Does Adjuvant Docetaxel Improve Biochemical Disease–Free Survival in Prostate Cancer?
Posted: Friday, December 13, 2019
According to research published in European Urology, docetaxel treatment administered after radical radiotherapy did not appear to improve biochemical disease–free survival in patients with advanced-risk prostate cancer. “Our result does not support the use of docetaxel after radical [radiotherapy] for intermediate- or high-risk [prostate cancer],” noted Pirkko-Liisa Kellokumpu-Lehtinen, MD, PhD, of Tampere University Hospital, Finland, and colleagues.
The international, phase III study included 376 patients who underwent radical radiotherapy. The participants were then randomly assigned to receive either 75 mg/m2 of docetaxel once every 3 weeks for 6 cycles with no continuous prednisone (n = 188) or ongoing surveillance (n = 188). All participants received neoadjuvant or adjuvant androgen-deprivation therapy. The median age of patients in both groups was 67. No difference was noted in the biochemical disease–free survival curves (P = .6) between the two arms.
A total of 147 patients (78%) in the docetaxel arm completed all 6 treatment cycles. At a median follow-up of 59 months, 58 patients in the docetaxel arm and 57 patients in the surveillance arm had prostate-specific antigen (PSA) levels that rose at least 2 ng/mL over the lowest recorded PSA value. The docetaxel group had an estimated 5-year rate of biochemical disease progression of 35%, whereas that rate was 28% in the surveillance group.
In patients treated with docetaxel, febrile neutropenia was reported in 16%. Though no recorded deaths were associated with docetaxel treatment, 20 deaths occurred in that group, with 9 attributed to disease. A slightly higher number of deaths were reported in the surveillance arm, with seven considered to be related to disease.
Disclosure: For full disclosures of the study authors, visit europeanurology.com.
