ORIGINAL RESEARCH article
Front. Oncol.
Sec. Genitourinary Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1650378
This article is part of the Research TopicAdvances in Combined Modality Treatments for Prostate CancerView all 5 articles
Time and cost burden associated with docetaxel in patients with metastatic castration-sensitive prostate cancer initiating an androgen receptor pathway inhibitor-based regimen
Provisionally accepted
Daniel Sentana-Lledo1*
Arjun Gupta2
Carmine Rossi3
Sabree Burbage4Jill Korsiak3Lilian Diaz3Gordon Wong3Dominic Pilon3Ibrahim Khilfeh4Alicia K Morgans1- 1Dana-Farber Cancer Institute, Boston, United States
- 2University of Minnesota Medical School, Minneapolis, United States
- 3Analysis Group Inc, Montreal, Canada
- 4Johnson & Johnson, Horsham, United States
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Background: The triplet combination of chemotherapy (docetaxel), androgen receptor pathway inhibitors (ARPI), and androgen deprivation therapy has recently become a recommended approach to treat metastatic castration-sensitive prostate cancer (mCSPC). This study aimed to compare the incremental time and cost burden of adding docetaxel to ARPI-based treatment among patients with mCSPC receiving chemotherapy-containing regimens (CCR) and non– chemotherapy-containing regimens (NCR) in the United States. Methods: Clinical data from community urology practices linked with claims data (1/1/2016-12/31/2023) were used to select patients initiating a CCR or NCR. Outcomes, including time spent managing mCSPC (days with prostate cancer-related resource utilization or management care) and healthcare costs, were compared between balanced cohorts using weighted multivariable Poisson and linear regressions. Results: 126 CCR and 837 NCR patients (mean age 64.7 years, 52.6% White, 14.4% Black) were followed for a mean of 6.3 (CCR) and 6.8 (NCR) months. The CCR cohort spent on average 4.1 days per-patient-per-month (PPPM) managing mCSPC vs 3.3 days PPPM in the NCR cohort (rate ratio: 1.18; 95% confidence interval [CI]; 1.03, 1.34). Mean all-cause total healthcare costs were $17,833 PPPM in the CCR cohort and $11,527 PPPM in the NCR cohort (weighted adjusted cost difference: $6,184; 95% CI: 3,515, 8,517). Conclusions: Patients initiating a CCR experienced greater time burden managing mCSPC and higher healthcare costs than those initiating an NCR. These findings support counseling expressing these differences in burden in mCSPC treatment decision-making conversations.
Keywords: Androgen Receptor Antagonists, chemotherapy, hormone receptor agonists, mCSPC, Prostate Neoplasms, Time burden, Triplet therapy
Received: 19 Jun 2025; Accepted: 29 Aug 2025.
Copyright: © 2025 Sentana-Lledo, Gupta, Rossi, Burbage, Korsiak, Diaz, Wong, Pilon, Khilfeh and Morgans. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Daniel Sentana-Lledo, Dana-Farber Cancer Institute, Boston, United States
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