54 Background: Prostate cancer (PC) is one of the most common cancers in men. When making treatment decisions, patient health-related quality of life (HRQoL) and caregiver need are important considerations, and as such it is imperative to understand the impact that PC has on HRQoL. We aimed to assess the impact of metastatic hormone-sensitive PC (mHSPC) and castration-resistant PC (mCRPC) on HRQoL and associated caregiver need. Methods: Real-world data were drawn from the PC Disease Specific Programme, a point-in-time survey conducted in the United States of America and Europe (France, Germany, Italy, Spain and the United Kingdom) between Jan-Aug 2020. Physicians completed patient record forms for their next 8 consecutively consulting adult metastatic PC patients (4 mHSPC/4 mCRPC). Eligible patients were invited to complete a voluntary patient self-reported form on caregiver need and HRQoL including EuroQol 5-dimension 5-level (EQ-5D-5L), EuroQol Visual Analogue Scale (EQ-VAS), Functional Assessment of Cancer Therapy – General/Prostate (FACT-G/P) and Brief Pain Inventory (BPI) questionnaires. Higher scores indicate better HRQoL and more pain. Data were analysed descriptively. Results: 376 mHSPC and 331 mCRPC patients completed patient self-reported forms. Demographics and clinical characteristics for mHSPC/mCRPC patients were: mean age 71.1/71.5 years, 77%/69% of patients had an ECOG performance status of 0-1, 82%/83% of patients were retired and 42%/44% of patients had a caregiver. At data collection, mean HRQoL scores for mHSPC/mCRPC patients were: 66.4/63.4 (EQ-VAS), 0.76/0.72 (EQ-5D-5L), 66.2/62.9 (FACT-G) and 94.6/90.2 (FACT-P). Patients with mHSPC had FACT-P social, emotional, functional and physical well-being subscale scores of 18.2, 14.7, 13.6 and 19.7, respectively. These scores were 17.7, 14.0, 12.7 and 18.5 in mCRPC patients, respectively. Mean “worst pain” scores were mild (3.6/3.9 on BPI for mHSPC/mCRPC patients). In terms of both non-professional and professional caregivers, mHSPC/mCRPC patients reported a mean of 31.6/28.9 care hours/week. Most caregivers were partners/spouses (in 89% of mHSPC and 82% of mCRPC patients) providing a mean of 29.0 and 27.7 care hours/week, respectively. Conclusions: We showed that HRQoL and well-being are impacted in both mHSPC and mCRPC patients, and that there is a considerable time burden on caregivers. Patients with mCRPC reported the lowest HRQoL scores and highest pain scores, suggesting that patients who are sicker may have greater disease burden. Our findings suggest an unmet need for HRQoL in patients with mHSPC and mCRPC, and also a need for greater caregiver support in these patients.