Efficacy and feasibility of additional cycles of docetaxel in combination with androgen deprivation therapy in metastatic hormone-sensitive prostate cancer

You have accessJournal of UrologyCME1 Apr 2023MP29-17 EFFICACY AND FEASIBILITY OF ADDITIONAL CYCLES OF DOCETAXEL IN COMBINATION WITH ANDROGEN DEPRIVATION THERAPY IN METASTATIC HORMONE-SENSITIVE PROSTATE CANCER Can Aydogdu, Florian Urban, Alexander Tamalunas, Elena Berg, Melanie Götz, Severin Rodler, Volker Heinemann, Christian G. Stief, and Jozefina Casuscelli Can AydogduCan Aydogdu More articles by this author , Florian UrbanFlorian Urban More articles by this author , Alexander TamalunasAlexander Tamalunas More articles by this author , Elena BergElena Berg More articles by this author , Melanie GötzMelanie Götz More articles by this author , Severin RodlerSeverin Rodler More articles by this author , Volker HeinemannVolker Heinemann More articles by this author , Christian G. StiefChristian G. Stief More articles by this author , and Jozefina CasuscelliJozefina Casuscelli More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003257.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Several phase III trials have assessed efficacy and safety of 6 cycles of docetaxel combined to androgen deprivation therapy (D-ADT) in metastatic hormone-sensitive prostate cancer (mHSPC). This is the current standard of care for a subgroup of patients. We aimed to assess whether treatment beyond 6 cycles of docetaxel prove to be more effective than the standard of care. METHODS: We retrospectively collected data from patients with histologically confirmed adenocarcinoma of the prostate and radiologically proven metastatic disease treated at a large tertiary care center. All patients with mHSPC were treated in first-line with D-ADT (75 mg/m2) intravenously on the first day of each 21-day cycle. A subset of patients was treated beyond the standard of 6 cycles. Clinical and pathological variables were examined, as were treatment-related toxicities; progression free survival on D-ADT (PFS1), progression free survival on subsequent therapy (PFS2) and overall survival (OS) were calculated from start of treatment to progression or death by log-rank test. RESULTS: Between 2018-2022 a total of 88 mHSPC patients were treated and observed for a median time of 11.9 months. Mean age was 66.3 years (range 50.1-82.7), and 78.4% had GS≥8, 69.3% a CHAARTED high-volume and 73.9% LATITUDE high risk disease. 56 pts. were treated with ≤ 6 cycles (D-ADTstand) (5.3% 1-2 cycles; 94.7 % ≥3 cycles; mean 5.2 cycles) and 32 were treated with >6 cycles docetaxel (D-ADTadd) (25.0% 7-8 cycles; 75.0% ≥9-10 cycles, mean 9.2 cycles). Frequency of toxicities did not differ in the groups. No significant differences were observed in median PFS1 (14.0 vs. 13.7 mos.) and PFS2 (5.5 vs. 8.9 mos.). Median OS in the D-ADTstand group was 39.9 mos., median OS in the D-ADTadd group was not yet reached. CONCLUSIONS: While more than 6 cycles of D-ADT in mHSPC proved to be feasible without significant additional toxicity, efficacy is not superior compared to the standard of 6 cycles. Overall survival data is not mature yet, but the benefit of more chemotherapy upfront is debatable and leverages further studies in light of the upcoming triplet combinations in mHSPC, that presumably will render doublet D-ADT obsolete in future. Source of Funding: none © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e388 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Can Aydogdu More articles by this author Florian Urban More articles by this author Alexander Tamalunas More articles by this author Elena Berg More articles by this author Melanie Götz More articles by this author Severin Rodler More articles by this author Volker Heinemann More articles by this author Christian G. Stief More articles by this author Jozefina Casuscelli More articles by this author Expand All Advertisement PDF downloadLoading ...