Treatment landscape and burden of disease in metastatic castration-resistant prostate cancer: systematic and structured literature reviews

Darren Leaning; Gagandeep Kaur; Alicia K Morgans; Ray Ghouse; Osvaldo Mirante; Simon Chowdhury

doi:10.3389/fonc.2023.1240864

Treatment landscape and burden of disease in metastatic castration-resistant prostate cancer: systematic and structured literature reviews

Front Oncol. 2023 Sep 27:13:1240864. doi: 10.3389/fonc.2023.1240864. eCollection 2023.

Authors

Darren Leaning¹, Gagandeep Kaur², Alicia K Morgans³, Ray Ghouse⁴, Osvaldo Mirante⁴, Simon Chowdhury⁵

Affiliations

¹ Department of Radiology and Oncology, James Cook University Hospital, South Tees NHS Trust, Middlesbrough, United Kingdom.
² Parexel Access Consulting, Parexel International, Mohali, Punjab, India.
³ Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States.
⁴ Advanced Accelerator Applications, a Novartis Company, Genève, Switzerland.
⁵ Department of Urological Cancer, Guy's, King's, and St. Thomas' Hospitals, and Sarah Cannon Research Institute, London, United Kingdom.

Abstract

Purpose: Metastatic castration-resistant prostate cancer (mCRPC) is a lethal disease that imposes a major burden on patients and healthcare systems. Three structured literature reviews (treatment guidelines, treatment landscape, and human/clinical/patient burden) and one systematic literature review (economic burden) were conducted to better understand the disease burden and unmet needs for patients with late-stage mCRPC, for whom optimal treatment options are unclear.

Methods: Embase^®, MEDLINE^®, MEDLINE^® In-Process, the CENTRAL database (structured and systematic reviews), and the Centre for Reviews and Dissemination database (systematic review only) were searched for English-language records from 2009 to 2021 to identify mCRPC treatment guidelines and studies related to the treatment landscape and the humanistic/economic burden of mCRPC in adult men (aged ≥18 years) of any ethnicity.

Results: In total, six records were included for the treatment patterns review, 14 records for humanistic burden, nine records for economic burden, three records (two studies) for efficacy, and eight records for safety. Real-world treatment patterns were broadly aligned with treatment guidelines and provided no optimal treatment sequencing beyond second line other than palliative care. Current post-docetaxel treatments in mCRPC are associated with adverse events that cause relatively high rates of treatment discontinuation or disruption. The humanistic and economic burdens associated with mCRPC are high.

Conclusion: The findings highlight a lack of treatment options with novel mechanisms of action and more tolerable safety profiles that satisfy a risk-to-benefit ratio aligned with patient needs and preferences for patients with late-stage mCRPC. Treatment approaches that improve survival and health-related quality of life are needed, ideally while simultaneously reducing costs and healthcare resource utilization.

Keywords: burden of disease; cost; economic burden; metastatic castration-resistant prostate cancer; treatment landscape; treatment pattern.

Publication types

Review

Grants and funding

This literature review and manuscript were sponsored by Advanced Accelerator Applications (AAA), A Novartis Company.