Adding Docetaxel to Standard Treatment in High-Risk Prostate Cancer
Posted: Tuesday, June 25, 2019
For men with high-risk nonmetastatic prostate cancer, chemotherapy with docetaxel improved overall survival from 89% to 93% at 4 years, with improved disease-free survival and reduction in the rate of distant metastasis, according to results from the phase III NRG Oncology RTOG 0521 trial. According to the authors, Seth A. Rosenthal, MD, of the Sutter Medical Group and Sutter Cancer Centers, Sacramento, California, and colleagues, the trial suggests that docetaxel chemotherapy may be an option for some men with high-risk prostate cancer.
The multicenter randomized study, published in the Journal of Clinical Oncology, evaluated 563 patients with high-risk nonmetastatic disease between 2005 and 2009. Patients were randomly assigned to receive standard long-term androgen suppression plus radiation therapy with or without adjuvant chemotherapy. The median follow-up was 5.7 years. The 6-year disease-free survival rate was 55% for androgen suppression plus radiation therapy and 65% for androgen suppression and radiation therapy plus docetaxel.
Docetaxel-based chemotherapy has been shown to improve overall survival among men with castration-resistant as well as castration-sensitive prostate cancer. As for patient tolerability in this trial, there were no unexpected toxicity signals observed. Regarding the adverse events experienced, 53.4%, 20.6%, and 1.4% of patients experienced grades 2, 3, and 4 adverse events in the androgen-plus-radiotherapy arm, respectively, and 28.7%, 37.9%, 25.9%, and 0.7% of patients experienced grades 2, 3, 4, and 5 adverse events with chemotherapy, respectively.
“These are promising results,” the investigators noted. “Physicians should be considering the discussion of this option with selected patients who are fit for chemotherapy.”
Disclosure: The study authors’ disclosure information may be found at ascopubs.org.