ESMO 2018: 12-Year Follow-up With Docetaxel-Based Chemotherapy in High-Risk Prostate Cancer
Posted: Wednesday, October 24, 2018
At the European Society for Medical Oncology (ESMO) 2018 Congress in Munich (Abstract 791O), Karim Fizazi, MD, PhD, of the Institut Gustave Roussy, Villejuif, France, and colleagues offered a 12-year follow-up of the GETUG-12 study, which focused on docetaxel-based chemotherapy in patients with high-risk localized prostate cancer. The investigators found that four cycles of docetaxel-based chemotherapy reduced the risk of clinical relapse or death in this patient population. In addition, they noted, “very long follow-up is needed to assess outcomes for high-risk localized prostate cancer.”
More than 400 patients took part in this clinical trial, with some randomly assigned to receive goserelin for 3 years and 4 cycles of docetaxel and estramustine (ADT+DE) or goserelin alone (ADT). They met the following inclusion criteria: T3 to T4 disease, Gleason score of at least 8, prostate-specific antigen level of at least 20 ng/mL, or pathologic node-positive disease. All of the men had a staging pelvic lymph node dissection, and local radiotherapy was administered at 3 months in the majority of patients (87%).
The 12-year rate of relapse-free survival was better with ADT+DE than with ADT (49.4% vs. 36.3%; P = .01). The median relapse-free survival was also longer with docetaxel-based therapy than without (11.6 years vs. 8.1 years)—a 3.5-year benefit. In addition, the 12-year rates of metastasis-free survival also favored the ADT+DE group over the ADT group (62.2% vs. 55.8%). As for the 12-year cumulative rate of second cancers, they were similar with and without docetaxel-based therapy (16.4% vs. 18.8%).
