Real-world treatment transitions and healthcare resource utilization in patients with metastatic castration-resistant prostate cancer in Colombia.

49 Background: Although 10-20% PC patients in Latin America (LA) progress to mCRPC, real-world data describing mCRPC patient journey in LA is limited. This study examines treatment patterns, healthcare resource utilization (HRU), survival, and increased post-mCRPC treatment burden among mCRPC patients in Colombia. Methods: This non-interventional, multicenter, retrospective study included patients who progressed to mCRPC between Jan/2017 and Jun/2023 and received at least one line of systemic therapy in Colombia. Patients treated with PARP inhibitors or enrolled in clinical trials were excluded. The McNemar test was applied to assess the healthcare burden before and after mCRPC. Results: 369 mCRPC patients that received 1L treatment were included. The median OS was 34.5 months and median PFS was 13.6 months. The median age was 72y at mCRPC diagnosis. In the 1L, 66.1% received ARPI while 31.2% taxane-based chemotherapy. Among those who progressed after 1L (n=245;66.4%), treatment transitions occurred predominantly from ARPI→chemotherapy (46.1%), followed by chemotherapy→ARPI (18.0%) and ARPI→ARPI (11.8%). Less common sequences included chemotherapy→chemotherapy (9.8%) and ARPI→Radium-223 (3.3%). In terms of HRU, 24.7% required at least one emergency room visit (ERV) and 44.4% hospitalization due to cancer-related issues; 61.8% required radiation therapy, and 54.5% consulted with a palliative care specialist (PCS). ERV and hospitalizations increased from 7.6% to 17.1% and from 15.7% to 28.7% before and after mCRPC, respectively (p for ERV <0.01 and hospitalization <0.01). Conclusions: In this first multicenter Colombian real-world study of mCRPC patients, ARPI dominated 1L therapy and ≈50% switched to chemotherapy on progression. Patients with mCRPC experienced a higher burden of HRU, with 3x and 2x increase in ERV and hospitalizations compared to pre-mCRPC. These findings underscore not only the significant clinical deterioration observed in the resistant disease setting but also the critical implications for budget planning, the importance of maintaining patients in mHSPC for as long as possible. Healthcare resource utilization of patients with mCRPC. Healthcare resource n-(%)(N=369) Mean number of visits HRU before mCRPCn-(%)(N=369) HRU after mCRPCn-(%)(N=369) p-value (before vs. after mCRPC) Months from PC diagnosis to first reported event* Months from mCRPC diagnosis to first reported event* ERV 91–(24.7) 1.8(±1.4) 28-(30.8) 63- (69.2) <0.01 43.5 (18.1-107.8) 12.3 (4.4-27.0) Hospitalization 164–(44.4) 1.7(±1.0) 58-(35.4) 106-(64.6) <0.01 42.6 (19.6-94.7) 10.6 (4.2-23.6) Palliative Care specialist** 201–(54.5) 8.1(±9.5) 56-(27.9) 144-(71.6) <0.01 41.2 (12.7-89.3) 10.3 (2.5-24.2) *Median-Interquartile range. **In one patient, data on the time of first reported HRU was not available.