Methods
A retrospective cohort of patients treated for mCRPC between 2020-2023 was identified in the ConcertAI NLP360 oncology electronic medical records (EMR) database, which includes data from 900+ US oncology centers. Evidence of CRPC and being previously diagnosed with mHSPC was confirmed through a clinical algorithm. Continuous EMR activity for ≥12 months pre-mCRPC and ≥6 months post-mCRPC was required to capture baseline characteristics and outcomes. Line of therapy was identified as ARPI, chemotherapy, poly (ADP-ribose) polymerase inhibitors (PARPIs), immunotherapy (pembrolizumab, sipuleucel-T), radiopharmaceuticals (Ra-223, 177Lu-PSMA-RLT), alone or in combination.
Results
Of609 patients, 456 (75%), 88 (14%), and 65 (11%) were White, African-American (AA), and other races, respectively. Median age was 72 years (interquartile range: 66-79). Nearly 85% had ECOG 0-1, 79% had bone metastases, and 42% received bone-health agents during baseline. Most received ADT alone for mHSPC (53%), followed by ADT+ARPI (37%) and ADT+Docetaxel (10%). Except for a higher use of bone-health agents at baseline in Whites (43% vs. 31%), there were no significant differences in baseline clinical and treatment characteristics by race. Overall, ARPI (62%) [abiraterone: 25%; enzalutamide: 24%; apalutamide: 9%; darolutamide 4%] and chemotherapy (22%) [docetaxel 16%; cabazitaxel 6%] were most common first-line treatment (1L Tx) for mCRPC. This trend was consistent by race except for a marginal higher use of ARPI and lower use of chemotherapy among AAs and vs. Whites (Table). Median real-world overall survival (rwOS) from 1L mCRPC Tx was 21 months (95% confidence interval: 18, 25) with no significant difference across the race groups.
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