Adjuvant Docetaxel Fails to Improve Biochemical DFS in High-risk Prostate Cancer

Share this content:
In prostate cancer, adjuvant docetaxel without hormone therapy did not improve biochemical disease-free survival after radical prostatectomy.
In prostate cancer, adjuvant docetaxel without hormone therapy did not improve biochemical disease-free survival after radical prostatectomy.

CHICAGO — In patients with high-risk prostate cancer, adjuvant docetaxel without hormone therapy did not improve biochemical disease-free survival after radical prostatectomy, according to findings presented at the 2016 American Society of Clinical Oncology (ASCO) Annual Meeting.1

"Adjuvant chemotherapy after surgery has been shown to improve survival and response rate in both metastatic breast and colorectal cancers," said lead investigator Goran Ahlgren, MD, PhD, urologist at Skane University Hospital in Malmo, Sweden. "We asked whether adjuvant chemotherapy after radical prostatectomy for prostate cancer will improve outcomes as well."

Because docetaxel therapy has been shown to prolong survival in advanced castration-resistant prostate cancer, researchers evaluated whether or not 6 courses of docetaxel improves biochemical disease-free survival following radical prostatectomy for high-risk locoregional prostate cancer.

For the phase 3 trial, investigators enrolled 459 patients with an average age of 62.2 years from centers in Denmark, Norway, Sweden, Finland, and Iceland. About 39% had pT3b disease and 37.5% had a Gleason score of 8 to 10. Patients were randomly assigned to receive docetaxel 75 mg/m2 IV every 3 weeks for 6 cycles or surveillance, followed by radical prostatectomy in both arms. Of those assigned to the chemotherapy arm, 5.2% withdrew prior to receiving any chemotherapy and 79.1% received all 6 cycles.

Results showed that at a median follow-up of 56.8 months, 47.9% of patients in the docetaxel arm had biochemical progression, defined as a rising PSA >0.5 ng/mL, compared with 38.9% in the surveillance arm (P=.078).

"We observed an initially lower biochemical progression rate in the chemotherapy arm, but the rate became higher from 6 to 24 months," Dr Ahlgren noted.

Six prostate cancer-related deaths occurred in the docetaxel group vs only 3 in the surveillance group. Also, 18.7% of docetaxel-treated patients reported febrile neutropenia.

RELATED: TRUS-biopsy Poorly Detects Prostate Cancer

The study further demonstrated that Gleason score ≥8 (P<.001) and presence of lymph node metastasis (P<.001) were significant predictors of progression, while treatment strategy was not (P=.067).

"Docetaxel without continuous corticosteroids may trigger biochemical progression in patients with a Gleason score ≤7," Dr Ahlgren concluded.

Reference

  1. Ahlgren G, Flodgren P, Tammela TLJ, et al. A randomized phase III trial between adjuvant docetaxel and surveillance after radical prostatectomy for high risk prostate cancer: Results of SPCG12. J Clin Oncol. 2016; 34 (suppl; abstr 5001).

Related Resources

You must be a registered member of Cancer Therapy Advisor to post a comment.

Sign Up for Free e-newsletters

Regimen and Drug Listings

GET FULL LISTINGS OF TREATMENT Regimens and Drug INFORMATION

Bone Cancer Regimens Drugs
Brain Cancer Regimens Drugs
Breast Cancer Regimens Drugs
Endocrine Cancer Regimens Drugs
Gastrointestinal Cancer Regimens Drugs
Gynecologic Cancer Regimens Drugs
Head and Neck Cancer Regimens Drugs
Hematologic Cancer Regimens Drugs
Lung Cancer Regimens Drugs
Other Cancers Regimens
Prostate Cancer Regimens Drugs
Rare Cancers Regimens
Renal Cell Carcinoma Regimens Drugs
Skin Cancer Regimens Drugs
Urologic Cancers Regimens Drugs