.1% in 2020 to 10% in 2024. Uptake was slower in Asia. Compared with recurrent mHSPC, a high proportion received combination therapy for de novo mHSPC. DISCUSSION: Findings highlight the adoption of combination strategies with either doublet or docetaxel triplet regimens between 2020 and 2024. One-fourth of patients received ADT monotherapy in 2024.