Study Finds Docetaxel May Benefit Some Patients With Prostate Cancer
Posted: Wednesday, May 29, 2019
Overall survival, distant metastasis, and disease-free survival rates were all significantly improved in men with high-risk localized prostate cancer when docetaxel chemotherapy was given as an adjuvant therapy to standard long-term androgen suppression plus radiotherapy, compared with men who did not receive the chemotherapy. Seth A. Rosenthal, MD, of Sutter Cancer Centers in Sacramento, California, and colleagues published the results of the phase III, multicenter, randomized NRG Oncology RTOG 0521 study in the Journal of Clinical Oncology.
Between 2005 and 2009, 612 patients were enrolled, and 563 were evaluable. Their mean prostate-specific antigen level was 15.1 ng/mL, and 53% had a Gleason score 9 to 10 cancer.
After a median follow-up of 5.7 years, the patients in the chemotherapy arm had a 4-year overall survival rate of 93%, versus 89% in the control arm (one-sided P = .034). The 6-year rate of distant metastasis was 9.1% for the chemotherapy recipients versus 14.0% for the controls (two-sided P = .044). Finally, the 6-year disease-free survival rate was 65% for those who received docetaxel versus 55% for those who did not (two-sided P = .043).
Since this trial was designed, additional studies “have examined the role of docetaxel chemotherapy earlier in the clinical course of prostate cancer,” noted Dr. Rosenthal and co-investigators. However, the men in their study had more aggressive disease than those in the others, in which docetaxel was shown to have a beneficial impact of less significance. In RTOG 0521, 84% of patients “had a Gleason score 8 to 10 disease, whereas a majority of patients in [the others] had a Gleason score less than or equal to 7 disease…. These differences underscore the need to select high-risk patients with the most aggressive disease when considering treatment with adjuvant docetaxel,” concluded the team.
Disclosure: The study authors’ disclosure information may be found at ascopubs.org.