Treatment-Related Burden of Illness of Castration-resistant Prostate Cancer with Bone Metastases in France

Background: Prostate cancer is the most common cancer in men in France; 10–20% of patients with prostate cancer develop castration-resistant prostate cancer (CRPC) within 5 years. Purpose: This analysis aimed to identify clinical characteristics, treatment patterns, and burden of CRPC. Methods: This was a retrospective analysis of real-world data from patients with metastatic CRPC (mCRPC) in France. Each participating physician provided data for 5–12 patients. Patients were grouped by metastatic site (bone only; bone + visceral) and first-line treatment (abiraterone; enzalutamide; docetaxel). All analyses were descriptive in nature. Results: Overall, 591 patients were included; 81% had bone only metastases, 14% had bone and visceral metastases (exact information regarding metastases unknown by physician for 5% of patients). Of the 481 patients with data available at first-line, abiraterone, docetaxel and enzalutamide was received by 55%, 33%, and 12%, respectively, at first-line, and 54%, 19%, and 20%, respectively, at second-line; 61% of patients received a single line of therapy. Abiraterone was the most common first-line treatment for patients with bone metastases only, and docetaxel for patients with bone+visceral metastases. Overall, 14% of patients experienced ≥1 symptomatic skeletal event (SSE). Pathologic fracture was experienced by 4.7%, 5.4% and 16.1% of patients receiving abiraterone, docetaxel, and enzalutamide, respectively, and 6.3%, 7.3% and 12.9% of patients receiving abiraterone, enzalutamide, and docetaxel, respectively, had bone radiotherapy. Conclusion: Abiraterone was the most common first-line treatment in mCRPC in France, followed by docetaxel; docetaxel was the most frequently-used treatment for patients with bone+visceral metastases.