Use of Doublet or Triplet Therapy in Metastatic Hormone-Sensitive Prostate Cancer Across Community-Based Urology Settings in the United States

Abstract

Introduction: This study examines patient clinical profiles and real-world utilization patterns of darolutamide doublet (DT; androgen deprivation therapy alone) and triplet therapy (TT; androgen deprivation therapy and docetaxel) for the treatment of metastatic hormone-sensitive prostate cancer (mHSPC).

Methods: This was a retrospective, observational study using the Precision Point Specialty Analytics (Specialty Networks) patient population health management platform to identify adult men with mHSPC who received darolutamide DT or TT between July 1, 2019, and March 31, 2023.

Results: Of 420 patients, 249 received DT and 171 received TT. Most patients included in the analysis were non-Hispanic White (DT: 67.1%; TT: 63.2%) and had Medicare insurance (DT: 77.5%; TT: 54.4%). Comorbid conditions were common, with hypertension (32.4%) and diabetes (15.0%) being the most prevalent. The mean PSA value on the index date was 20.9 ng/mL (SD 87.2 ng/mL) in the DT cohort and 66.4 ng/mL (SD 286.4 ng/mL) in the TT cohort. Most patients presented with high-grade cancer at diagnosis, with 50.6% of patients in the DT cohort and 74.2% of patients in the TT cohort having a high (≥8) Gleason score at diagnosis. The median duration of darolutamide treatment was 48 weeks in the DT cohort and 46 weeks in the TT cohort.

Conclusions: This study demonstrated that darolutamide DT and TT are used ubiquitously across community urology practices in the United States for the treatment of mHSPC.

Keywords: drug utilization; neoplasm metastasis; prostatic neoplasms.

Figure 1.

Study design.

Figure 2.

Patient attrition schematic. DT indicates doublet therapy; mHSPC, metastatic hormone-sensitive prostate cancer; PC, prostate cancer; TT, triplet therapy.