A real-world evidence (RWE) study on the treatment of metastatic castration-resistant prostate cancer (mCRPC) has provided new insights into the therapeutic strategies for mCRPC. The analysis was based on data from 2,500 patients treated in Finland.
Over the last ten years, new therapeutic options have become available for mCRPC. In Finland, androgen receptor pathway inhibitors (ARPIs) were introduced as a first-line treatment in 2018. Before 2018, these treatments were available only after chemotherapy.
The RWE study sought to evaluate the therapeutic landscape of mCRPC in Finland between 2013 and 2021. The clinical expert for the study was Dr. Antti Rannikko, a urology specialist from Helsinki University Hospital (HUS) and the study was sponsored by AstraZeneca.
“The results indicate that, after 2018, the proportion of patients treated with ARPI medications increased. Moreover, patient survival improved by 10 months, despite the inclusion of a larger number of older patients and those with more comorbidities in the treatment group,” explains Riikka Mattila, Scientific Advisor at Medaffcon.
Previously, first-line chemotherapy required patients to be in sufficiently good condition to tolerate the treatment. With the introduction of better-tolerated ARPI medications, treating frail patients has become possible.
According to Riikka Mattila, the most challenging part of the project was identifying the correct patients within the dataset. The study utilized patient data from HUS and the Wellbeing Services County of Southwest Finland (Varha) covering the years 2013–2021. Data included all information recorded in hospital information systems, such as pathology reports and laboratory results. This data was linked to causes of death records from Statistics Finland and reimbursed drug purchase data from Kela, the Social Insurance Institution of Finland.
The dataset included a total of 31,000 prostate cancer patients, 2,500 of whom were identified as having mCRPC.
“Metastasis and castration resistance are not recorded in a structured format, so identifying the correct patients required text mining. This process included analyzing sentences from patient records written by treating physicians. Additionally, we utilized laboratory measurements, diagnostic codes, pathology reports, medication data, and procedure codes to identify the relevant patients,” Mattila explains.
By accessing patient data from multiple sources, the researchers ensured that only the eligible patients were included in the study.
“By linking deep clinical data with broad datasets, we were able to conduct a comprehensive analysis of the treatment and outcomes of mCRPC patients.”
According to Riikka Mattila, the study’s results demonstrate that the treatment of mCRPC has advanced, enabling more patients to access care due to the introduction of new medications.
Real-world treatment patterns and survival outcomes in men with metastatic castration-resistant prostate cancer in Finland: a national, population-based cohort study. Rannikko A, Hölsä O, Ågesen T, Ekman M, Mattila R. Acta Oncologica (2025).
Find more RWE study summaries here.
Medaffcon, founded in 2009, is a Nordic research and consulting company specializing in Real-World Evidence, Medical Affairs, and Market Access. With offices in Stockholm, Sweden, and Espoo, Finland, we provide expert services across the Nordic region. Our services combine strong medical and health economic expertise with modern data science.
The company employs some 30 experts. Since 2017, Medaffcon has been a subsidiary of Tamro Oyj and is part of the PHOENIX group, which is a leading provider of healthcare services in Europe.
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Scientific Advisor
PhD
Riikka joined Medaffcon in February 2021. She has a wide-ranging experience from different therapy areas from atherosclerosis and birth asphyxia to neurodegeneration. She has more than 15 years of experience in research, three of which in Max Planck Institute in Germany. Her PhD thesis from 2011 focused on cholesterol metabolism.
Riikka’s strenghts include broad know-how and interest in diverse therapy areas, as well as enthusiasm and experience in both written and verbal scientific communication. At Medaffcon she enjoys varied projects and effectiveness of research.
Real world evidence fascinates Riikka because there is so much data, and more accumulating all the time, and most of this data is unused. There is potential for findings to support clinicians and the pharmaceutical industry, as well as alleviate the lives of patients. She is also happy that decisions in health care are increasingly evidence based.
Sr. Scientific Advisor
RWE Lead
PhD
+358 50 345 2393
mariann.lassenius@medaffcon.com
Mariann joined Medaffcon’s team in 2016 after finishing her PhD. The transition to real world evidence (RWE) research was a natural continuum to her previous research career. Through RWE studies, she has had the privilege to gain a broad insight into working with different stakeholders within the healthcare field. The vast proportion of her days goes towards interacting with clients, planning and performing RWE studies, and supporting Medaffcon’s RWE team. Subjects that keep her work interesting are the vast variability of customers and projects, problem-solving, and interacting with people.
“The number of RWE studies has increased since stakeholders within the healthcare industry have an increasing demand for knowledge-based decision making tools that need to be fulfilled. The future, therefore, has an ever-increasing emphasis on RWE”.