TOPLINE:
Swedish registry data show.
METHODOLOGY:
- The use of doublet therapy has increased significantly in Sweden in recent years given the growing body of evidence demonstrating that doublet therapy improves survival in individuals with de novo metastatic castration-sensitive prostate cancer.
- Investigators wanted to see whether the increasing use of doublet therapy in this patient population has improved survival when taking various other factors into consideration.
- The analysis, which included 11,382 men diagnosed with metastatic castration-sensitive prostate cancer in Sweden from 2008-2020 and registered in the country’s National Prostate Cancer Register, explored the use of doublet therapy over time and its association with survival, adjusting for age, comorbidities, and cancer characteristics.
- The researchers estimated average 5-year and 10-year survival over time using a survival model.
TAKEAWAY:
- During the study period, patients exhibited a shift toward less advanced prostate cancer, with median prostate-specific antigen (PSA) levels at diagnosis decreasing from 145 to 107 ng/mL in men with metastatic disease.
- Upfront treatment with doublet therapy in these men simultaneously increased from 1% in 2016 to 44% in 2020.
- Adjusted 5-year overall survival increased from 26% between 2008-2012 to 35% in the period 2017-2020; in the 5 years following diagnosis, patients’ mean survival increased by about 6 months between 2008-2012 and 2017-2020.
- The percentage of patients still alive at 10 years doubled from 9% in 2008 to 18% in 2020. Improvements were greater in men younger than 80 years old.
IN PRACTICE:
“A clinically meaningful increase in long-term survival was observed in men diagnosed with de novo [metastatic castration-sensitive prostate cancer] between 2008 and 2020 in Sweden. We argue that the main reason for this improvement was the increased upfront use of doublet therapy,” the authors concluded.
SOURCE:
The study, with first author Christian Corsini, MD, of Uppsala (Sweden) University, was published online in JAMA Network Open.
LIMITATIONS:
Although there were no substantial changes in the diagnostic workup, unmeasured and unknown changes over the years may have affected survival. The researchers lacked information on PSA levels during follow-up, and therefore could not assess progression-free survival. Some upfront docetaxel use was not captured before 2017.
DISCLOSURES:
The study received funding from the Swedish Cancer Society and Region Uppsala. The authors reported no relevant financial relationships.
A version of this article first appeared on Medscape.com.
