Survival Impact of Chemohormonal Therapy in Metastatic Hormone-Sensitive Prostate Cancer
Posted: Thursday, September 13, 2018
Docetaxel added to androgen-deprivation therapy (ADT) significantly prolonged overall survival over ADT alone in patients who have metastatic hormone-sensitive prostate cancer with high-volume disease, according to long-term follow-up of a randomized phase III study. However, for patients with low-volume disease, no overall survival benefit was reported. These data from the CHAARTED trial were reported by Christos E. Kyriakopoulos, MD, of the University of Wisconsin School of Medicine and Public Health, Madison, and colleagues, in the Journal of Clinical Oncology.
A total of 790 patients with metastatic hormone-sensitive prostate cancer were equally assigned to receive either ADT in combination with docetaxel or ADT alone. After a median follow-up of 53.7 months, the median overall survival was 57.6 months in the chemohormonal therapy arm compared with 47.2 months in the ADT-alone arm (hazard ratio = 0.72). Of the 513 patients with high-volume disease, the median overall survival was 51.2 months with chemohormonal therapy versus 34.4 months with ADT alone (hazard ratio = 0.63).
“Combining novel therapies with ADT at the time of initiating systemic therapy for [metastatic hormone-sensitive prostate cancer] has emerged as a strategy to potentially delay the development of [castration-resistant prostate cancer] and improve quality of life and [overall survival],” the authors reported. However, they added, the benefit is “clearly defined” for patients who have high-volume disease.