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Hormonal treatment for newly diagnosed metastatic prostate cancer: a population-based study from the California cancer registry

Prostate Cancer and Prostatic Diseases (2023)Cite this article

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A Correction to this article was published on 14 November 2023

This article has been updated

Abstract

Introduction

To evaluate how often men with metastatic prostate cancer (mPC) receive standard of care treatment with androgen deprivation therapy (ADT).

Methods

Men aged ≥20 years with newly diagnosed mPC (stage IV) between 2010 and 2018 were identified using California Cancer Registry data. Receipt of hormonal therapy as initial cancer treatment was examined by patient/tumor characteristics at time of diagnosis. Chi-square tests and logistic regression, adjusted for covariates, were performed to assess association between receipt of hormonal therapy and patient/tumor characteristics.

Results

We identified 13,680 men with newly diagnosed mPC, of which 3637 had local metastasis (N1) only while 9596 had distant metastasis (M1) with or without N1 disease. 21.8 % (n = 2980) of men did not receive ADT. The highest rate of receiving ADT was among men between ages 75–84 (81.6%) and the lowest rate was in men over 85 (76.0%). Asian men had the largest proportion receiving ADT (n = 962, 81.5%) with remaining subgroups having similar proportion of men receiving ADT (76.8% to 77.2%). Once adjusted for covariates, regression results showed men with a higher Gleason score (8–10) were more likely to receive ADT (OR 2.04, 1.82–2.27, p = < 0.001) as well as men with distant sites of metastatic disease (OR 4.02, 3.62–4.46, p = < 0.001). Men residing in neighborhoods with the lowest socioeconomic status were least likely to receive ADT (OR 0.79, 0.68–0.93, p = 0.0032). No differences in receipt of ADT were observed by race/ethnicity.

Discussion

Despite significant advancements in the treatment of mPC in recent years, over one-fifth of patients did not receive ADT, which is the backbone for all new systemic therapies. This dataset might help address some of the prostate cancer care disparities in California.

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Data availability

The data that support the findings of this study are not openly available due to reasons of sensitivity are available from the corresponding author upon reasonable request.

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Author information

Authors and Affiliations

  1. Hoag Family Cancer Institute, Newport Beach, CA, USA

    David J. Benjamin

  2. Cancer Registry of Greater California (CRGC), Public Health Institute, Sacramento, CA, USA

    Anshu Shrestha, Dimitra Fellman & Rosemary D. Cress

  3. Department of Public Health Sciences, University of California Davis, Davis, CA, USA

    Rosemary D. Cress

  4. Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK

    Mark P. Lythgoe

  5. Division of Hematology and Oncology, Department of Medicine, University of California, Irvine, Orange, CA, USA

    Arash Rezazadeh Kalebasty

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  1. David J. Benjamin
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Contributions

DJB: conceptualization, methodology, writing – original draft, writing – review & editing; AS: conceptualization, methodology, writing – original draft, writing – review & editing, supervision; DF: conceptualization, methodology, formal analysis, writing – original draft, writing – review & editing; RDC: conceptualization, methodology, writing – original draft, writing – review & editing; MPL: conceptualization, writing – review & editing; ARK: conceptualization, methodology, writing – original draft, writing – review & editing, supervision.

Corresponding author

Correspondence to David J. Benjamin.

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Competing interests

ARK has the following disclosures: Stock and Other Ownership Interests: ECOM Medical. Consulting or Advisory Role: Exelixis, AstraZeneca, Bayer, Pfizer, Novartis, Genentech, Bristol Myers Squibb, EMD Serono, Immunomedics, Gilead Sciences. Speakers’ Bureau: Janssen, Astellas Medivation, Pfizer, Novartis, Sanofi, Genentech/Roche, Eisai, AstraZeneca, Bristol Myers Squibb, Amgen, Exelixis, EMD Serono, Merck, Seattle Genetics/Astellas, Myovant Sciences, Gilead Sciences, AVEO. Research Funding: Genentech, Exelixis, Janssen, AstraZeneca, Bayer, Bristol Myers Squibb, Eisai, Macrogenics, Astellas Pharma, BeyondSpring Pharmaceuticals, BioClin Therapeutics, Clovis Oncology, Bavarian Nordic, Seattle Genetics, Immunomedics, Epizyme. Travel, Accommodations, Expenses: Genentech, Prometheus, Astellas Medivation, Janssen, Eisai, Bayer, Pfizer, Novartis, Exelixis, AstraZeneca. DJB has received consulting fees from Seagen. MPL has received advisory fees from Clovis Oncology. The remaining authors (AS, DF, and RDC) have no disclosures.

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The original online version of this article was revised: The following sentence in the second paragraph of the Results section should read: “Men who were 85 years or older were least likely to receive ADT (76.0%) as opposed to men between the ages of 20-54 (78.9%). Men between ages 75-84 had the highest proportion of receipt of ADT (81.6%).” Instead of: “Men between ages 75–84 were least likely to receive ADT (81.6%) as opposed to men between the ages of 20–54 (78.9%). Men between ages 75–84 had the highest proportion of receipt of ADT among all age groups.” There is also a typographical error in Table 2. Additionally, the following sentence should read: “Specifically, men who were 85 years or older had 44% lower odds of receiving ADT (95% CI: 0.44, 0.71) and men from the lowest nSES areas had 21% lower odds of receiving ADT as the initial treatment compared to men of ages 20–54 and those from the highest nSES neighborhood, respectively.” Instead of: “Specifically, men who were 85 years or older had 44% lower odds of receiving ADT (95% CI: 0.44, 0.71) and men from the lowest nSES areas had 19% lower odds of receiving ADT as the initial treatment compared to men of ages 20–54 and those from the highest nSES neighborhood, respectively”.

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Benjamin, D.J., Shrestha, A., Fellman, D. et al. Hormonal treatment for newly diagnosed metastatic prostate cancer: a population-based study from the California cancer registry. Prostate Cancer Prostatic Dis (2023). https://doi.org/10.1038/s41391-023-00732-9

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