Overview
Although androgen receptor pathway inhibitors (ARPIs) are widely used in advanced prostate cancer, treatment patterns following ARPI exposure remain poorly understood across different racial, ethnic, and socioeconomic groups. Using the Flatiron Health Research Database, this study evaluated 667 US patients with metastatic castration-resistant prostate cancer (mCRPC) diagnosed between January 2023 and August 2024 who received first-line (1L) mCRPC therapy after prior ARPI use.
The study revealed meaningful real-world disparities in clinical presentation and care delivery. Non-Hispanic Black patients were more likely to present at a younger age than Non-Hispanic White patients, with significantly higher median PSA levels at metastatic diagnosis (154.5 vs. 36.3 ng/mL in Non-Hispanic White patients) and were more likely to live in lower socioeconomic status (SES) neighborhoods. Additionally, Black patients and those living in the lowest SES areas received chemotherapy rather than repeat ARPI therapy more frequently in the 1L mCRPC setting compared to White or higher-SES patients.
Why this matters
This research highlights key real-world inequities in prostate cancer care, showing how race and neighborhood socioeconomic factors may be associated with disease severity at diagnosis and subsequent treatment choices. Uncovering these care gaps provides critical evidence to inform targeted healthcare policies, reduce structural barriers, and ensure equitable access to novel cancer therapies for all patient populations.