The treatment patterns of castration-resistant prostate cancer in Japan, including symptomatic skeletal events and associated treatment and healthcare resource use

ABSTRACT

Background: Real-world treatment patterns of bone metastatic castration-resistant prostate cancer (mCRPC) in Japan were examined, focusing on treatment patterns and resource use differences attributed to symptomatic skeletal events (SSEs).

Methods: Urologists (N = 176) provided retrospective chart data for patients with mCRPC (N = 445) via online surveys. Descriptive analyses and chi-square tests evaluated treatment patterns and their differences by SSE presence; generalized linear mixed models examined healthcare resource utilization differences as a function of SSEs.

Results: Patients were on average 73.6 years old (SD = 8.3), diagnosed with prostate cancer 5.1 years (SD = 6.2), castration-resistant 2.3 years (SD=2.0), and had 7.9 bone metastases sites (SD=12.4). Novel anti-hormones showed increased adoption as mCRPC treatment. Simultaneously, luteinizing hormone-releasing hormone (LHRH) agonist/antagonist use was common (43.6% of patients in 1^st line), even as CRPC treatment had started. SSEs were uncommon (2–3% per treatment line; 5% at any time), but were associated with increased opioids, strontium-89, bisphosphonates, and NSAIDs use, plus increased healthcare visits (all p < .05).

Conclusions: LHRH agonist/antagonist treatment combinations remain the mCRPC treatment mainstay in Japan. However, novel anti-hormone therapies are becoming well-accepted in practice. SSEs were associated with increased healthcare resource and analgesic use, highlighting the need for efficient symptom management.

KEYWORDS:

• Healthcare resource use
• metastatic castration-resistant prostate cancer
• pain management
• symptomatic skeletal events
• treatment
• treatment patterns

Acknowledgments

The authors acknowledge the research support of Atsuko Matsumoto, who is an employee of Kantar Health. The authors would also like to acknowledge Errol J. Philip, PhD, and Martine C. Maculaitis, PhD, who contributed to the literature review and provided editorial support to the manuscript. Drs. Philip and Maculaitis are paid consultants to Kantar Health. The authors would also like to thank Aya Narimatsu and Saaya Tsutsue of Bayer Yakuhin, Ltd. for additional review of the data.​​

Declaration of interest

E Wang, DA Ledesma, and Y Aitoku were full-time employees of Bayer at the time of this study. H Uemura was a paid consultant to Bayer Yakuhin at the time of this study. M DiBonaventura and K Concialdi were full-time employees of Kantar Health, the organization which received funding for this study, at the time of this study.

Additional information

Funding

This study was funded by Bayer Yakuhin, Ltd.