nmCRPC and mHSPC: Immediate Impact of 2019 ASCO Annual Meeting on Clinical Practice


OBR and MD Outlook are pleased to share excerpts from the most recent MDoutlook’s OncoPolls™ from his year’s ASCO annual meeting in Chicago. This report highlights three presentations concerning the use of 2nd generation anti-androgens (2nd gen AAs) in the treatment of “early advanced” prostate cancer: non-metastatic, castration resistant prostate cancer (nmCRPC) and metastatic, hormone sensitive prostate cancer (mHSPC).

This research is based on separate, identical surveys conducted with US and EU5-based treaters of prostate cancer. The full complimentary report is available through MDoutlook per details below.

OncoPoll™ Methodology

  • Primary research phase involved surveys to verified and validated oncologists and urologists with an identified clinical interest in prostate cancer utilizing targeting parameters within the proprietary MDoutlook®global cancer treater panel
  • Timing: June 2019. Launched shortly after close of 2019 American Society of Clinical Oncology (ASCO) Annual Meeting, held in Chicago, IL., May 31-June 4, 2019
  • Fielding via interactive web-based survey instruments, utilizing proven MDoutlook methodology and proprietary technology
  • Links to discussed abstracts on the ASCO website were provided within the survey
  • Responses: 108 total, 73 oncologists (37 US | 36 EU5) and 35 urologists (15 US | 20 EU5)

Abstract #5000: Darolutamide in nmCRPC

Key Conclusions about Abstract #5000 (Darolutamide in nmCRPC)

  • Overall level of awareness about this abstract is still only moderate
    • Calculated average of 2.23 on 0 to 5 scale
    • As anticipated, awareness is higher among oncologists than urologists
    • Interestingly, Europeans are more aware of this presentation than Americans
  • After reviewing the abstract, the respondents believe Darolutamide has a better efficacy and safety profile than currently available options for nmCRPC
  • Upon regulatory approval and commercial availability, there will be some immediate integration of Darolutamide into the treatment practices for nmCRPC
    • Overall, 12-15% of nmCRPC patients will be treated with Darolutamide, with varying percentages based on the type of physician treating and geography (ranging from 8-21% of total patients)
    • More physicians in Europe will use Darolutamide in their nmCRPC practices (46% vs. 26% of US physicians), with the US oncologists being the population least likely to use it (only 20% will use in at least 1 patient) (data not shown)

Abstracts #LBA2 & #5006:
Enzalutamide & Apalutamide in mHSPC

Key Conclusions about Abstracts #LBA2 & #5006 (Enzalutamide and Apalutamide in mHSPC)

  • Similar moderately high level of awareness about both of these abstracts, with slightly higher awareness by oncologists over urologists, and Europeans over Americans
  • After reviewing the abstract, even though #LBA2 about Enzalutamide was presented during the Plenary Session, the Apalutamide Oral Abstract was actually thought to have a small edge in both efficacy and safety & tolerability
  • There will be an increased usage of both Enzalutamide and Apalutamide in the mHSPC setting expected to increase, distinct preferences are seen by specialty and regionality

Overall Conclusions: Immediate Impact of 2019 ASCO Presentations on the Clinical Practice for mHSPC and nmCRPC

  • This year was a banner year for prostate cancer, with 3 major presentations concerning 2ndgen AAs in the treatment of nmCRPC and mHSPC
    • As seen with the similar level of awareness between #LBA2 and #5006, the interest and newsworthy results from related presentations likely drives coordinate learning
  • The 2ndgen AAs are becoming (if not already) the standards of care for the mHSPC and nmCRPC populations of prostate cancer patients. The use of ADT alone will likely be only for early / localized disease while chemotherapy will move back to the last lines of treatment (in mCRPC)
  • Competition among the 2ndgen AAs is likely only going to get more intense with the 4th(Darolutamide) expected to soon receive its commercial authorization. Additional studies will be needed to clearly differentiate these agents from each other and identify the specific patient population(s) best suited for each one

For a more detailed analysis report, personalized to suit your informational needs, please click here to visit MDoutlook or click here to view this report.

Submitted by Robert Stephan, SVP, Research & Operations and Jan Heybroek, President MDoutlook.

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