The incidence and fatality rates for prostate cancer vary substantially between Asians and Westerners. There was no information available on the precise prevalence of mHSPC in Thailand. In the Thai community, researchers for a study seeking to identify the prevalence, mortality, and clinical features of mHSPC.
From October 1, 2015, to September 30, 2019, 128 patients at Ramathibodi Hospital with newly diagnosed mHSPC were examined using retrospective data. Patients were grouped into the high-risk group by the LATTITUDE study and the high-volume disease (HVD) group by the CHAARTED trial.
A total of 128 individuals (12.9% of all newly diagnosed patients) had De Novo mHSPC; their median age was 72.91 years. There were 103 (80.5%) and 92 (71.9%) patients in the HVD and High-risk categories. OS was 37.2 months in all populations, 34.36 months in the HVD group, and 34.36 months in the high-risk group, respectively. The mCRPC development period was 16 and 15.37 months in all populations and the HVD group. In terms of overall survival, there was no statistically significant difference between HVD and LVD at 34.36 and 39.27 months, respectively (P=0.14). However, the LVD took substantially longer to acquire mCRPC than the HVD, respectively, at 25.14 and 15.37 months (P=0.03). The remaining patients received IARP or ADT in combination with docetaxel or ADT, which accounted for 121 (94.5%) and 7 (5.4%) patients, respectively. ADT was administered to the majority of patients.
De novo mHSPC was more common and manifested as a greater tumor burden in the Thai population than in the Western population. More than 70% of the cases were either high volume or high risk. Nevertheless, antiandrogen-deprived therapy was still the only treatment covered by insurance and is the gold standard of care.