Session: PD16: Prostate Cancer: Advanced (including Drug Therapy) III
PD16-11: Real World Characterization of Patients Receiving Relugolix or Androgen Deprivation Therapy Injections in Combination with Oral Anti-Androgens in 2021 (The REAL ADT ORAL Study): Analysis from a US EMR Database
Oakland University William Beaumont School of Medicine
Introduction: Relugolix, approved in December 2020, is the first oral gonadotropin releasing hormone (GnRH) receptor antagonist to treat advanced prostate cancer (PC). Some guidelines do not recommend relugolix in combination with other PC medications. This study reports the real-world occurrence of relugolix treatment prescribed in combination with other PC medications (ComboPCRx). It describes the demographic and clinical characteristics of these patients compared to patients receiving injectable androgen deprivation therapy (ADT) in ComboPCRx. Methods: Retrospective observational analysis was conducted using de-identified EMR data from 536,539 patients representing 89 community urology practices in the US (PPS Analytics). The analysis captured all patients on ADT in 2021, the first year of relugolix’s availability. Descriptive analysis of demographic (age, race/ethnicity) and clinical characteristics [radiation therapy (RTx), metastatic disease (METS), and occurrence of ComboPCRx)] are reported by ADT type (any ADT, degarelix, leuprolide, relugolix). Results: In 2021, 51,735 patients were treated with ADT: 45,599 (88.1%) with leuprolide, 7,428 (14.6%) with degarelix, and 3,096 (6.0%) with relugolix. ComboPCRx was found in 10,024 (19.4%) patients (Table 1). The mean age of ComboPCRx patients was 72.0 (SD:8.5) years, most were white/Caucasian (66.9%). Of these ComboPCRx patients, RTx and METS were found in 27.3% and 74.0%, respectively. ComboPCRx with relugolix was found in 698 patients with similar mean age and race as the overall ComboPCRx cohort, but in a higher proportion of METS (83.1%). Enzalutamide was the most frequently observed ComboPCRx with any ADT (45.7%), and by ADT type. Abiraterone and apalutamide were more frequently prescribed with degarelix (25.3% and 35.5%) and relugolix (26.1% and 30.5%) than with leuprolide (18.9% and 21.1%). Conclusions: This analysis of ADT utilization in 2021 from urology EMR data shows that anti-androgens were the most common class of ComboPCRx with ADT, regardless of ADT type. As additional data become available, future studies will focus on duration of ComboPCRx and their outcomes. SOURCE OF Funding: Myovant Sciences GmbH, in collaboration with Pfizer
