转移性去势抵抗性前列腺癌 (mCRPC) 的真实治疗模式和生存率尚未针对全部按服务收费的医疗保险人群进行描述。新诊断患有 mCRPC 的男性在 1/ 期间的医疗保险按服务收费索赔中被确定。 1/2014-6/30/2019。除非患者死亡，否则男性在诊断前≥1年和诊断后≥6个月有mCRPC证据和连续保险覆盖。描述了诊断后的治疗模式。使用 Kaplan-Meier 分析对 mCRPC 诊断和一线 (1 L) 治疗开始后的生存进行建模。在 14,780 名 mCRPC 男性中，平均年龄为 76 岁，mCRPC 后中位随访时间为 17.0 个月。 22% 的 mCRPC 后未接受延长生命的治疗，78% 接受≥1 线治疗 (LOT)，42% 接受≥2 个 LOT，20% 接受≥3 个 LOT。从开始 1L 到下一次 LOT 或随访结束的中位时间为 13.7 个月，从 2L 开始为 10.9 个月，从 3L 开始为 8.9 个月。 ≥2 系男性中最常见的 1 L 至 2 L 治疗顺序是 NHT 随后不同的 NHT (33%)、化疗后 NHT (14%) 和 NHT 随后化疗 (13%)。对于那些开始使用 1 L NHT 治疗的人来说，只有 28% 的人接受了不同类别的后续治疗。 mCRPC 后的中位生存期为 25.6 个月，治疗开始后的中位生存期为 23.4 个月。超过五分之一的 mCRPC 医疗保险患者没有接受任何延长生命的治疗，不到一半的人接受了 2 L 治疗。 NHT 是最常见的 1 L 和 2 L 疗法，患者接受 1 L NHT 治疗，然后接受不同的 2 L NHT 治疗，这是最常见的治疗顺序。所有患者诊断后的中位生存期为 25.6 个月。这些数据突显了 mCRPC 患者治疗严重不足的情况，特别是 NHT 之外的治疗以及现实世界数据中序贯 NHT 的常见使用。© 2023。作者。

Real-world treatment patterns and survival in metastatic castration-resistant prostate cancer (mCRPC) have not been characterized for the full fee-for-service Medicare population.Men newly diagnosed with mCRPC were identified in Medicare fee-for-service claims during 1/1/2014-6/30/2019. Men had evidence of mCRPC and continuous insurance coverage ≥1 year before and ≥6 months after diagnosis unless patients died. Treatment patterns after diagnosis were described. Survival from mCRPC diagnosis and from start of first-line (1 L) therapy was modeled using Kaplan-Meier analysis.Among 14,780 men with mCRPC, mean age was 76 and median follow-up after mCRPC was 17.0 months. 22% received no life-prolonging therapy after mCRPC, 78% received ≥1 line of therapy (LOT), 42% underwent ≥2 LOTs, and 20% had ≥3 LOTs. Median time from start of 1 L to next LOT or end of follow-up was 13.7 months, 10.9 months from 2 L start, and 8.9 months from 3 L start. The most common 1 L to 2 L treatment sequences among men with ≥2 lines were NHT followed by a different NHT (33%), chemotherapy followed by NHT (14%), and NHT followed by chemotherapy (13%). For those initiating 1 L treatment with NHTs, only 28% received subsequent treatment with a different class of therapy. Median survival was 25.6 months after mCRPC and 23.4 months following treatment initiation.More than 1 in 5 Medicare patients with mCRPC did not receive any life-prolonging therapy, and less than half received 2 L therapy. NHTs were the most common 1 L and 2 L therapies, with patients treated with NHT as 1 L followed by a different NHT for 2 L as the most common treatment sequence. Median survival from diagnosis for all patients was 25.6 months. These data highlight the dramatic undertreatment that occurs for mCRPC patients, particularly for therapies beyond NHTs as well as the common use of sequential NHTs in real-world data.© 2023. The Author(s).