Overall Survival of Patients with Castration-Resistant Prostate Cancer Receiving Docetaxel-Prednisolone
Article Sidebar
Main Article Content
Abstract
Background: Prostate cancer is prevalent in aging males. If the patient can live longer enough, every patient will suffer from castration resistant prostate cancer (CRPC). The CRPC is the state of disseminated disease which progresses even though the patient has undergone castration. Docetaxel/prednisolone regimen has been established the standard of care for such patients, and can be reimbursed in Thailand since 2011. It is not known whether the policy that provided such an expensive treatment benefited to Thai CRPC patients. We performed the retrospective cohort study of Thai CRPC patients who had attended in Vajira Hospital between January 1, 2011 to December 31, 2015. The primary endpoint was overall survival (OS) among patients who had been treated with docetaxel/prednisolone.
Methods: Data from the medical records of CRPC patients treated with docetaxel/prednisolone regimen were analysed with respect to clinical, prostate-specific antigen (PSA) response and overall survival. The data were compared to the results of the TAX 327 study.
Results: There were 41 CRPC patients in our cohort. Thirty-seven of them were treated with docetaxel/prednisolone regimen. At the diagnosis of CRPC, the median age of the patients was 74 (IQR 13) and PSA was 127 (IQR 695). The median Gleason score was 8 (IQR 1.54). In case of the patients with PS 0 and 1 and without underlying comorbidities, this regimen was well tolerated. The most common cause of discontinuation was progression of disease. The overall survival was 15 months (IQR 2.78). PSA response rate (according to PCWG) was 67.7%. The median OS of our cohort was less compared to the TAX 327 study; however, our patients was older, had higher PSA and Gleason score.
Conclusion: In well-selected CRPC patients, docetaxel/prednisolone regimen is well tolerated and leads to prolonging of survival not much different from the original study. We advocate that such regimen should be beneficial to Thai CRPC patients as well.
Article Details
References
2. สำนักพัฒนาวิชาการแพทย์ กรมการแพทย์ กระทรวงสาธารณสุข. แนวทางเวชปฏิบัติการวินิจฉัยและรักษาโรคมะเร็งต่อมลูกหมาก.กรุงเทพฯ: กรุงเทพเวชสาร. 2549.
3. Delongchamps NB, Singh A, Haas GP. The role of prevalence in the diagnosis of prostate cancer. Cancer Control. 2006; 13(3): 158.
4. Cross CK, Shultz D, Malkowicz SB, Huang WC, Whittington R, Tomaszewski JE, et al. Impact of race on prostate-specific antigen outcome after radical prostatectomy for clinically localized adenocarcinoma of the prostate. J Clin Oncol. 2002; 20(12): 2863-8.
5. Krupski TL, Kwan L, Afifi AA, Litwin MS. Geographic and socioeconomic variation in the treatment of prostate cancer. J Clin Oncol. 2005; 23(31): 7881-8.
6. Gudmundsson J, Sulem P, Manolescu A, Amundadottir LT, Gudbjartsson D, Helgason A, et al. Genome-wide association study identifies a second prostate cancer susceptibility variant at 8q24. Nat Genet. 2007; 39(5): 631-7.
7. Yeager M, Orr N, Hayes RB, Jacobs KB, Kraft P, Wacholder S, et al. Genome-wide association study of prostate cancer identifies a second risk locus at 8q24. Nat Genet. 2007; 39(5): 645-9.
8. Zheng SL, Sun J, Wiklund F, Smith S, Stattin P, Li G, et al. Cumulative association of five genetic variants with prostate cancer. N Engl J Med. 2008; 358(9): 910-9.
9. Basch E, Loblaw DA, Oliver TK, Carducci M, Chen R, Frame JN, et al. Systemic therapy in men with metastatic castration-resistant prostate cancer: American Society of Clinical Oncology and Cancer Care Ontario clinical practice guideline. J Clin Oncol. 2014; 32(30): 3436-48.
10. Tannock IF, de Wit R, Berry WR, Horti J, Pluzanska A, Chi KN, et al. Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer. N Engl J Med. 2004;351(15):1502-12.
11. Kellokumpu-Lehtinen PL, Harmenberg U, Joensuu T, McDermott R, Hervonen P, Ginman C, et al. 2-Weekly versus 3-weekly docetaxel to treat castration-resistant advanced prostate cancer: a randomised, phase 3 trial. Lancet Oncol. 2013; 14(2): 117-24.
12. Mohler JL, Armstrong AJ, Bahnson RR, D'Amico AV, Davis BJ, Eastham JA, et al. National Clinical Practice Guidelines in Oncology: Prostate Cancer, version 1.2016. J Natl Compr Canc Netw. 2016 Jan; 14(1): 19-30.
13. De Bono JS, Logothetis CJ, Molina A, Fizazi K, North S, Chu L et al. Abiraterone and increased survival in metastatic prostate Cancer. N Engl Med. 2011; 364(21):1995-2005.
14. Ryan CJ, Smith MR, de Bono JS, Molina A, Logothetis CJ, Souza P et al. Abiraterone in metastatic prostate cancer without previous chemotherapy. N Engl J Med. 2013; 368:138-48.
15. Scher HI, Fizazi K, Saad F, Taplin ME, Sternberg CN, Miller K, et al. Increased survival with enzalutamide in prostate cancer after chemotherapy. N Engl Med. 2012; 367(13): 1187-97.
16. Beer TM, Armstrong AJ, Rathkopf DE, Loriot Y, Sternberg CN, Higano CS, et al. Enzalutamide in metastatic prostate cancer before chemotherapy. N Engl J Med. 2014; 371: 424-33.
17. Scher HI, Halabi S, Tannock I, Morris M, Sternberg CN, Carducci MA et al. Design and end points of clinical trials for patients with progressive prostate cancer and castrate levels of testosterone: recommendations of the Prostate Cancer Clinical Trials Working Group. J Clin Oncol. 2008; 26(7):1148-59.
18. Schallier D, Decoster L, Braeckman J, Fontaine C, Degreve J. Docetaxel in the treatment of metastatic castration-resistant prostate cancer (mCRPC): an observational study in a single institution. Anticancer Res. 2012; 32(2): 633-41
19. Peters N, Armstrong K. Racial differences in prostate cancer treatment outcomes: a systemic review. Cancer Nurs. 2005; 28(2): 108-18.
20. Cho IC, Joung JY, Seo HK, Chung J, Park WS, Lee KH. Treatment outcome of docetaxel plus prednisolone for metastatic castration-resistant prostate cancer in Korea. J Cancer Res Ther. 2014; 10(2): 251-7.