Applying Real-World Evidence to mCSPC Care

In this episode, “Applying Real-World Evidence to mCSPC Care,” our panel explores the challenges clinicians face when making treatment decisions for patients with metastatic castration-sensitive prostate cancer (mCSPC) in the absence of direct head-to-head comparisons among androgen receptor pathway inhibitor (ARPI)-based treatment strategies. As the treatment landscape continues to evolve, the expert faculty discuss how real-world considerations, including treatment access, insurance coverage, and patient costs, can significantly influence therapeutic decisions, sometimes as much as the clinical evidence itself.

The panelists examine the types of evidence that help inform treatment selection when prospective comparative trials are unavailable. They discuss the value of retrospective analyses, post hoc evaluations of registration studies, network meta-analyses, and real-world evidence in addressing clinically relevant questions that randomized trials may not fully answer. The panel highlights how these real-world data can provide insight into treatment effectiveness and safety outcomes across broader and more diverse patient populations than those typically enrolled in clinical trials.

Expert faculty also discuss the role of real-world evidence in evaluating treatment performance among patient groups often underrepresented in clinical studies, including racial and ethnic minorities and patients with significant comorbidities. They emphasize how these datasets may improve confidence in applying clinical trial findings to everyday practice while acknowledging the limitations inherent in non-randomized analyses. Throughout the discussion, the panel of experts underscores the importance of balancing evidence from multiple sources, recognizing both the strengths and shortcomings of available data, and using a patient-centered approach to guide treatment decisions in an increasingly complex mCSPC treatment landscape.

Our next episode, “Evaluating Real-World Evidence and Clinical Endpoints in mCSPC,” explores how the panelists interpret comparative datasets, assess the strengths and limitations of real-world evidence, and evaluate the impact of patient characteristics on treatment outcomes. They also discuss the clinical relevance of endpoints such as overall survival, PSA90, time to next treatment, and progression to mCRPC when assessing ARPI-based therapies in mCSPC.