Docetaxel in the treatment of metastatic castration-resistant prostate cancer (mCRPC): an observational study in a single institution.
نویسندگان
چکیده
BACKGROUND Treatment with docetaxel in combination with prednisone is the standard first-line treatment in patients with metastatic castration-resistant prostate cancer (mCRPC). For patients failing first-line docetaxel no standard has emerged. OBJECTIVES The outcome in routine daily clinical practice of a cohort of unselected chemotherapy-naïve mCRPC patients treated with docetaxel plus methylprednisolone as first- and further-line treatment in a single institution was investigated. PATIENTS AND METHODS Data from the medical records of patients treated with docetaxel plus methylprednisolone either in a three-weekly (75 mg/m(2)) (D3) or a three-of-four-weekly (35 mg/m(2))(D1) schedule as first- or further-line treatment were analysed with respect to clinical and prostate-specific antigen (PSA) response, time-on-treatment (TOT), treatment-free interval (TFI), overall survival time (OS) and toxicity and were compared to the results of the registration study TAX 327. RESULTS Out of 41 patients, 28 and 13 received first-line docetaxel according to the D3 and the D1 schedules respectively. An overall PSA response ≥50% was achieved in thirty patients (73%). In ten patients (24%) the PSA level was normalised. The median OS of the total population was 18.7 months. No significant differences were observed between the D3 and the D1 regimens with respect to PSA response, duration of PSA response, TOT, TFI and OS. Patients obtaining a normalisation of PSA level achieved a significantly superior OS, TOT and TFI compared to those without normalisation of PSA. Second-line treatment with docetaxel in nine patients induced a normalisation in PSA level in two (22%). The TOT and TFI from the start of second-line treatment, was significantly superior in docetaxel compared to non-docetaxel treated patients. Treatment with docetaxel was well-tolerated and only two patients were withdrawn for non-haematological toxicity during first- and further-line treatment. There were no differences in either subjective or objective side-effects between both treatment schedules. CONCLUSION The results of the retrospective analysis of non-selected patients with mCRPC treated with docetaxel chemotherapy are in line with the data from TAX 327. Normalisation of PSA during first-line treatment with docetaxel is associated with a better survival irrespective of second- or further-line treatment used. Retreatment with docetaxel in second- or further-line remains a treatment option in docetaxel-sensitive patients.
منابع مشابه
Abiraterone acetate for metastatic castration-resistant prostate cancer post-docetaxel
Abiraterone acetate (AA) 1000-mg daily, a selective irreversible androgen biosynthesis inhibitor of cytochrome P450 c17 (CYP17) enzyme, is used in combination with prednisone 10-mg daily to treat docetaxel-treated patients with metastatic castration-resistant prostate cancer (mCRPC). Several studies have demonstrated the safety and efficacy of this compound in men with mCRPC. Interim results fr...
متن کاملThe Iranian Society of Nuclear Medicine practical guideline on radioligand therapy in metastatic castration-resistant prostate cancer using 177Lu-PSMA
Prostate-specific membrane antigen (PSMA) is a type II transmembrane protein, which is anchored in the cell membrane of prostate epithelial cells. It is highly expressed on prostate epithelial cells and strongly up-regulated in prostate cancer. Although, 177Lu-PSMA has been recently introduced for radionuclide therapy of metastatic castration-resistant prostate cancer (mCRPC) with co...
متن کاملContemporary agents in the management of metastatic castration-resistant prostate cancer.
Docetaxel-based chemotherapy has been the standard of care for metastatic castration-resistant prostate cancer (mCRPC) since 2004. Over the past few years, there has been a significant paradigm shift in the treatment landscape of this disease. A deeper understanding of prostate cancer biology, along with the development of novel agents has created hope towards treating chemotherapy-naïve and re...
متن کاملAbiraterone: A Review of its Pharmacokinetic, Pharmacodynamic Profile and Clinical Efficacy
Prostate cancer is a common cancer and it causes significant morbidity and mortality in elderly males. Management for metastatic castration resistant prostate cancer has improved tremendously over the last decade with newer agents improving overall survival and quality of life of patients. Until recently, docetaxel was the only agent to show an improvement in overall survival in patients with m...
متن کاملTreatment evolution for metastatic castration‐resistant prostate cancer with recent introduction of novel agents: retrospective analysis of real‐world data
Despite increasing drug treatment options for metastatic castration-resistant prostate cancer (mCRPC) patients, real-world treatment data are lacking. We conducted retrospective analyses of commercial claims and electronic medical record (EMR) databases to understand how treatment patterns for mCRPC have changed in a US-based real-world population. Truven Health Analytics MarketScan(®) (2000-20...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- Anticancer research
دوره 32 2 شماره
صفحات -
تاریخ انتشار 2012